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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 5  |  Issue : 2  |  Page : 72-75

Child dental patient accompanying person: A cross-sectional study


1 Department of Preventive Dentistry, University of Benin, Benin City, Nigeria
2 Department of Periodontics, University of Benin, Benin City, Nigeria

Date of Web Publication25-Oct-2016

Correspondence Address:
Clement Chinedu Azodo
Department of Periodontics, Room 21, 2nd Floor, Prof Ejide Dental Complex, University of Benin Teaching Hospital, P.M.B. 1111 Ugbowo, Benin City, Edo State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2278-0521.193001

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  Abstract 

Objective: To determine the child dental patient accompanying person to the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: This cross-sectional, observational study was conducted among patients attending the Paediatric Dental Clinic of University of Benin Teaching Hospital, Nigeria, between June and November 2014. Data collected include age, gender, ethnicity, socioeconomic status of the patient, accompanying person, period of visit (school calendar period, holiday period, or school public holiday), appointment time (morning or afternoon), and type of dental treatment (emergency visit, routine dental treatment, new patient assessment, and follow-up visit). Results: Data of 385 pediatric dental visits of children aged 0.18-16 years with a mean age of 8.57 ΁ 3.99 years were recorded and analyzed. The majority of the participants were Edo State indigenes, females (56.4%), aged 6-12 years (57.1%), and of high socioeconomic status. The majority (60.8%) of the children were accompanied by their mother. Both parents were the main accompanying person of children aged 0-5 years, nonparents for the indigenous children, and fathers in emergency visits. Conclusion: Data from this study revealed mothers as the dominant child dental patient accompanying person. There existed a statistically significant difference among accompanying person, age of patient, ethnicity, and type of treatment.

Keywords: Accompanying person, child, dental visit, Nigeria


How to cite this article:
Ogordi PU, Azodo CC. Child dental patient accompanying person: A cross-sectional study. Saudi J Health Sci 2016;5:72-5

How to cite this URL:
Ogordi PU, Azodo CC. Child dental patient accompanying person: A cross-sectional study. Saudi J Health Sci [serial online] 2016 [cited 2019 Jun 18];5:72-5. Available from: http://www.saudijhealthsci.org/text.asp?2016/5/2/72/193001


  Introduction Top


Children all over the world rely on adults to accompany them to outside their immediate environment and accompanying them to their dental appointment is not an exception. The accompany person to a child's dental appointment provides means of transportation and some form of security, moral, and psychosocial support; assists in providing information on present and past medical/dental history, take care of the bills and most especially provides informed consent after the child would have assented to the intervention. [1],[2],[3] It is clearly important that appropriate adult accompanies children to their dental treatments because of their legal and psychosocial roles among others.

The child dental patient accompanying person is also deemed to have roles in the behavioral management of the child. Although the majority of the British Society of Paediatric Dentist support parental accompaniment of children during the course of their treatment, conflicting views, and practices on parental presence as at the time of their child's dental procedure exists. It has been reported that parental presence may not have a clear, direct influence on child distress and behavioral outcomes. [4] The proponents of parental presence during a child's dental procedure stated that eliminating separation anxiety enhances parental satisfaction in feeling that they can play a useful role, as well as perceived sense of duty. [5],[6],[7],[8],[9] Scanty information on child dental patient accompanying person that exist in the literature was conducted in Europe and Middle East which has a contrasting culture with Nigeria. [1],[2],[10] The established cultural effect on health seeking behaviors may be deemed to influence child dental patient accompany person in Nigeria. The objective of this study was to determine the child dental patient accompanying person at the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria.


  Materials and methods Top


Ethical consideration

The protocol for this study was reviewed and approval granted by the Ethics and Research Committee of the University of Benin Teaching Hospital, Benin City, Nigeria. Written informed consent was obtained from parents and guardian of the children using the Nigerian National Health Research Ethics Code Model.

Study design/setting

This cross-sectional study was conducted among consecutive patients attending the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City, Nigeria, between June and November 2014.

Inclusion criteria

Consenting attendees at the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City.

Exclusion criteria

Attendees at the Paediatric Dental Clinic of the University of Benin Teaching Hospital, Benin City, that did not give consent were excluded from the study.

Sample size/sampling

The minimum sample size for this study was 385 which was calculated using Cochran's formula for epidemiological studies: [11] n = z2 p (1 − p)/d2 . Where n = sample size, z = z statistics for a level of confidence (set at 1.96 corresponding to 95.0% confidence level), p = prevalence = 50% (0.5) (11), q = 1 − p, and d = degree of accuracy desired (error margin) = 5% (0.05). The convenience sampling technique was utilized in the recruitment of the participants.

Data collection tool

Data collection was done through a dentist-administered questionnaire. The questionnaire was validated by two experts in oral health research. Pretest of the questionnaire was done among twenty nonresearch participants in the same clinic to ensure reliability. The questionnaire which was anonymous with no identifiers elicited information such as the age of patients, gender, ethnicity, socioeconomic status, accompanying person, and their relationship to the patient; the appointment time (morning or afternoon), academic period (school/holiday), and the types of dental appointment (emergency visit, routine dental treatment, a new patient assessment with or without orofacial defect, and follow-up dental treatment). Socioeconomic status was categorized using their father's or guardian's educational level as high with the attainment of tertiary institution, middle with the attainment of secondary school, and low with the attainment of primary school or no formal education which is a socioeconomic classification previously used by Oredugba and Savage among children in Nigeria. [12] This classification of socioeconomic status is preferred to the use of occupation because of the high rate of unemployment in the country. [12]

Statistical analysis

The data were analyzed using the IBM SPSS Statistics for Windows, Version 21.0. (IBM Corp., Armonk, NY, USA). Chi-square test was used for comparing proportions. The level of statistical significance was chosen at P < 0.05.


  Results Top


Data of 385 pediatric dental visits children aged 0.18-16 years with a mean age of 8.57 ± 3.99 years were recorded and analyzed. The majority of the participants were Edo State indigenes, females (56.4%), aged 6-12 years (57.1%), and of high socioeconomic status. School calendar period constituted more than half (56.1%) of the presenting period and morning appointment sessions accounted for about four-fifths (79.5%) of the sessions in the study. The dominant care offered was routine (42.1%) and emergency (36.6%) treatments. The majority (60.8%) of the children were accompanied by their mother. Father was the accompanying person in 11.2% of cases, while both parents were in 15.1% of cases. Others relatives accounted for 11.2% of the accompanying person in this study. A minority of patients 1.6% were accompanied by their grandparents and family friends (0.3%). In this study, both parents were the main accompanying person for children aged 0-5 years, while nonparents were the leading accompanying person for the older children (P < 0.001). Both parents were the lead male child dental patient accompanying person (P = 0.556), and nonparents were the lead accompanying person in the low-socioeconomic group (P = 0.246). Nonparents were the leading accompanying person for the indigenous participants, while fathers were the leading accompanying person for the nonindigenous participants (P = 0.030). In this study, the relationship between appointment type and accompanying person for dental treatment revealed that the father most frequently accompanied their children in emergency visits, both parents in new patient assessment and nonparents in routine dental visits and follow-up visits (P < 0.001). The majority of the visits were morning appointment (79.5%) during school calendar period (56.1%). There was no statistically significant relationship between the accompanying person, time of appointment, and calendar period [Table 1].
Table 1: Relating child dental patient characteristics to the accompanying person

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  Discussion Top


The role of accompany an adult to the dental appointment of a child cannot be overemphasized. The accompany person provides some form of security, as well as moral and psychosocial support; assists in providing information on present and past medical/dental history and above all, provide inform consent having fully understood the proposed treatment. [1],[2],[3] In this study, 12.9% of the accompanying person were not the parents of the attending child thereby undermining critical information necessary for optimal treatment and the parental responsibility to give informed consent for the child dental treatment and these factors may have implication in litigation. Mothers dominated as the child dental patient accompany person in this study because mothers culturally nurture and care for their children and are expected to seek care for them when they are sick while the father funds the bill. This study finding is consistent with findings of others studies in Europe [1],[2] where the mothers were the most accompanied person and inconsistent with a study in Jordan [10] where fathers were the most accompanied person. The striking difference in the culture and religious practices between in Southern Nigeria where this study was conducted and Jordan as it relates to outside the home movement restriction of females may explain the dominant female accompanying person.

The perceived reduction of the effect of illness with aging may explain why both parents were the main accompanying person for children aged 0-5 years and the decline in parental accompaniment of older children. Both parents were the male child dental patient lead accompany person because male children are viewed to be strong and need to be treated more roughly because they are usually independent, assertive, and autonomous. Hence, the presence of their father who is a disciplinary is needed to enhance better behavior and co-operation from them to receive dental treatment.

Nonparents were the child dental patient lead accompany person in the low-socioeconomic group because both parents cannot afford to be denied their daily income which barely meets their minimum family financial obligations. Nonindigenous population usually needs to assert their authority to facilitate their rights and privileges. Such assertion of authority is usually associated with masculinity in Nigeria thereby explaining why the fathers were the leading accompanying person for the nonindigenous child dental patients.

Fathers outstandingly lead care seeking a path in an emergency visit to restore hope to their wife and mother of the children as the emotional attachment of mothers, fail them in taking an optimal decision in emergency situations. The masculine presence is highly respected in emergency care in hospitals because this reduces time wasting in informed consent and child care bill offset. Care impact and outcome in follow-up visit and routine dental care can be predicted thereby explaining why nonparents accompanied children for such visits.

The majority of the visits were morning appointment during school calendar period could be explained by the combined proportion of emergency visit and new patient assessment. In these situations, anxiety is high necessitating morning dental visit leading to school hours loss. Reports of children with poorer oral health status missing school more than other school children exist in the literature. [13],[14] The findings of this study may be limited by the sole recruitment of participants from a tertiary health-care setting. However, it was only this tertiary health-care setting in this state that had a pediatric dentist who renders almost all aspects child dental health-care services thereby attracting a wide range of cases. Further studies comparing child dental patient accompanying person in dental health-care settings with and without pediatric dentist is recommended.


  Conclusion Top


Data from this study revealed mothers as the dominant child dental patient accompanying person. There existed a statistically significant difference among accompanying person, age of patient, ethnicity, and type of treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Virdee PK, Rodd HD. Who accompanies children to a dental hospital appointment? Eur Arch Paediatr Dent 2007;8:95-8.  Back to cited text no. 1
    
2.
Lal SM, Parekh S, Mason C, Roberts G. The accompanying adult: Authority to give consent in the UK. Int J Paediatr Dent 2007;17:200-4.  Back to cited text no. 2
    
3.
Shahid SK, Godson JH, Williams SA, Nykol J. Obtaining informed consent for children receiving dental care: A pilot study. Prim Dent Care 2008;15:17-22.  Back to cited text no. 3
    
4.
Piira T, Sugiura T, Champion GD, Donnelly N, Cole AS. The role of parental presence in the context of children′s medical procedures: A systematic review. Child Care Health Dev 2005;31:233-43.  Back to cited text no. 4
    
5.
Crossley ML, Joshi G. An investigation of paediatric dentists′ attitudes towards parental accompaniment and behavioural management techniques in the UK. Br Dent J 2002;192:517-21.  Back to cited text no. 5
    
6.
Marzo G, Campanella V, Albani F, Gallusi G. Psychological aspects in paediatric dentistry: Parental presence. Eur J Paediatr Dent 2003;4:177-80.  Back to cited text no. 6
    
7.
Gonzalez JC, Routh DK, Saab PG, Armstrong FD, Shifman L, Guerra E, et al. Effects of parent presence on children′s reactions to injections: Behavioral, physiological, and subjective aspects. J Pediatr Psychol 1989;14:449-62.  Back to cited text no. 7
    
8.
Kain ZN, Mayes LC, Wang SM, Caramico LA, Krivutza DM, Hofstadter MB. Parental presence and a sedative premedicant for children undergoing surgery: A hierarchical study. Anesthesiology 2000;92:939-46.  Back to cited text no. 8
    
9.
Ryder IG, Spargo PM. Parents in the anaesthetic room. A questionnaire survey of parents′ reactions. Anaesthesia 1991;46:977-9.  Back to cited text no. 9
    
10.
Khraisat HM, Alsakarna BK. Who accompanies paediatric dental patients and the types of dental treatment provided at Queen Alia Military Hospital? J Royal Med Sci 2011;18:73-7.  Back to cited text no. 10
    
11.
Cochran WG. Sampling Techniques. 3 rd ed. New York: John Wiley and Sons, Inc.; 1977.  Back to cited text no. 11
    
12.
Oredugba FA, Savage KO. Anthropometric finding in Nigerian children with sickle cell disease. Pediatr Dent 2002;24:321-5.  Back to cited text no. 12
    
13.
Blumenshine SL, Vann WF Jr., Gizlice Z, Lee JY. Children′s school performance: Impact of general and oral health. J Public Health Dent 2008;68:82-7.  Back to cited text no. 13
    
14.
Jackson SL, Vann WF Jr., Kotch JB, Pahel BT, Lee JY. Impact of poor oral health on children′s school attendance and performance. Am J Public Health 2011;101:1900-6.  Back to cited text no. 14
    



 
 
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