Non-Cochrane · intervention · PM42736887
Parental Acceptance and Preferences Regarding Advanced Versus Basic Behavior Management Techniques in Pediatric Dentistry: A Systematic Review and Meta-Analysis of Observational Studies from the Middle East.
Abed Faisal, Baghlaf Khlood, Abudawood Shahad N, et al. · Healthcare (Basel, Switzerland) · 2026 · PubMed · doi:10.3390/healthcare14172729
Findings
17 findings
| Population | ||||
|---|---|---|---|---|
| Parents of healthy children aged 2 to 14 years in the Middle East | General anesthesia (GA) | Tell-Show-Do (TSD) | Parental acceptance or preference (binary: number of parents accepting or preferring the technique) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Overall (acceptance and preference subgroups combined) | OR 0.04 [0.02, 0.08] GRADE not reported 5 studies · 1376 participants |
| Parents of children receiving pediatric dental care in the Middle East | General anesthesia | Tell-Show-Do | Parental acceptance Middle Eastern pediatric dentistry · Acceptance; binary | OR 0.03 [0.02, 0.07] GRADE not reported 4 studies · 546 participants |
| Parents of children receiving pediatric dental care in the Middle East | General anesthesia | Tell-Show-Do | Parental acceptance score Middle Eastern pediatric dentistry · Overall; continuous | SMD -1.03 [-1.54, -0.51] GRADE not reported 3 studies · 184 participants |
| Parents of children receiving pediatric dental care in the Middle East | General anesthesia | Tell-Show-Do | Parental acceptance score Middle Eastern pediatric dentistry · Studies reporting total sample means | SMD -0.72 [-0.98, -0.47] GRADE not reported 2 studies · 130 participants |
| Parents of healthy children aged 2 to 14 years in the Middle East | General anesthesia (GA) | Tell-Show-Do (TSD) | Parental acceptance score (continuous VAS, standardized mean difference) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Studies reporting sex-stratified means (Jafarzadeh 2015 female and male arms) | SMD -1.41 [-2.29, -0.52] GRADE not reported 1 study · 108 participants |
| Parents of healthy children aged 2 to 14 years in the Middle East | General anesthesia (GA) | Tell-Show-Do (TSD) | Parental acceptance or preference (binary: number of parents accepting or preferring the technique) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Parental preference (preference studies) | OR 0.08 [0.05, 0.15] GRADE not reported 1 study · 284 participants |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Tell-Show-Do | Parental acceptance score Middle Eastern pediatric dentistry · Overall; continuous | SMD -1.87 [-2.32, -1.43] GRADE not reported 3 studies |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Tell-Show-Do | Parental acceptance score Middle Eastern pediatric dentistry · Studies reporting total sample means | SMD -1.97 [-2.27, -1.67] GRADE not reported 2 studies · 130 participants |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Tell-Show-Do | Parental acceptance Middle Eastern pediatric dentistry · Acceptance; binary | OR 0.10 [0.06, 0.15] GRADE not reported 3 studies · 410 participants |
| Parents of healthy children aged 2 to 14 years in the Middle East | Protective stabilization (PS) | Tell-Show-Do (TSD) | Parental acceptance score (continuous VAS, standardized mean difference) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Sex-stratified means, passive restraint (Jafarzadeh 2015) | SMD -2.30 [-3.74, -0.87] GRADE not reported 1 study · 216 participants |
| Parents of healthy children aged 2 to 14 years in the Middle East | Protective stabilization (PS) | Tell-Show-Do (TSD) | Parental acceptance score (continuous VAS, standardized mean difference) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Sex-stratified means, active restraint (Jafarzadeh 2015) | SMD -1.39 [-1.71, -1.06] GRADE not reported 1 study · 216 participants |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Tell-Show-Do | Parental acceptance or preference Middle Eastern pediatric dentistry · Overall; binary | OR 0.07 [0.05, 0.11] GRADE not reported 5 studies · 688 participants |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Tell-Show-Do | Parental preference Middle Eastern pediatric dentistry · Preference; binary | OR 0.05 [0.03, 0.08] GRADE not reported 2 studies · 278 participants |
| Parents of healthy children aged 2 to 14 years in the Middle East | General anesthesia (GA) | Nitrous oxide (N2O) | Parental acceptance or preference (binary: number of parents accepting or preferring the technique) Middle East (Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait) · Parental preference (preference study) | OR 0.32 [0.24, 0.43] GRADE not reported 1 study · 752 participants |
| Parents of children receiving pediatric dental care in the Middle East | Protective stabilization | Nitrous oxide | Parental acceptance Middle Eastern pediatric dentistry · Overall; binary | OR 0.92 [0.20, 4.36] GRADE not reported 2 studies · 270 participants |
| Parents of children receiving pediatric dental care in the Middle East | General anesthesia | Nitrous oxide | Parental acceptance or preference Middle Eastern pediatric dentistry · Overall; binary | OR 0.54 [0.19, 1.58] GRADE not reported 3 studies · 646 participants |
| Parents of children receiving pediatric dental care in the Middle East | General anesthesia | Nitrous oxide | Parental acceptance Middle Eastern pediatric dentistry · Acceptance; binary | OR 0.72 [0.13, 4.01] GRADE not reported 2 studies · 270 participants |
Included primary studies 14
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al Zoubi 2021 Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background DOI:10.1007/s40368-021-00607-4 | 2021 | 1 other review | not stated | not extracted yet |
| Al Zoubi 2021 Parental acceptance of advanced behaviour management techniques in paediatric dentistry in families with different cultural background. PMID:33768499 | 2021 | 1 other review | not stated | not extracted yet |
| Abdulla & Wassel 2024 Parental Acceptance Towards Various Behavior Guidance Techniques Used in Pediatric Dentistry in Some Private and Governmental Dental… DOI:10.21608/edj.2023.242462.2759 | 2024 | this review only | Parental acceptance or preference (binary: number of parents accepting or preferring the technique); Parental acceptance or preference; Parental acceptance | not extracted yet |
| Aldhelai 2023 Parental Acceptance of Behavior Management Techniques for Pediatric Dental Visits in Qassim, Saudi Arabia: A Cross-sectional Study DOI:10.2174/0118742106271451230922113920 | 2023 | this review only | Parental acceptance or preference (binary: number of parents accepting or preferring the technique); Parental acceptance or preference; Parental acceptance | not extracted yet |
| Alkandari 2016 Dentists' and Parents' Attitude Toward Nitrous Oxide Use in Kuwait DOI:10.2344/14-00008.1 | 2016 | this review only | not stated | not extracted yet |
| Alkandari 2016 Dentists' and Parents' Attitude Toward Nitrous Oxide Use in Kuwait. PMID:26866406 | 2016 | this review only | Parental acceptance | not extracted yet |
| Candan 2023 Predictors of Parental Acceptance towards Contemporary Behavior Management Techniques Used in Pediatric Dentistry: A Preliminary Study on… PMID:37892255 | 2023 | this review only | Parental acceptance or preference (binary: number of parents accepting or preferring the technique); Parental acceptance or preference | not extracted yet |
| Hashemi 2021 DOI:10.22038/ijp.2020.53106.4216 | NR | this review only | Parental acceptance score (continuous VAS, standardized mean difference) | not extracted yet |
| Jafarzadeh 2015 DOI:10.22037/jds.v33i1.24748 | NR | this review only | Parental acceptance score (continuous VAS, standardized mean difference) | not extracted yet |
| Jahanimoghadam 2018 DOI:10.22122/johoe.v7i2.406 | NR | this review only | Parental acceptance score (continuous VAS, standardized mean difference) | not extracted yet |
| Qandeel 2024 DOI:10.9790/0853-2306072127 | NR | this review only | Parental acceptance or preference (binary: number of parents accepting or preferring the technique); Parental acceptance or preference | not extracted yet |
| Sabbagh 2021 Prevalence and Parental Attitude Toward Nitrous-Oxide and Papoose-Board Use in Two Dental Referral Centers in Saudi Arabia: A… DOI:10.2147/ccide.s340158 | 2021 | this review only | not stated | not extracted yet |
| Sabbagh 2021 Prevalence and Parental Attitude Toward Nitrous-Oxide and Papoose-Board Use in Two Dental Referral Centers in Saudi Arabia: A… PMID:34992465 | 2021 | this review only | not stated | not extracted yet |
| Taran 2018 The Effect of Parenting Styles on Behavior Management Technique Preferences in a Turkish Population. PMID:30355432 | 2018 | this review only | Parental acceptance or preference (binary: number of parents accepting or preferring the technique); Parental acceptance or preference | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Parental Acceptance of Passive Protective Stabilization During Pulp Therapy in Primary and Young Permanent Dentition: A Systematic Review… (2026) | 2 | 0.10 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Parents (mothers or fathers) of healthy (ASA I) children aged 2 to 14 years in the Middle East | Parents in Iran, Turkey, Saudi Arabia, Bahrain, Egypt, Jordan, Kuwait (n=1409 parents) |
| Intervention | Advanced behavior management techniques (conscious sedation, general anesthesia, active/passive protective stabilization, physical restraint, papoose board) | General anesthesia, sedation, protective stabilization/physical restraint (active, passive), papoose board |
| Comparison | Basic techniques: Tell-Show-Do or nitrous oxide | Tell-Show-Do (8 studies); nitrous oxide (5 studies) |
| Outcomes | Parental acceptance or preference for behavior management techniques | Parental acceptance or preference (binary percentages, VAS or Likert scores) |
| Study designs | Observational studies (case-control, cohort, cross-sectional with comparison groups) | 11 cross-sectional studies (9 in meta-analysis) |
| Timing | Not specified | Not specified |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: N/A · NRSI: Partial Yes | NRSI: Yes · RCT: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | NRSI: No · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |