Perception of Pediatric Dentists on Child Patient Behavior and their Dental Care Management during the COVID-19 Pandemic

Lisboa, Maria Eduarda Silveira Rodrigues; Cademartori, Mariana Gonzalez; Costa, Vanessa Polina Pereira da; Goettems, Marília Leão; Azevedo, Marina Sousa

doi:10.1590/pboci.2026.023

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 26 • 2026 • https://doi.org/10.1590/pboci.2026.023 linkcopy

Perception of Pediatric Dentists on Child Patient Behavior and their Dental Care Management during the COVID-19 Pandemic

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To evaluate the perception of Brazilian pediatric dentists (PD) regarding the behavior of child patients and their dental care management during the COVID-19 pandemic.

Material and Methods: A self-administered online questionnaire was answered. Professionals who assisted children and/or adolescents, who had a postgraduate degree in Pediatric Dentistry, and worked in public and/or private services, were considered eligible for the study. Demographic information, perception of behavior changes of children and adolescents during appointments and the use of behavioral management techniques (Remained the same; Reduced/suspended or Increased employment) were collected. Fisher's exact test was used (p<0.05) to assess the association between the use of behavior management techniques and the perception of the child’s behavior in the consultation during the pandemic.

Results: A total of 231 PD participated, of which 45.6% noticed a worsening in the behavior of children and adolescents during the pandemic. Regarding the management of child behavior, appropriate/physical contact was the technique that had the greatest reduction/suspension of use (77.6%), followed by the distraction technique using toys and books (55.9%). A higher prevalence of protective stabilization use (p<0.001) and positive reinforcement (p=0.002) was identified among PD who noticed a worsening of the behavior.

Conclusion: The COVID-19 pandemic interfered with the dynamics of pediatric dental appointments regarding the use of some behavioral management techniques, as well as the perception of child behavior.

Keywords:
Pediatric Dentistry; Pandemic; Coronavirus; Dental Care.

Questions	Answer Alternatives
During the pandemic, did you notice changes in the behavior of children and adolescents during dental care?	1- No; 2-Yes, it has improved; 3-Yes, it got worse; 4-I don't know.
Regarding the child behavior management, how do you evaluate the impact of the pandemic on the use of these techniques in your care routine	Answer alternatives*
1. Protective stabilization	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
2. Positive reinforcement (delivery of souvenirs/gifts) at the end of the consultation	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
3. Appropriate/physical contact	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
4. Distraction with tablet	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
5. Distraction with television	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
6. Distraction with toys/books	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
7. Nitrous oxide inhalation	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
8. Sedative drugs	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
9. General anesthesia	1-Remained the same; 2- Reduced/suspended employment; 3-I increased employment
In the behavioral management technique called positive pre-visit imagery, patients receive videos/photos/books to be viewed before their dental appointment. That way they can get to know the dentist who will see you, the office environment and know what to expect during your dental visit. Do you use this technique with your patients?	1-No; 2-Yes, I started using it during the pandemic; 3-Yes, I used it before the pandemic started

Variables	N	%
Sex
Female	220	95.2
Male	11	4.8
Workplace
Public and Private	48	20.8
Private	164	71.0
Public	19	8.2
Age (Years)
20-29	37	16.0
30-39	85	36.8
40-49	45	19.5
50-59	48	20.8
Over 60	16	6.9
City Where You Work^*#
Small	45	19.8
Medium	77	33.9
Big	105	46.3
Time Since Graduation (Years)
Up to 5	29	12.6
5 to 10	52	22.5
10 to 15	36	15.6
15 to 20	25	10.8
20 to 25	22	9.5
Over 25	67	29.0

Behavior	N	%
I didn't notice changes	110	48.3
Improved the behavior	14	6.1
Worse the behavior	104	45.6

Behavioral Management Technique	N	Remained the Same	Reduced/Suspended	Increased
		N (%)	N (%)	N (%)
Protective Stabilization	202	149 (73.8)	29 (14.3)	24 (11.9)
Positive Reinforcement	226	161 (71.3)	24 (10.6)	41 (18.1)
Appropriate/Physical Contact	228	48 (21.1)	177 (77.6)	3 (1.3)
Distraction with Tablet	120	64 (53.4)	34 (28.3)	22 (18.3)
Distraction with Television	158	99 (62.7)	13 (8.2)	46 (29.1)
Distraction with Toys/Books	204	72 (35.3)	114 (55.9)	18 (8.8)
Nitrous Oxide Inhalation	55	34 (61.8)	7 (12.7)	14 (25.5)
Sedative Drugs	48	30 (62.5)	6 (12.5)	12 (25.0)
General Anesthesia	64	38 (59.4)	16 (25.0)	10 (15.6)

	Behavior
Exposure Variable	I didn't Notice Changes		Improved		Got Worse		p-value*
	N	(%)	N	(%)	N	(%)
Protective Stabilization							<0.001
Remained the same	80	54.42	15	53.57	2	8.33
Reduced/Suspended	7	4.76	4	14.29	2	8.30
Increased	60	40.82	9	32.14	20	83.33
Positive Reinforcement							0.002
Remained the same	86	54.09	12	52.17	9	21.95
Reduced/Suspended	7	4.40	2	8.70	5	12.20
Increased	66	41.51	9	39.13	27	65.85
Appropriate/Physical Contact							0.764
Remained the same	26	54.17	82	47.13	1	33.33
Reduced/Suspended	3	6.25	11	6.32	0	0.00
Increased	19	39.58	81	46.55	2	66.67
Distraction with Tablet
Remained the same	34	53.13	12	37.5	7	31.82
Reduced/Suspended	2	3.13	4	12.5	3	13.64
Increased	28	43.75	16	50.00	12	54.55
Distraction with Television							0.069
Remained the same	48	48.98	4	33.33	16	34.78
Reduced/Suspended	2	2.04	2	16.67	4	8.70
Increased	48	48.98	6	50.00	26	56.52
Distraction with Toys/Books							0.133
Remained the same	39	54.17	52	46.85	4	22.22
Reduced/Suspended	4	5.56	6	5.41	2	11.11
Increased	29	40.28	53	47.75	12	66.67
Nitrous Oxide Inhalation							0.167
Remained the same	20	58.82	4	66.67	4	28.57
Reduced/suspended	2	5.88	0	0.00	0	0.00
Increased	12	35.29	2	33.33	10	71.43
Sedative Drugs							0.848
Remained the same	13	43.33	2	40.00	4	33.33
Reduced/suspended	3	10.00	1	20.00	1	8.33
Increased	14	46.67	2	40.00	7	58.33
General Anesthesia							0.725
Remained the same	18	48.65	5	33.33	4	40.00
Reduced/suspended	3	8.11	3	20.00	1	10.00
Increased	16	43.24	7	46.67	5	50.00
Positive Pre-Visit Imagery							0.274
Don't use it	74	50.34	15	41.67	20	46.51
Started to use	10	6.80	0	0.00	4	9.30
Already used	63	42.86	21	58.33	19	44.19

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In the frequency distribution, those who had never used the technique were not considered.