Current practices and perceived effectiveness of alternative behavioral management techniques for pediatric dental anxiety: a cross-sectional survey of dentists in Spain

Objectives Fear of the dentist and associated anxiety in pediatric patients can negatively impact dental care and oral health. Traditional behavioral management techniques, such as physical restraint or sedation, are increasingly debated and rejected. The main objective of this study was to analyze the level of knowledge, use, and perceived effectiveness of alternative behavioral management techniques among practicing dentists in Spain. Materials and methods A cross-sectional study was conducted with 144 dental practitioners from Seville, Spain, predominantly female (77.8%) and aged 25–35 years (44.4%). Participants represented various specialties, with general dentistry being the most common (51.4%). Data were collected regarding the frequency of use, knowledge, and perceived effectiveness of behavioral management techniques for pediatric patients. Results Across all specialties, the most frequently reported behavioral management technique was tell-show-do, particularly among general dentists, orthodontists, and pediatric dentists. Endodontists primarily favored positive reinforcement, whereas oral surgeons/implantologists reported higher use of pharmacological management. Use of physical restraint was minimal and limited to pediatric dentistry. Conclusions The study highlights the need to enhance training in emotional management and alternative behavioral management techniques to prevent future trauma and reduce the likelihood that children will avoid dental care due to anxiety. Additionally, adapting the clinical environment to be more child-friendly is important to support effective behavioral management. Clinical relevance Improving dentists' knowledge and use of alternative behavioral management strategies can reduce pediatric dental anxiety, improve patient cooperation, and promote long-term oral health by encouraging regular dental visits.