Restraint in pediatric dentistry in the Norwegian Public Dental Service: An exploratory and descriptive study using qualitative and quantitative methods

Abstract

In her dissertation «Restraint in pediatric dentistry in the Norwegian Public Dental Service», Regina Skavhellen Aarvik and colleagues investigated the use, experience, and documentation of restraint during dental treatment of children and adolescents in the Public Dental Service (PDS) in Norway. The overall aim of the dissertation was to explore and develop knowledge on the use of restraint during pediatric dental treatment in the Norwegian PDS. In a cross-sectional questionnaire study, they found that a proportion of children and adolescents report having experienced restraint, either physical and/or psychological, during dental treatment. These individuals were significantly more afraid of dental treatment and had lower trust in dentists compared to those who did not report a history of restraint. The dental records of the adolescents who reported to have a history of physical restraint showed that they have significantly poorer oral health and a higher total time spent in the dental service, compared to a random sample of adolescents without a history of physical restraint. There was no association between patient-reported restraint and dental records describing restraint. In focus group interviews, Aarvik and colleagues found that public dentists report occasional use of restraint to administer necessary dental treatment. This involves difficult ethical assessments where the focus is the best interest of the child, but this path is not always easy to identify. In conclusion, the use of restraint seems to be a difficult clinical challenge that can place a strain on both non-specialist dentists and patients. This topic should receive increased attention in the future.