Restraint in paediatric dentistry: a qualitative study to explore perspectives among public, non-specialist dentists in Norway

Figures & data

Table 1. Gender, clinical experience and demographic distribution of the participants.

Category	Variables	n
Gender	Female	6
	Male	3
Clinical experience	<10 years	5
	≥10 years	4
Location	Rural	4
	Central	5

Table 2. The interview guide used for both focus groups.

Interview guide
Can you tell about one time a child did not want to have dental treatment? What happened and how did you handle it?
What type of dental treatment is, in your opinion, absolutely necessary to perform the same day?
Can you tell me about a situation where you felt that there was no other option than to go through with the treatment even though the child resisted?
Have you experienced thinking ‘we have to do this today’ and then quit before the treatment was completed? What made you quit?
Can you tell me about a method you use that normally means that the treatment succeeds without resulting in a feeling that the treatment was performed against the child’s will?
Can you tell me about a typical situation where you choose to offer sedative agents? How do you explain it to the parents?
Can you tell me about an experience where you sedated a child who still resisted receiving dental treatment?
How does it feel when the child resists dental treatment? Does the feeling differ when the child is sedated and when he/she is not?
Do you know if there are routines about how to follow up on children when a dentist feels that the dental treatment was traumatic?
Can you give an example of how you would record a situation where a child expressed discomfort and opposition during the dental treatment?
What experiences do you have of dealing with children after treatments they have opposed? Some of you have worked in dentistry for a long time and others for a shorter. Can you share your experiences about the oral health of children who opposed dental treatment earlier on but still had it performed? And have you seen any behavioural changes in those children?
Is there something you think we should add to cover the topic even better?

Figure 1. Schematic representation of the thematic analysis performed in this study. The arrows from steps 3–5 show that the steps are based on the research question and the data material.

Table 3. An extract from the thematic analysis showing how the main themes were established.

An excerpt of the transcribed text Step 1	NVivo code Step 2	Temporary theme Steps 3–4	Final theme Steps 5–6
‘The child doesn’t sleep or eat. Takes analgesics. Toothache can be very painful. If you have a 04 [molar tooth] with a short path to the pulp and you use several hours on behaviour guidance, then you have pulpitis. I have experienced it several times, and I’m sure others have as well (several agree saying ‘mmm’/nodding). Then you don’t have time.’	Children with toothache are forced to receive dental treatment as a result of dentists’ desire to remedy pain and suffering	Dental pain and pathologies are reasons for the use of restraint	Some dentists justify the use of restraint in paediatric dentistry
‘When the child is sedated, my point of view is that the treatment should be done.’	Doing whatever is necessary to complete dental treatment when the child is sedated	Physical restraint often occurs when the child is sedated	Physical restraint is often legitimised by the fact that the child is sedated
‘You don’t want to be a dentist anymore. Those days – you get a headache and feel that your legs fall asleep. You are completely exhausted.’	Negative emotions after the use of physical restraint during paediatric treatment	Demanding clinical situations lead to negative personal emotions	The use of restraint evoked difficult ethical evaluations