Student Theses, Dissertations and Capstones

Document Type


Degree Name

Master of Science (M.S.) in Dentistry


College of Dental Medicine

Publication Date / Copyright Date



A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry.

Goals and objectives. To gather information intended to advocate for increased behavioral sciences integration into dentistry that could directly benefit the pediatric population by easing transitions to other dental specialists or into adult dental care. Furthermore, to facilitate the potential indirect effect of vertical transmission reduction through fearful adults pursuing dental care. Background. Extensive detail is provided regarding; the negative effects of DFA on the patient and practitioner, deficits in the literature on the topic, identification and management of different types of fear, and detailed behavior guidance techniques applicable to the adult population. Methods. A 28-question survey instrument was designed and sent to 6,117 ADA members in the United States via a medical marketing agency regarding attitudes and beliefs of dentists on behavior guidance techniques practiced on adults. Frequencies and one-tailed z-proportion tests were used to investigate dentists’ skills in treating dental fear and anxiety in adult patients, current strategies used in practice to treat these patients, and explore the need for additional education. Results. A total of 234 people responded to the survey; of which, 162 responses qualified for analysis. Overall, the majority of dental practitioners perceive that they understand the conceptual framework of techniques and can effectively apply them; yet, most experience stress, difficulty, and have very limited educational background in behavior guidance. There was an interest in learning the correct application of techniques, but unwillingness to pay for education that could teach such skills. The results of the analysis enable acceptance of the alternative hypothesis for portions of every aim. Conclusion. In relation to the study group, with very limited DFA knowledge, dentists are apt to be blinded to the potential understanding, application, and success that can come with behavior guidance education and integration into the dental field. This conclusion was supported by the contradictory answers provided by survey participants. Sufficient information was gathered to validate that a need exists to advocate for increased behavioral sciences integration into dentistry. With limited modern literature this study implies a need to invest into well-designed studies to prove a behavior guidance deficit exists in the U.S. dentist population, in addition to benefits that accompany a knowledgeable provider. This is a replication of a study done by Brahm et al. and we thank those authors for their assistance in the development of the measurement instrument.





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Dentistry Commons