The Appropriateness (or lack thereof) of Physical Restraints for Managing Challenging Pediatric Dental Behavior.
Believers in its appropriateness prefer the euphemistic1 term “protective immobilization or stabilization” in contrast to the negative connotation implied by simply describing physical restraint. This manuscript provides a critical look from the perspective of a child-oriented behavioral researcher and private practitioner of forty years who shares a most unenthusiastic bias towards a reliance on restraint techniques to overcome interfering and undesirable child behavior. Those capable of working within a framework of coping potential responsive to verbal communications and conventional mainstream interventions might best approach challenging.
While there are some practitioners making use of a broad range of behavioral management strategies, there are others who make use of a limited arsenal of techniques to manage difficult and challenging behaviors.
Some clinician’s today ban parents in a mandatory fashion from the operatory with the belief that parent presence competes for their ability to establish a rapport with the child. A skeptical analysis might also include that these clinicians prefer not to allow parents to witness their management of challenging children.
Recent literature5 has begun to explore parent views regarding the point at which the use of sedative techniques to minimize or eliminate the use of physical restraint is or is not preferable for their children. The vast majority of parents who have observed both options applied to manage their children overwhelmingly agree they prefer the use of sedation. While it is the intention of using sedative techniques to eliminate or reduce the need to restrain undesirable patient movement, inadequacy of sedative measures alone is not at all uncommon.
Pediatr Neonatal Nurs Open J. 2017; 4(1): e1-e3. doi: 10.17140/PNNOJ-4-e007