Parenting Styles and Sedation Efficacy in Pediatric Dental Care; a Study in Uncooperative Children Aged 4 to 6 Years: Structural Equation Modeling Approach Publisher



M Gharavi MATINE ; K Salem KATAYOUN ; E Shirazi ELHAM
Source: Medical Journal of the Islamic Republic of Iran Published:2024

Abstract

Background: Behavioral problems in children contribute significantly to non-compliance and lack of cooperation with dentists.This study aimed to assess the impact of parenting styles on the success of conscious sedation with midazolam in uncooperative children aged 4 to 6 years. Methods: This short-term longitudinal study included ninety-six children aged 4–6 years who were classified as uncooperative according to the Frankl Behavior Rating Scale (Frankl I, II), requiring pulp treatment and Stainless-Steel Crown (SSC) restoration. Midazolam was orally administered at 0.25 mg/kg. Parents completed the Parental Stress Dental Questionnaire (PSDQ), Strengths and Difficulties Questionnaire (SDQ), and Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS). Treatment began at least thirty minutes post-drug administration. Vital signs were monitored using a pulse oximeter. Sedation effectiveness was assessed with the Houpt scale at local anesthesia injection (T0), cavity preparation (T1), restoration (T2), and treatment conclusion (T3). Statistical analysis used Kruskal-Wallis and Mann-Whitney U tests (P < 0.05). Results: Most parents (69, 71.9%) had an authoritative parenting style, while 10 (10.4%) were authoritarian, and 17 (17.7%) were permissive. Authoritative parenting is associated significantly with sedation success (P = 0.001) and reduced dental fear (P = 0.008). Conversely, authoritarian (P = 0.031) and permissive (P = 0.001) parenting styles are associated with sedation failure. Authoritarian parenting is associated positively with increased dental fear (P = 0.001). No significant association was found between permissive parenting style and dental fear (P > 0.05). No significant association existed between behavioral problems and parenting styles (P > 0.05). There was no significant association observed between permissive parenting style and dental fear (P = 0.279). Similarly, no significant associations were found between behavioral problems and specific parenting styles: authoritative (P = 0.625), authoritarian (P = 0.050), and permissive (P = 0.522). Conclusion: Understanding parenting styles aids in predicting conscious sedation success with midazolam and assisting in managing uncooperative children during dental procedures. © 2024 Elsevier B.V., All rights reserved.