Goumans C, Veerkamp J S J, Aartman I H A
Department of Cariology Endodontology Pedodontology, ACTA, The Netherlands.
Eur J Paediatr Dent. 2004 Mar;5(1):15-8.
This was to investigate the influence of emotional and behavioural problems on the choice of treatment type. In addition, the actual contents of the treatment of dentally fearful children was studied in an attempt to develop dental treatment protocols for children with such problems.
The parents of 265 children (144 girls, mean age 88.4 months, SD+/-34.2 months), referred to a centre for special dental care, were asked to complete the Child Behaviour Check List (CBCL) before their first appointment. The CBCL was used to assess behavioural problems. All selected children were dentally anxious (score >or=35 on the Children's Fear Survey Schedule Dental Subscale, CFSS-DS). After treatment, the children's records were analysed on treatment type and contents.
The CBCL score was related to the type of treatment. Children treated with the aid of nitrous oxide sedation scored significantly higher on the CBCL than children treated with behavioural management or under intravenous anaesthesia (IVA). In the IVA group more surfaces were treated than in the other groups. The CBCL score was not related to the treatment contents (number of surfaces filled, amount of radiographs, sealants, stainless steel crowns or pulpotomies), the time spent on the child's treatment or the number of sessions.
Dentally anxious children with behavioural problems as assessed by the CBCL have dental treatment (contents and length) comparable with that of dentally anxious children without those problems. However, anxious children with behavioural problems are more often treated with nitrous oxide sedation. Therefore, there seems to be an urgent need for access to nitrous oxide sedation for dentists working in special dentistry.
本研究旨在调查情绪和行为问题对治疗类型选择的影响。此外，还对患有牙科恐惧症儿童的治疗实际内容进行了研究，以期为有此类问题的儿童制定牙科治疗方案。
265名儿童（144名女孩，平均年龄88.4个月，标准差±34.2个月）的家长被转介至一家特殊牙科护理中心，要求他们在首次就诊前填写儿童行为检查表（CBCL）。CBCL用于评估行为问题。所有入选儿童均患有牙科焦虑症（儿童恐惧调查量表牙科分量表，CFSS-DS得分≥35分）。治疗后，对儿童的治疗记录进行治疗类型和内容分析。
CBCL得分与治疗类型有关。使用氧化亚氮镇静辅助治疗的儿童在CBCL上的得分显著高于采用行为管理或静脉麻醉（IVA）治疗的儿童。IVA组治疗的牙面比其他组更多。CBCL得分与治疗内容（补牙面数、X光片数量、窝沟封闭剂、不锈钢冠或牙髓切断术）、儿童治疗时间或治疗次数无关。
经CBCL评估，有行为问题的牙科焦虑儿童的牙科治疗（内容和时长）与无此类问题的牙科焦虑儿童相当。然而，有行为问题的焦虑儿童更常采用氧化亚氮镇静治疗。因此，对于从事特殊牙科工作的牙医来说，获取氧化亚氮镇静似乎迫在眉睫。
