Assessing Temperament as a Predictor of Nitrous Oxide Inhalation Sedation Success Using the Children's Behavior Questionnaire Short Form

Abstract

University of Washington Abstract Assessing Temperament as a Predictor of Nitrous Oxide Inhalation Sedation Success Using the Children’s Behavior Questionnaire Short Form Thomas Matthew Griffith, DDS Chair of the Supervisory Committee: Travis Nelson, DDS, MSD, MPH Department of Pediatric Dentistry Purpose: To investigate whether child temperament is associated with success in nitrous oxide inhalation sedation in pediatric dentistry. Methods: Child-caregiver dyads were enrolled from patients receiving dental care with nitrous oxide inhalation sedation at a university-based pediatric dental clinic. Children between 36-95 months of age who were ASA I or II were eligible for inclusion. To assess child temperament, caregivers completed the Children’s Behavior questionnaire Short Form (CBQ-SF). Behavior was scored based upon specific behavioral notes abstracted from the patient’s chart, the Frankl Score, and the ability to complete the previously planned treatment. This data was abstracted from the chart after the appointment was completed. The Frankl scores were provided by the dentist who performed the treatment. Results: The sample population consisted of 48 patient-caregiver dyads. The overall behavioral failure rate was 15% (N=7/48). Presence of disruptive behavior was 20% (N=9/46). There was no significant difference in sedation outcome associated with sex, ASA status, insurance status, or complexity of treatment provided. Variation of child behavior was found to be significantly associated with an increase in age. The broad temperament category of effortful control and the subcategory dimensions of attention control, inhibitory control, frustration, sadness, soothability, activity, and impulsivity were significantly associated with sedation outcome. Effortful control, attention control, inhibitory control, pleasure from low intensity activities, frustration, fear, sadness, soothability, activity, and impulsivity were significantly associated with Frankl Behavior Score. Conclusions: The results of this study suggest that the temperament scales of effortful control, attention control, inhibitory control, frustration, sadness, soothability, activity, and impulsivity may be important determinants of a child’s behavior and overall success during a dental procedure while under the effects of nitrous oxide inhalation sedation.