Impact of Lockdown on Children's Lifestyle and Their Collaboration During Dental Sessions

 

TAKE-HOME MESSAGE

  • The behavior of 212 Italian children, aged 3 to 16 years, during dental visits was assessed before and after lockdown orders in Italy. The authors hypothesized that the lockdown strengthened relationships between children and parents, favorably affecting child behavior at the dental office. It was found that 82% of children had an improvement in behavior after the lockdown, especially children whose parents were home with the child during the lockdown.

  • This study showed an improvement in child behavior at the dental office after lockdown orders. Further investigations are necessary to validate findings and evaluate child behavior during lockdown in other populations and locations.
– James  Boynton, DDS, MS

AIM

To analyse lifestyle of Italian families during lockdown, evaluating its possible impact on the collaboration of children with the paediatric dentist and associated predictive factors.

MATERIALS AND METHODS

Only patients aged between 3 and 16 years, who had started treatment before the lockdown and had spent this periodwith both parents were included in the study. The interviews were carried out using an anonymous questionnaire that assessed school and play activities, the type of diet, the time dedicated to home oral hygiene and the activities carried out with parents. Parents' work situation during lockdown was included to correlate it with time spent at home. The Frankl Behavior Rating Scale was used to determine the degree of cooperation during dental sessions pre- and post-lockdown. Chi-square test and Fisher's Exact tests were used to identify statistical associations of improvement with each categorical variable. Student's t-test was used to highlight the differences in mean values of continuous variables between subjects considered more cooperative and unimproved subjects. Hosmer-Lemeshow test was used to assess the goodness-of-fit of the model. Assumption of linearity of independent variables and log-odds were assessed by Box-Tidwell transformation. Final selection was carried out using the Akaike criterion and all statistical analyses were carried out using the STATA statistical software package.

RESULTS

The sample consisted of 212 patients (103F; 109M). The age ranged between 3 and 16 years with an average age of 9.03 years; 82.08% (95% CI 76.24-86.99) of the subjects showed an improvement in collaboration compared to pre-lockdown. Logistic analysis reveals a statistically significant increase of the odds of improvement in patients with a lower pre-lockdown collaboration (OR: 6.05, p = 0.001), in children with a parental presence at home (jobless, OR : 30.55, p <0.001; in "smart working", OR: 23.06, p <0.001) when compared to children whose parents work away from home. From a further exploratory analysis, time dedicated to home oral hygiene was increased if associated with an increased presence of the parents at home (p = 0.015).

CONCLUSION

Changes in family routines and increased parental presence at home, during the COVID-19 pandemic lockdown, are associated with improved collaboration of children during dental sessions. A statistical association between the increase in time spent on oral hygiene and the increased presence of parents at home was found.

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