SHORT COMMUNICATION. A form of ‘parental presence/absence’ (PPA) technique for the child patient with dental behaviour management problems
N. Kotsanos*, T. Coolidge**, D. Velonis*, K. N. Arapostathis*
ABSTRACT
AIM: This paper reports on the use of early introduction of a
specific parental presence/absence (PPA) behavioural technique
to manage the initially uncooperative child. METHODS: Using a prospective design, 440 healthy children aged
3 to 10 years visited a paediatric dental practice within 33
months. Children exhibiting initially Frankl ‘negative’ and
‘definitely negative’ behaviour were empathically offered parental
presence only if they were cooperative. Otherwise, the
parent stepped out until behaviour improvement. Statistics:
t-tests and Chi-square tests were used to compare characteristics
of initially cooperative and uncooperative children,
as well as proportions of parents who were asked to leave
the surgery. The technique’s success was assessed by a one
sample binomial test. RESULTS: 75 of the children presented
as Frankl either ‘negative’ (30) or ‘definitely negative’ (45)
at their first visit; 70 (93.3%, p< 0.001) responded to the PPA
technique by displaying positive behaviour as their first visit
progressed. 38 responded without the need to ask the parent
to exit the practice room, while the other 32 responded
only after their parent exited. 52 children had additional appointments,
and 8 required an application of PPA at a second
appointment; all children cooperated in all subsequent
appointments. CONCLUSION: Early and empathic application
of the PPA technique appears very successful in managing
initially uncooperative child patients, suggesting that
a randomised controlled trial of the technique is warranted.
Key words: Behaviour management, negative behaviour, uncooperative child dental patient, parental presence
Eur Archs Paediatr Dent 2009;10(2):90-92
Depts. of
*Paediatric Dentistry, Aristotle University of Thessaloniki, Greece,
**Dental Public Health Sciences, University of Washington, USA.
Postal address: Dr N. Kotsanos. Dept. of Paediatric Dentistry, Dental School,
Aristotle University of Thessalonica, GR-54 124, Greece
Email: kotsanos@dent.auth.gr
