UB Dentists Propose Guidelines For Allowing Parents In Dental Treatment Room

BUFFALO, N.Y. -- To allow or not to allow parents in the dental treatment room with their children -- that is a question dentists have been debating for decades.

Those who say "no" contend parents distract both the child and the dentist, create anxiety in the patient, increase negative behavior and interfere with the development of dentist-patient rapport.

Proponents argue that parents should be included because separation can increase the child's stress in an already difficult situation, they can observe the child's experience and allay fears, and are available immediately to consult with the dentist on treatment options. Supporters cite studies showing that parents' presence has no adverse effect on the child's behavior in the dental chair.

Two pediatric dentists from the UB School of Dental Medicine -- Margaret Certo, D.D.S., clinical assistant professor, and Joseph E. Bernat, D.D.S., associate professor and chair of pediatric dentistry -- reviewed arguments on both sides of the question in a recent issue of New York State Dental Journal and suggest guidelines for permitting parents in the treatment room that should please both parents and practitioners. Both have permitted parents to be present during treatment throughout their practices.

Recommendations to exclude parents, developed in the 1960s and early '70s, were based largely on several studies that found that a child's negative behavior increased in response to rising anxiety in an anxious mother. The recommendations do not pertain to the initial exam, Certo said, when dentists routinely allow parents to be present.

However, other research has not supported this position. The authors cite several studies, the most recent published in 1993 in the British Dental Journal, all of which found no significant difference in behavior between children with and without parents in the room. Some data showed that children were more relaxed and showed slightly less negative behavior when a parent was present.

Surveys of parents have revealed a definite wish not to be excluded from the treatment room. Certo and Bernat cite a 1992 pilot study they conducted at The Children's Hospital of Buffalo involving parents of 100 randomly selected children that showed 75 percent

always wanted to be with their children during dental treatment. The remaining 25 percent said they wanted to be with their children "sometimes" during their treatment.

A related study published the same year, conducted at a U.S. Air Force dental clinic, found that 92 percent of parents who wished to remain in the room felt their children would feel better if they were there.

However, a 1983 survey of dentists showed that nearly 75 percent said they did not allow parents in the room when treating their children.

The authors point out that, given societal changes in recent years, a unilateral decision by the dentist to exclude parents may no longer be acceptable or advisable.

The changes they cite include an increase in violence, leading parents to feel they must protect their children at all times; more families in which both parents work, leaving them little time to spend with their children and increasing their motivation to be a part of all their activities whenever possible; and more knowledgeable consumers, who are more litigious and want to be sure they're getting good value for their money.

In addition to satisfying the desires of parents, inviting their participation has several advantages for the dentist, the authors note, the most important being opening communication between the dentist and parent.

"A parent who hears a child crying or screaming from behind a closed door may create problems for the dentist and staff when reunited with the child, especially if the child's report of the experience conflicts with that of the dentist and staff," Certo points out.

"Including parents can be a very rewarding experience for the dentist who treats children," Certo states. "It can help build trust and understanding with the families of our young patients."