Camoin A, Faulks D
Aix Marseille Univ, CNRS, EFS, ADES, Marseille, France.
APHM, Timone, Pôle PROMOD, Service d'Orthopédie dento-faciale et d'odontologie pédiatrique générale, Marseille, France.
Eur Arch Paediatr Dent. 2025 May 1. doi: 10.1007/s40368-025-01041-6.
There is controversy and debate around the use of pharmacological and physical dental behaviour support techniques amongst practitioners treating patients with challenging behaviour and intellectual and neurodevelopmental disabilities. However, the experiences of patients and caregivers remain underexplored. This scoping review aimed to identify the experience of patients with intellectual and neurodevelopemental disabilities and challenging behaviour and their caregivers regarding the use of physical and pharmacological procedures during dental care.
A scoping review was conducted, incorporating evidence from both quantitative and qualitative study designs to clarify concepts and identify gaps in the literature, using all the main medical databases.
From 1575 screened records, 13 studies were included. Ten were quantitative or mixed-method studies focusing on the acceptance of behaviour support techniques from the caregiver's perspective, particularly for children with special needs. Seven studies were from the Americas, none from Europe or Africa. Two major themes emerged: validity of consent; and the acceptance of different dental behaviour support techniques by parents and caregivers.
The most acceptable techniques for parents and caregivers were non-invasive, behaviour based support techniques. When these failed, physical support techniques seemed to be more acceptable than pharmacological approaches (sedation or general anaesthesia), although this may be related to cultural context and/or lack of financial support. No studies reported the patient perspective of behaviour support techniques so no conclusions can be drawn as to which techniques are acceptable from the patient's point of view. Further qualitative studies are essential to explore the experiences and expectations of patients with special dental care needs.
在治疗有挑战行为以及智力和神经发育障碍患者的从业者中，围绕使用药理学和物理性牙科行为支持技术存在争议和辩论。然而，患者和护理人员的经历仍未得到充分探索。本范围综述旨在确定智力和神经发育障碍且有挑战行为的患者及其护理人员在牙科护理期间使用物理和药理学程序方面的经历。
进行了一项范围综述，纳入定量和定性研究设计的证据，以澄清概念并识别文献中的差距，使用了所有主要医学数据库。
从1575条筛选记录中，纳入了13项研究。其中10项是定量或混合方法研究，重点是从护理人员的角度看待行为支持技术的接受情况，特别是针对有特殊需求的儿童。7项研究来自美洲，无来自欧洲或非洲的研究。出现了两个主要主题：同意的有效性；以及父母和护理人员对不同牙科行为支持技术的接受情况。
对父母和护理人员来说，最可接受的技术是基于行为的非侵入性支持技术。当这些技术无效时，物理支持技术似乎比药理学方法（镇静或全身麻醉）更可接受，尽管这可能与文化背景和/或缺乏经济支持有关。没有研究报告患者对行为支持技术的看法，因此无法从患者角度得出哪些技术是可接受的结论。进一步的定性研究对于探索有特殊牙科护理需求患者的经历和期望至关重要。
