Determining Parenting Styles and other Factors Rendering Definitely Negative Children’s Behavior in Dental Office at The First Dental Visit

Introduction: It is believed that parental styles not only can strategically impact how a child behaves but can also influence how a child can handle unfamiliar situations. Parenting styles also influence how a child copes with stresses and stimuli, including those in the dental office. Aim of the study: To determine various parenting styles and other factors that may render children’s behavior to be definitely negative in dental office at the first dental visit. Subjects and Methods: Patients 3-6 years old, showing definitely negative behavior and apparently free from conditions limiting cognitive development were included in the study. Yet, patients with severe dental pain/ history of dental treatment / phobia were excluded. One of the researchers performed oral examination and dental prophylaxis to assess children’s behavior. First questionnaire (PFQ) investigated family data. Second questionnaire (PCPR) assessed parenting style based on Baumrind’s parenting types. Pilot study was performed, whereby; some questions were omitted while others were modified. Statistical analysis was performed & significance level was set at P ≤ 0.05. Results: This study was conducted on 150 patients; 83 males (55.3%) and 67 females (44.7%). Regarding results of PFQ, the followings were encountered; 84% of parents were married, 50% had secondary school education, 84.7% aged 25-35 years, 46.7% had two children, 67.3% reside in urban areas, 46.7% had monthly family income < 5000 Egyptian pounds and 50.7% reported that their children had no previous encounters with either a doctor or physician. Results of PPCPR showed that 54.7% of parents were permissive, 43.3% were authoritarians and 2% were authoritative. Statistical significant association between educational level and family size versus parental style (P-values = 0.007 & 0.010 respectively) was noted. While age, gender, marital status and monthly income showed no statistical significant association with parental style. Conclusion: Definitely negative behavior was highly noted in children of permissive and authoritarian parents. Educational level and family size were significantly associated with parental style. (2942) Samah Mohamed Awad and Hany Mohamed Saber E.D. J. Vol. 64, No. 4 INTRODUCTION Children’s behavior is a major challenge facing pediatric dentists in daily practice. In order to provide positive dental treatment, factors that may alter children’s behavior in the dental clinic should be surveyed thoroughly. Children responses to dental treatment are greatly influenced by various factors. These factors may include; level of cognition and age, dental fear and anxiety, home environment and discipline rules, culture, nature of child-parent relationship and parental style. (1) It is believed that parental styles not only can strategically impact how a child behave but can also influence how a child can handle unfamiliar situations. Further, parental styles may likewise influence how a child copes with stresses and stimuli, including those encountered in the dental office. (2) Parenting styles were defined early by Baumrind, 1971 (3) as authoritative, authoritarian or permissive. Although showing compassion, the authoritative parents exhibit firm communication with their children. Thus, show both high warmth and control. Authoritarian parents, on the other hand, display harsh practices as; strict commands, shouting and even physical punishment. Thus, show high control but low warmth. Whereas, permissive parents provide few to no commands and usually spoil their children. Thus, show high warmth but low control. (4,5) Moreover, it is believed that parental styles are changing and hereafter, it is of utmost importance for pediatric dentists to take this manner into consideration in order to be properly equipped to treat each patient accordingly. (6, 7) Any act that may affect a child physical or emotional status or future development is considered as abuse. An increasing awareness of this problem and its deleterious consequences on children’s wellbeing and mental health has been noted globally. (8) Corporeal or rather physical punishment often implicates psychological burden as well. (9) Although banned by law in several countries, corporal punishment is still used as a means of discipline by some parents. Studies by psychology professionals weighed possible merits of this type of punishment (e.g. immediate compliance) against potential risks (e.g. child aggression and inexplicable mental health). Some studies had concluded that this approach in child discipline was somewhat effective, (10,11) however other studies had revealed that it was unproductive at its best and detrimental at its worst. (12,13) In spite of the controversy among studies invoked on either side of the argument, investigating factors affecting children’s behaviors as well as the settings associated with parental styles is crucial. This is to warrant suitable psychological management of children during dental treatment and hence delivering dental care of high quality. (14) From this perspective, this study aimed to determine parenting styles and other factors that may render child’s behavior to be definitely negative in dental office at the first dental visit. SUBJECTS AND METHODS Study design and settings This observational study was conducted on patients and parents presented to clinics of Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University for their first dental visit. Sample size calculation Sample size calculation was calculated based upon results of Baier et al., 2004 (15) regarding the proportion of children with definitely negative behavior in addition to average number of new patients attending daily the clinics of Pediatric Dentistry Department Faculty of Dentistry Cairo University. Proportion was 7% and average monthly number of patients was 2400 new patients/ month. Using α level = 0.05 and 4% margin of error; minimum estimated sample size was 147 patients. This calculation was performed using StatCalc formulas of Epi Info 7.2.2. 2 software. PARENTING STYLES AND DEFINITELY NEGATIVE CHILDREN (2943) Selection criteria Based on Howenstein et al., 2015 (16) criteria, patients were enrolled in or excluded from the current study according to the following inclusion and exclusion criteria