Behaviour support in dentistry: A Delphi study to agree terminology in behaviour management

Mac Giolla Phadraig C 1 , Healy O 2 , Fisal AA 3 , Yarascavitch C 4 , van Harten M 1 , Nunn J 1 Show all authors , Newton T 5 , Sturmey P 6 , Asimakopoulou K 7 , Daly B 1 , Hosey MT 5 , Kammer PV 8 , Dougall A 1 , Geddis-Regan A 9 , Pradhan A 10 , Setiawan AS 11 , Kerr B 12 , Friedman CS 13 , Cornelius BW 14 , Stirling C 15 , Hamzah SZ 16 , Decloux D 17 , Molina G 18 , Klingberg G 19 , Ayup H 20 , Buchanan H 21 , Anjou H 22 , Maura I 23 , Bernal Fernandez IR 24 , Limeres Posse J 25 , Hare J 12 , Francis J 3 , Norderyd J 26 , Rohani MM 3 , Prabhu N 27 , Ashley PF 28 , Marques PF 29 , Chopra S 30 , Pani SC 31 , Krämer S 32

Affiliations 

  • 1 School of Dental Science, Trinity College Dublin; Dublin Dental University Hospital, Dublin, Ireland
  • 2 Trinity College Dublin, Lincoln Place Dublin 2, Ireland
  • 3 Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
  • 4 Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
  • 5 King's College London, London, UK
  • 6 The Graduate Center and Queens College, City University of New York, New York, USA
  • 7 Oxford Brookes University, Oxford, UK
  • 8 Federal University of Santa Catarina, Florianopolis, Brazil
  • 9 Manchester University NHS Foundation Trust, Manchester, UK
  • 10 School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Surry Hills, Australia
  • 11 Department of Pediatric Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
  • 12 Guy's and St Thomas' NHS Foundation Trust, London, UK
  • 13 Schulich School of Medicine and Dentistry, London, Ontario, Canada
  • 14 The Cleveland Children's Surgery Center, Cleveland, Ohio, USA
  • 15 Crisis Prevention Institute, Milwaukee, Wisconsin, USA
  • 16 Ministry of Health, Kajang Hospital, Kajang, Malaysia
  • 17 Mount Sinai Hospital, Toronto, Ontario, Canada
  • 18 Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Cordoba, Argentina
  • 19 Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
  • 20 Ministry of Health, Bandar Seri Begawan, Brunei Darussalam
  • 21 Medical School, University of Nottingham, Nottingham, UK
  • 22 Department of Paediatric Dentistry, National Oral Disability Centre for Rare Disorders, The Institute for Postgraduate Dental Education, Jönköping, Sweden
  • 23 Hospital HM NENS, Barcelona, Spain
  • 24 Aspanaes - Servicio de Atención Diurna Terapéutica, Santiago de Compostela, Spain
  • 25 Santiago de Compostela University, Santiago de Compostela, Spain
  • 26 The Institute for Postgraduate Dental Education, Jönköping and CHILD research group, School of Health and Welfare, Jönköping University, Jönköping, Sweden
  • 27 The University of Sydney, School of Dentistry, Faculty of Medicine and Health AND Westmead Centre for Oral Health | Western Sydney Local Health District, Surry Hills, Australia
  • 28 UCL Eastman, London, UK
  • 29 Faculdade de Medicina Dentária, Unidade Odontopediatria, Universidade de Lisboa, Lisboa, Portugal
  • 30 Berkshire Community Dental Service, Skimped Hill Health Centre, Berkshire, UK
  • 31 Faculty of Dentistry, University of British Columbia B.C. Children's Hospital, Vancouver, British Columbia, Canada
  • 32 Facultad de Odontología, Universidad de Chile, Santiago, Chile
Community Dent Oral Epidemiol, 2024 Aug;52(4):550-571.
PMID: 38516782 DOI: 10.1111/cdoe.12953

Abstract

OBJECTIVES: Dental behaviour support (DBS) describes all specific techniques practiced to support patients in their experience of professional oral healthcare. DBS is roughly synonymous with behaviour management, which is an outdated concept. There is no agreed terminology to specify the techniques used to support patients who receive dental care. This lack of specificity may lead to imprecision in describing, understanding, teaching, evaluating and implementing behaviour support techniques in dentistry. Therefore, this e-Delphi study aimed to develop a list of agreed labels and descriptions of DBS techniques used in dentistry and sort them according to underlying principles of behaviour.

METHODS: Following a registered protocol, a modified e-Delphi study was applied over two rounds with a final consensus meeting. The threshold of consensus was set a priori at 75%. Agreed techniques were then categorized by four coders, according to behavioural learning theory, to sort techniques according to their mechanism of action.

RESULTS: The panel (n = 35) agreed on 42 DBS techniques from a total of 63 candidate labels and descriptions. Complete agreement was achieved regarding all labels and descriptions, while agreement was not achieved regarding distinctiveness for 17 techniques. In exploring underlying principles of learning, it became clear that multiple and differing principles may apply depending on the specific context and procedure in which the technique may be applied.

DISCUSSION: Experts agreed on what each DBS technique is, what label to use, and their description, but were less likely to agree on what distinguishes one technique from another. All techniques were describable but not comprehensively categorizable according to principles of learning. While objective consistency was not attained, greater clarity and consistency now exists. The resulting list of agreed terminology marks a significant foundation for future efforts towards understanding DBS techniques in research, education and clinical care.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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