Impact of parental presence on children during dental treatment

Abstract

Objectives: Parents play a significant role in how a child performs during dental treatment. There were inconclusive evidence on the effect of parental presence and absence during dental treatment. This study aimed to systematically review the influence of parental presence on children's fear and behaviour during dental treatment. Methods: Five electronic databases were searched (Pubmed, Ovid Embase, Ovid MEDLINE, Scopus, and Web of Science) for randomized controlled trials investigating the association between parental presence/absence and child's dental fear and behaviour during the dental treatment in March 2020. The outcomes evaluated were children's dental anxiety and behaviour assessments including heart rate, self-reported anxiety, Frankl scale and Venham scale. Cochrane Collaboration tool was used to assess the risk of bias in randomized controlled trials. Meta-analysis was conducted. Heterogeneity was assessed. Results: A total of 4220 studies were identified from the search. Eleven randomized controlled trials with 1167 participants aged 3 to 12 years old met eligibility criteria and were included. The method of assessments of dental fear and behaviour in the studies varied. Meta-analysis showed no significant difference in children's self-reported dental anxiety (WMD=-0.077; 95% CI=-0.340, 0.186; I2=0.0%, P=0.566) or behaviour (WMD=-0.062; 95% CI=-0.204, 0.080; I2=2.1%, P=0.393) with or without the parents in the dental environment. However, the mean heart rate of the participants was significantly lower when the parents were present during dental treatment (WMD=-8.735; 95% CI=-12.810, -4.660; I2=89.3%, P<0.001). Conclusions: Parental presence or absence during dental treatment of children were not shown to affect the children's dental behaviour.