Centro Universitário Newton Paiva, Belo Horizonte, Minas Gerais, Brazil.
Faculdade de Ciências da Saúde, Brasília, Distrito Federal, Brazil.
Int J Paediatr Dent. 2021 May;31(3):318-336. doi: 10.1111/ipd.12762. Epub 2021 Mar 17.
The presence of parents during the dental appointment can affect the child's behaviour and, consequently, the success of the treatment.
This systematic review aimed to evaluate whether parents' presence in the operatory room influences children's behaviour, anxiety and fear during dental treatment.
EMBASE, Cochrane Library, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, OpenGrey and ProQuest Dissertations and Theses Databases were searched. Randomized and non-randomized clinical trials in which some measure assessing children's behaviour and/or anxiety and fear during dental treatment with the presence and absence of parents were included. Two reviewers assessed studies for selection, extracted data, evaluated bias (Joanna Briggs Institute) and graded the certainty of evidence (Grading of Recommendations, Assessment, Development and Evaluation). Random-effects meta-analyses using mean difference (MD) and narrative synthesis were performed.
A total of 2846 papers were identified, and after a 2-phase selection, sixteen studies were included (five in meta-analyses). There was no difference in children's behaviour in the presence or absence of parents (P = .23, P = .40, P = .60 and P = .89, respectively). The presence or absence of parents did not influence children's anxiety (P = .94 and P = .97) or fear (DM: -0.08; CI:-0.34-0.19, P = .24). All included studies presented a high risk of bias, and the certainty of evidence was considered to be very low.
It is concluded that parents' presence in the operation room does not influence children's (up to 12 years old) behaviour, anxiety and fear during dental treatment with very low certainty of evidence. Methodological limitations of included studies, however, suggest that better designed trials are needed to adequately understand this issue.
家长在看诊时的在场与否会影响孩子的行为，进而影响治疗的效果。
本系统综述旨在评估在操作间中家长的在场是否会影响儿童在牙科治疗过程中的行为、焦虑和恐惧。
检索了 EMBASE、Cochrane 图书馆、LILACS、PubMed、PsycINFO、Scopus、Web of Science、Google Scholar、OpenGrey 和 ProQuest Dissertations and Theses Databases。纳入了一些评估儿童在有或无家长在场时进行牙科治疗过程中的行为和/或焦虑和恐惧的测量值的随机和非随机临床试验。两名评审员评估研究的选择、提取数据、评估偏倚（Joanna Briggs 研究所）并对证据确定性进行分级（推荐评估、发展与评价分级）。使用均数差（MD）进行随机效应荟萃分析和叙述性综合分析。
共确定了 2846 篇论文，经过 2 个阶段的选择，最终纳入了 16 项研究（其中 5 项进行了荟萃分析）。有或无家长在场时，儿童的行为没有差异（P=0.23、P=0.40、P=0.60 和 P=0.89）。家长的在场或不在场并不影响儿童的焦虑（P=0.94 和 P=0.97）或恐惧（DM：-0.08；CI：-0.34 至 0.19，P=0.24）。所有纳入的研究都存在较高的偏倚风险，证据的确定性被认为是非常低的。
操作间内家长的在场不会影响儿童（12 岁以下）在牙科治疗过程中的行为、焦虑和恐惧，其证据确定性非常低。然而，纳入研究的方法学局限性表明，需要更好设计的试验来充分了解这个问题。
