Journal of South Asian Association of Pediatric Dentistry
Volume 6 | Issue 3 | Year 2023

Extending Behavior Shaping to New-age Parents in Pediatric Dental Operatories

Gauri Kalra1, JK Dhillon2, VP Mathur3

1Department of Pediatric and Preventive Dentistry, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India

2Abbeville Dentistry, Texas, United States

3Department of Pediatrics, Centre for Dental Education & Research (CDER), All India Institute of Medical Sciences (AIIMS), Delhi, India

Corresponding Author: Gauri Kalra, Department of Pediatric and Preventive Dentistry, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India, Phone: +91 9910329898, e-mail: drgauri_dentist@yahoo.co.in

How to cite this article: Kalra G, Dhillon JK, Mathur VP. Extending Behavior Shaping to New-age Parents in Pediatric Dental Operatories. J South Asian Assoc Pediatr Dent 2023;6(3):103–104.

Source of support: Nil

Conflict of interest: None

The pediatric dentistry treatment triangle was introduced by Wright in 1975 and depicts the three-way relationship between the child, parents, and the dental staff, with the child being the focus and center of attention of the entire dental staff.1 Parents have an important influence on the child’s fear and anxiety toward dental treatment. Due to the changes in parenting styles over the past decades and societal changes, there has been a vivid change in the child’s behavior due to the more permissive attitude of parents. Parents expect more from the pediatric dentist and less from their child leading to more disruptive behaviors in the dental operatory.2 Parents nowadays are over-involved and tend to try to protect their child by trying to remove all problems and obstacles from their child’s life.3 This is a huge shift from earlier when parents set limits and allowed their child to learn to manage stressful situations such as a dental visit.2 There has been a reversal in the logical parent–child relationship due to these changes. Thus, it becomes even more important to understand the different parenting styles in order to provide effective behavior management.

There are four main parenting types, as characterized by Baumrind—authoritarian, authoritative, permissive, and neglectful parenting style.4 It has been reported that two of these parental types, namely, authoritarian and permissive, are associated with ineffective discipline due to a lack of balance between demandingness and responsiveness. In a study by Viswanath in 2020 examining the impact of parenting style on behavior, it was observed that more negative behaviors were seen in children of permissive and authoritarian parents compared to children of authoritative parents.5 In another study by Shalini et al., it was observed that children with authoritative parenting styles exhibited more positive behaviors.6 In a review of the literature, Saikiran et al. also introduced some other types of parenting styles, such as helicopter parents, snowplow parents, and crunchy parents all of which negatively impact child behavior.7

There is a sea of literature available describing the various parenting styles and their effect in modulating different behaviors and attitudes among their children during their dental visits. Accordingly, various behavior-shaping techniques have been suggested by experts to tame such disruptive behaviors in children. In view of the current literature, as discussed within this paper, it also proves that altered parental attitudes may act as major roadblocks in managing children in dental operations.8 There have been scenarios when parents become a single point of contact while communicating with children during dental visits and do not permit the pediatric dentists to deal with the child alone and react even more dramatically while the child is undergoing any invasive treatment. Their expectations of a painless and stress-free treating environment, even in cases when the child is not ready to sit on the dental chair, have made the task more challenging for pediatric dentists. Newer strategies focusing on child behavior shaping have taken a front seat in handling young patients in pediatric dentistry. They include the addition of pretend plays, audio-visual aids, virtual reality, animal-assistive activity, and many more.9 However, role of parents in managing children during their dental treatment has taken a lesser front. In fact, their too-interfering and hovering attitudes have complicated child and pediatric dentist relationship (Fig. 1). There have been common instances in pediatric dental setup when the parents themselves start scolding their children about consuming sugary snacks in front of the pediatric dentist and blame the child for requiring a dental visit. They portray the child’s dental visit as an act of punishment for them for consuming sugary diet. Such situations create negative behavior in young patients, thereby jeopardizing effective dental treatment.

Fig. 1: New-age pedodontic triangle

Moreover, being pediatric dentists, we have been trained to deal with managing children but not their parents. The curriculum of pediatric dentistry, too, has been designed to cater only to the needs of children to provide effective dental treatment. However, the changing times demand not only understanding the basics of child psychology and management of child behavior in pediatric dentistry but also comprehending parental psychology and extending behavior-shaping techniques to the parents and caregivers of young patients in dental operatory.

Through this editorial, the editors wish to highlight the altered parenting styles in this new era and their influence on child’s behavior and their upbringing. Such parental behavior must be understood well, and behavior shaping for parents must be included as a separate topic, keeping in mind the changes necessary in the changing times. Parents, especially mothers, being the central source of influence on their children, must be handled effectively. This is essential to provide effective treatment for the child patient and instill a positive attitude not only in the pediatric patient but also in its parents.

As quoted by Dr Soni Stephen (Southside Pediatric Dentistry, Australia), dentists nowadays treat sensitive new-age children with sensitive new-age parents who live in a sensitive society, necessitating the sensitive new-age pediatric dentist.


1. Wright GZ, McAulay DJ. Current premedicating trends in pedodontics. ASDC J Dent Child 1973;40(3):185–187. PMID: 4266765.

2. Sheller B. Challenges of managing child behavior in the 21st century dental setting. Pediatr Dent 2004;26(2):111–113. PMID: 15132271.

3. Segrin C, Woszidlo A, Givertz M, et al. Parent and child traits associated with overparenting. J Soc Clin Psychol 2013;32(6):569–595. DOI: 10.1521/jscp.2013.32.6.569

4. Baumrind D. Child Development Today and Tomorrow. San Francisco: Jossey-Bass; 1989. pp. 349–378.

5. Viswanath S, Asokan S, Geethapriya PR, et al. Parenting styles and their influence on child’s dental behavior and caries status: an analytical cross-sectional study. J Clin Pediatr Dent 2020;44(1):8–14. DOI: 10.17796/1053-4625-44.1.2

6. Shalini K, Uloopi KS, Vinay C, et al. Impact of parenting style on child’s behavior and caries experience in 3-6-year-old children: a cross-sectional study. Int J Clin Pediatr Dent 2023;16(2):276–279. DOI: 10.5005/jp-journals-10005-2517

7. Saikiran KV, Nuvvula S, Challa RR, et al. Parental attitudes and parenting styles in paediatric dentistry: a review of the current literature. J Updates Pediatric Dent 2022;1(1):12–18. DOI: 10.54276/JUPD.2021.1103

8. Casamassimo PS, Wilson S, Gross L. Effects of changing U.S. parenting styles on dental practice: perceptions of diplomates of the American Board of Pediatric Dentistry presented to the College of Diplomates of the American Board of Pediatric Dentistry 16th Annual Session, Atlanta, Ga, Saturday, May 26, 2001. Pediatr Dent 2002;24(1):18–22. PMID: 11874053.

9. Kapil D, Saraf BG, Sheoran N, et al. Contemporary behavior guidance techniques to outsmart child’s anxious mind. J South Asian Assoc Pediatr Dent 2021;4(1):41–49. DOI: 10.5005/jp-journals-10077-3070

© The Author(s). 2023 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.