Management of dental behaviour problems. A 5-year follow-up.

The aim of the study was to evaluate the lasting results of treatment designed to increase cooperative behaviour in children with advanced anxiety or fear of the dental situation. The first 50 children referred in 1976 to the pedodontic clinic in Orebro, Sweden, on account of management problems, were chosen. Of these children 45 were able to participate in a follow-up study in 1982, comprising information from records and from questionnaires sent to the child/parent as well as to the referring dentist. In 1976 most of the children had not accepted dental treatment for several years and were in great need of dental care. Nevertheless, after systematic stepwise learning, based on the "tell-show-do" method, together with reinforcement, 36 children could be treated conventionally and another 5 after preoperative sedation. In 4 cases postponement was chosen. Of the total treatment time, 28 per cent was spent on managing behaviour problems. If all treatment, including injection, had been carried out with positive acceptance in 1976, as well as during the following 5 years, without the patient being fearful or having physical symptoms, the lasting result of managing behaviour problems was considered positive. These criteria were fulfilled in 78 per cent of the cases. Furthermore, the results indicate that the main reason for dental behaviour problems usually lies in the child's prior experience of the dental situation and that the present treatment model is effective in reducing dental fear and gives most children a lasting positive attitude to dental care and dental health.