Attitudes towards the use of hand over mouth (HOM) and physical restraint amongst paediatric specialist practitioners in the UK

Abstracts on this page have been chosen and edited by Dr Trevor Watts

Abstract

HOM was considered unsuitable, but physical restraint was considered appropriate with some patients.

Main

Newton JT, Patel H et al. Int J Paediatr Dent 2004; 14: 111–117

The gentle use of HOM in dealing with non-cooperative behaviour has long been a matter of controversy, with both legal and moral objections. Parents have considered physical restraint more acceptable than sedation or HOM. In this survey, all 216 registered paediatric dentistry specialists in the UK were asked for their views and 83% responded.

Between 80% and 90% of specialists understood HOM correctly, namely that the mouth alone is covered, the child is told why, and given directions regarding behaviour. Use was endorsed, in hysterical behaviour only, by 32%, but rejected in all circumstances by 59%. Physical restraint was endorsed for handicapped patients (by 62%), the very young (39%), the premedicated (20%), and those who physically resisted (14%). About half the specialists felt HOM would lead a child to fear treatment.