Predicting children’s behaviour during first dental visit

GIZA, Egypt: A study by researchers at Cairo University aimed to identify psychological attributes in children using the behavioural screening Strengths and Difficulties Questionnaire (SDQ) prior to their first dental treatment. They found a strong correlation between total difficulty scores and child behaviour and concluded that identifying psychological disorders assists dentists in planning and providing more effective paediatric treatment.

The study group consisted of 128 children aged 4 to 7 years who were undergoing their first dental treatment as outpatients at postgraduate clinics in the Paediatric Dentistry and Dental Public Health Department in the Faculty of Dentistry at Cairo University. Caregivers completed the SDQ prior to the restorative dental treatment, and the children’s behaviour was evaluated using the Frankl behaviour rating scale.

The SDQ results showed that just over one-fifth of the study sample had emotional or conduct problems (22.7% and 20.0%, respectively) and that 9.5% had hyperactivity and peer problems. Social problems were detected in 2.4%. Emotional problems were found to be more prevalent among girls (69.0% compared with 31.0% among boys), and conduct problems were more prevalent among boys (80.0% compared with 19.2% among girls). According to the Frankl scale, 8.6% of the total sample group were extremely negative, 22.7% were negative, 44.5% were positive and 24.2% were extremely positive.

The researchers wrote: “A strong negative correlation was found between the emotional attribute score, the conduct attribute score, the hyperactivity attribute score, and child behaviour. Also, a strong negative correlation was found between the internalising score, the externalising score, and child behaviour. The total difficulty score showed a very strong negative correlation with child behaviour.”

Discussing the findings, the researchers said that assessing a child’s development and emotional state enables dentists to more effectively plan and accomplish dental treatment. They said that the importance of early detection of behavioural problems in children was being recognised worldwide but that research concerning childhood psychiatric disorders was lacking in developing countries.

“The high prevalence of psychological disorders, especially in developing countries, is strongly related to health and development concerns in young people such as low education levels, violence, malnutrition, and poor somatic health,” they wrote.

The researchers said that the study proved that at least 8–10% of children aged under 5 years experience clinically significant and impairing mental health problems and that the study findings corroborated those from previous studies which have reported a worldwide prevalence of psychiatric problems among children at between 10% and 20%. “Children with these problems, as well as their families, experience distress, and can suffer substantially. They also demonstrate impairment across multiple domains, including dental treatment,” the researchers said.

Despite the strong correlation found in the study between total difficulty scores and child behaviour, the researchers said that further research was needed to confirm that the questionnaire is suited to predicting behaviour in all children.

The study, titled “Assessment of child psychological attributes using strength and difficulties questionnaire for prediction of child behavior at first dental visit: A cross-sectional study”, was published online on 8 April 2022 in BDJ Open.


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