THE INFLUENCE OF THE FAMILY

Clinical observations and research findings suggest that home environment plays a major role in the
dental attitudes of children. Therefore, the patient’s family environment must be taken into account to
reach the aim in the practice of dentistry. These critical factors invlove:

1. Maternal anxiety
We have already known that parent’s dental attitudes are conveyed to their offspring and that
these attitudes can affect a child’s cooperative behavior. Highly anxious mothers had a negative
influence on their children (uncooperativeness). Children of all ages can be affected by their
mothers’ anxieties.
2. Preparation of the child for dentistry
Mothers attempt to resolve their children’s anxiety especially in their first dental visit.
Unfortunately, these attempts actually resulted in an increase in the anxiety level. Mothers
apparently are unaware of the ways how to prepare their children. Although they had good
intention, they said the wrong things due to their incomprehension. In fact, a straightforward
approach to child preparation is designed to achieve a semblance support for the child. A
simple letter can do much toward relaxing a mother and helping her prepare her child for the
dental visit. If the elements of surprise and lack of information are removed by parent
preparation, children can be expected to behave more cooperatively.
3. Sociocultural factors
a. Socioeconomic factors
Researches show that there is significant relationship between the use of dental
services and social class. The lower the class, the lower was the dental service
utilization. In another words, the lower the class is less likely to seek dental help unless
they are in pain.
Moreover, it is found that the social class has effect on the behavior of parents and
children. A higher degree of cooperation from children in the upper socioeconomic
group as compared with that of the middle and lower social classes is found. According
to McDonald, the future-oriented, conscientious, middle-class parents have tends to
seek dental care readily and ccoperatively, and they have accepted tooth-brushing and
dental check-ups more as a matter of course.
b. Cultural and ethnic factors
Differences of religion, ethnic origin and family size, as well as socioeconomic status,
have contributed to the great variety of values and practices. Each subculture has its
own set of valued traits that it expects its members to posses. These traits may differ
according to sex, social class, ethnic and religious background.
4. Sibling relationship
A younger child’s misbehavior in dental office can be the direct result of an older sibling’s
influence. The process of reproducing behavior exhibited by a model is called “identification”.
The child then thinks, feels, and behaves like his model. The attitude developed by the older
child is a prefabricated framework for the younger sibling to build on and learn from. The
firstborn child had his parents’ behavior as a model while children born later have, in addition
to parents, older siblings available as models. This language of personality is not always
negative if the older child is a cooperative patient. The presence of an older sibling in the
operatory had a favourable effect on the behavior of the younger child at the first visit.
 When children observe siblings or peers in the dental office, the procedures should not be
frightening to the observer. Movements should be slow and instrumentation minimal. Loud
noises are often upsetting to the very young child.
 Ordinal position, sex and spacing of children in the family
The firstborn child or only child was more anxious about dental treatment and more
sensitive to pain than children born later. The influence of sex and spacing on birth-
order effect is more readily seen when the spacing is two years of less. When the
siblings are of the same sex, they behave similarly. If the spacing increases to four years
and the sex is different, the behavioral qualities of the children are quite dissimilar.
5. Sources of uncooperative behavior in the family unit
The misbehavior may be caused by:
- Behavior contagion  the substantial correlation between the fears of mothers and their
preschool children
- Threatening the child with the dentist as a punishment
- Well-intentioned but improper preparation of the child
- Discussing dentistry within hearing of the child
- Children’s anxieties, generated both internally and externally.

Source: Wrigth, Gerald Z. Behavior Management in Dentistry for Children. 1975. Philadelphia: W.B.
Saunders Company.