Temperament as a predictor of behavior for conscious sedation in dentistry

Temperament can be defined as the behavioral style of a child or the manner in which a child interacts with the environment. Nine temperament categories have been identified: activity level, biological rhythmicity, initial approach/withdrawal, adapt­ ability, intensity, mood, persistence/attention span, distractibility, and sensory threshold. Temperament categories can be quantified using the Toddler Temperament Scale (TTS), a written questionnaire completed by the caretaker. For this study,29 healthy children, 14 males and 15 females, ages 18 to 36 months (mean age 30 = 6.2 months) and a mean weight of 13.8 kg=2.1 kg were sedated with 2 mg/kg hydroxyzine pamoate (p.o.) and 2 mg/kg body weight of meperidine (submucosal). Parents completed the TTS during dental treatment in an adjoining room. The recording of baseline vital statistics, the mirror and explorer examination, and the entire operative procedure were videotaped. The Ohio State University Behavior Rating Scale was used to rate the videotapes of each child’s behavior according to the following discrete categories: quiet behavior, crying without struggling, and struggling movement with or without crying. For data analysis, all negative behavior (struggling and for crying) was summed. Using a stepwise linear regression, approach/withdrawal tendency (multiple R = 0.38, r2- = 0.15, and P = 0.0015) and adaptability (multiple R = 0.58, r2 = 0.34, and P = 0.009) were found to predict the total percentage of struggling behavior, and approach/withdrawal also approached significance in predicting the percentage of all negative behavior (multiple R = 0.35, r2 = 0.12, and P = 0.055). The results of this study suggest that approach/withdrawal tendency as measured by the TTS may be an important determinant of a sedated child’s behavior during dental treatment. (Pediatr Dent 15:348-52, 1993)