Behavior management in Pediatric Dentistry during and after Corona pandemic

Sonu Acharya1Orcid


The current paper mainly focuses on how the things have changed and what are the specific changes that we can incorporate in our clinics so that we can make it less fearful to the children in present scenario.
The present pandemic situation has brought about significant changes within the dental clinics and their environment. Each and everything had undergone transformation that has become a “new normal”.
Pediatric dentists must adopt all the required behavior management skills and be cautious about the whole procedure.


Children are not miniature adults. They should be treated as different entity and not just as adults who are shortened. Children have their own apprehensions and fear. The most commonly encountered is the fear of the unknown. Fear is something which is innate and inborn. Fear of dentistry is there in every individual, whether young or old. This is mostly subjective in nature. Children show exaggerated fear for dentistry as this is something new to them. The pediatric dentists are trained in behavior management for reducing fear. There have been many methods, both pharmacological and non-pharmacological for behavior management in children. The pediatric dentists were able to apply one or the other behavior management techniques till now. Sudden appearance of a pandemic caused by nCOV-2 (coronavirus) changed everything. The change in practice pattern is bound to effect all the dental patients, more so the children. Here we will discuss how the behavior management techniques will change for children and how we can get some newer methods to reduce the fear.

Keywords: Behavior Management; Coronavirus; COVID-19; Pediatric Dentistry

Author Affiliations

  1. Professor at Department of Pediatric and Preventive Dentistry, Institute of Dental sciences, SOA(Deemed to be University), Bhubaneswar, Odisha, India-751003 (✉ Correspondence:
  1. American Academy of Pediatric Dentistry. Policy on medically necessary care. Pediatr Dent 2015;37:18-22
  2. Baier K, Milgrom P, Russell S, Mancl L, Yoshida T. Children’s fear and behavior in private pediatric dentistry practices. Pediatr Dent 2004;26:316-321
  3. Wu L, Gao X. Children’s dental fear and anxiety: exploring family related factors. BMC Oral Health 2018;18:100-107
  4. Brill WA. The effect of restorative treatment on children’s behavior at the first recall visit in a private pediatric dental practice. J Clin Pediatr Dent 2002; 26:389-394
  5. World Health Organization. Coronavirus disease (covid-19) pandemic [Internet] [cited 20 Oct 2020]. Avaliable from:
  6. The workers who face the greatest coronavirus risk. The New York Times (New York) [Internet] [cited 10 Oct 2020]. Available from:
  7. Coronavirus disease [Internet] [cited 10 Oct 2020]. Available from:
  8. Moodley R, Naidoo S, Wyk J V. The prevalence of occupational health related problems in dentistry: A review of the literature. J Occup Health 2018;60:111-125
  9. Fang F. and Luo X. Facing a major epidemic of 2019 novel corona virus infection: pediatricians’ thoughts. Chinese J Pediatr 2020;58:81-88
  10. Gao X., XingS, JhaoJ. Parental psychological control and the relationship with children’s psychosocial functioning. Advances in Psych Scien 2016;24:1792-1801
  11. Buchanan H. Assessing dental anxiety in children: The revised smiley faces program. Child Care Health Dev 2010;36:534–538.
  12. Jin Z, Zhang X, Han ZR. Parental Emotion Socialization and Child Psychological Adjustment among Chinese Urban Families: Mediation through Child Emotion Regulation and Moderation through Dyadic Collaboration. Front Psychol 2017;8:2198-2204
  13. Li Y, Liu L, Lv Y, Xu L, Wang Y, Huntsinger CS. Mother–child and teacher–child relationships and their influences on Chinese only and non-only children’s early social behaviors: The moderator role of urban–rural status. Child Youth Serv Rev 2015;51:108-116
  14. Demby K.P, Riggs S.A, Kaminski PL. Attachment and family processes in children’s psychological adjustment in middle childhood. Fam Process 2017;56:234–249
  15. Kaseva K, Dobewall H, Yang X, Pulkki-Råback L, Lipsanen J, Hintsa Physical Activity, Sleep, and Symptoms of Depression in Adults – Testing for Mediation. Med Sci Sports Exerc 2019;51:1162-1168.
  16. White, S. H. Some educated guesses about cognitive development in the pre-school years. In: R.D Hess and R M Bear, editors. Early education: Current theory, research, and action. Chicago: Aldine, Press; 2017.p.203–214
  17. American Dental Association Commission on Dental Accreditation. Accreditation Standards for Advanced Specialty Education Programs in Pediatric Dentistry. 1st ed. Chicago.: American Dental Association; 2013
  18. Park JG. Color perception in pediatric patient room design: Healthy children vs. pediatric patients. High Educ Res Dev 2009;2:6-28
  19. Nuttall NM, Bradnock G, White D, Morris J, Nunn J. Dental attendance in 1998 and implications for the future. Br Dent J 2001;15:357-3587
  20. Mittal R, Sharma M. Assessment of psychological effects of dental treatment on children. Contemp Clin Dent 2012;3:2–7
  21. Gustafsson A, Arnrup K, Broberg AG, Bodin L, Berggren U. Psychosocial concomitants to dental fear and behaviour management problems. Int J Paediatr Dent 2007;17:449–459
  22. Gaertner BM, Spinrad TL, Eisenberg N. Focused Attention in Toddlers: Measurement, Stability, and Relations to Negative Emotion and Parenting. Infant Child Dev 2008;17:339-363.
  23. Nanda U, Chanaud CM, Brown L, Hart R, Hathorn K. Pediatric art preferences: Countering the “one-size-fits-all” approach. High Educ Res Dev 2009;2:46–61
  24. Izzetti R, Nisi M, Gabriele M, Graziani F. COVID-19 transmission in dental practice: brief review of preventive measures in Italy. J Dent Res 2020;99:1030-1038
  25. Peng X., Xu X., Li Y., Cheng L., Zhou X., Ren B. Transmission routes of 2019-nCoV and controls in dental practice. Int J Oral Sci 2020;12:1–6
  26. Wells MH, McCarthy BA, Tseng CH, Law CS. Usage of behavior guidance techniques differs by provider and practice characteristics. Pediatr Dent 2018;40:201-208.
  27. Carmona JR. COVID-19 Outbreak and Dentistry. Odovtos-International J Dent Sci 2020; 22:9-15
  28. Royal College of Surgeons of England Recommendations for Paediatric Dentistry during COVID-19 pandemic. [Internet] [cited 28 Aug 2020]. Available from:
  29. Meng L, Hua F, Bian Z. Coronavirus disease 2019 (Covid-19): Emerging and future challenges for dental and oral medicine. J Dent Res 2020;99:481-487
  30. Lauer SA, Grantz KH, Bi Q, Forrest KJ, Zheng Q, Hannah RM et al. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann Intern Med 2020;172:577-582
  31. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020:e20200702
  32. Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 Infection in Children. N Engl J Med 2020;382:1663-1665
  33. De Amorim RG, Frencken JE, Raggio DP, Chen X, Hu X, Leal SC. Survival percentages of atraumatic restorative treatment (ART) restorations and sealants in posterior teeth: an updated systematic review and meta-analysis. Clinical Oral Invest 2018; 22: 2703-2725
  34. Schwendicke F, JägerAM, Paris S, Hsu LY, Tu YK. Treating pit and fissure caries: a systematic review and network meta-analysis. J Dent Res 2015;94:522-533
  35. Seifo N, Cassie H, Radford JR, Innes NP. Silver diamine fluoride for managing carious lesions: an umbrella review. BMC Oral Health 2019;19:145-155
  36. Innes NP, Evans DJ, Stirrups DR. Sealing caries in primary molars: randomized control trial, 5‐year results. J Dent Res 2011;90:1405-1410
  37. Xiang M, Zhang Z, Kuwahara K. Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected. Prog Cardiovasc Dis 2020;20:30096-30097.
  38. Ma Q.X., Shan H., Zhang H.L., Li G.M., Yang R.M., Chen G.M. Potential utilities of mask wearing and instant hand hygiene for fighting SARS-CoV-2. J Med Virol 2020:92:1562-1271
  39. Lo GR. The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS COV-2) in dentistry. Management of biological risk in dental practice. Int J Environ Res Public Health 2020;17:3067-3072
  40. Moore, SA, Faulkner G, Rhodes RE, Brussoni M, Tala CB, Ferguson LJ, et al. Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey. Int J Behav Nutr Phys Act 2020:17;1-11
  41. Halla G., Laddu D.R., Phillips S.A., Lavie C.J., Arena R. A tale of two pandemics: how will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another? Prog Cardiovasc Dis 2020 Apr 8. Doi: 10.1016/j.pcad.2020.04.005 42. Jiao WY, Wang LN, Liu J, Fang SF, Jiao FY, Massimo PM et al. Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic. J Pediatr 2020;221: 264-266

Article Info

Contemp Pediatr Dent 2020:1(1):13-21

Received: 11 September 2020

Accepted: 23 October 2020

Online First: 15 December 2020


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					Sonu Acharya. Behavior management in Pediatric
Dentistry during and after Corona pandemic.
Contemp Pediatr Dent 2020:1(1):13-21.

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