Attitudes towards the use of hand over mouth (HOM) and physical restraint amongst paediatric specialist practitioners in the UK.
OBJECTIVE
To assess the views of paediatric specialist dental practitioners in the United Kingdom of the use of the hand over mouth technique and physical restraint.


METHODS
Questionnaire survey of all specialist dental practitioners in paediatric dentistry in the United Kingdom (n = 216). Replies were received from 179 individuals (82.8%).


RESULTS
The majority of the sample (over 80%) described HOM as having three components, broadly mirroring the description of the technique in clinical textbooks. Approximately 60% of the respondents reported that HOM should never be used (106 individuals, 59.2%). Those who endorsed the use of HOM suggested it should be used with cases of hysterical, tantrum behaviour (57 respondents, 32%). The use of physical restraint was endorsed for certain disabled patients by 110 individuals (62%); for very young patients by 69 respondents (39%); premedicated patients by 35 respondents (20%); physically resistive patients by 25 respondents (14%). Forty-three respondents (24%) felt there were no psychological consequences of the use of HOM or physical restraint; 91 (51%) felt that HOM would result in the child fearing dental treatment.


CONCLUSIONS
Specialist paediatric dental practitioners in the UK are familiar with the technique of HOM although they also feel that this technique should never be used. A large proportion of practitioners felt that the use of physical restraint was appropriate with certain disabled patients. The most commonly anticipated psychological sequeala which may accompany the use of these techniques was subsequent fear of dental treatment.
Department of Dental Public Health & Oral Health Services Research, GKT Dental Institute, 18 Guy's Tower, Guy's Hospital, London SE1 9RT, UK. tim.newton@kcl.ac.uk
J T
JT
Newton
H
H
Patel
S
S
Shah
P
P
Sturmey
D001291:Attitude of Health Personnel; D002648:Child; D002653:Child Behavior Disorders / Q000517:prevention & control; D016854:Dental Anxiety / Q000209:etiology; D019140:Dental Care for Children / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010377:Pediatric Dentistry / Q000706:statistics & numerical data; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires