401 - Impact of Observer Presence on Pediatric Dentist Performance

Purpose: The presence of parents, guardians, or observers during pediatric dental procedures may influence provider performance, patient behavior, treatment efficiency, safety, and interpersonal dynamics. This study assessed dentists' perceptions of these effects to guide evidence-based policies optimizing clinical experiences for patients, families, and providers.

Methods: A cross-sectional anonymous online survey was distributed to alumni email lists of two pediatric dentistry residency programs and the American Academy of Pediatric Dentistry (AAPD) membership (approximately 8,286 recipients). The survey assessed demographics, observer presence frequencies by procedure type, perceived effects of parental absence on provider and patient outcomes, rationales for presence policies, commonly reported problems, and management strategies. Data were analyzed descriptively per STROBE guidelines.

Results: Of 421 respondents (5.08 percent response rate), 95.5 percent were pediatric dentists. Observer presence was reported as routine during examinations (84.6 percent always) and for children aged three years and younger (89.8 percent) but infrequent during general anesthesia (77.0 percent never). Parental absence was perceived to improve provider focus (71.3 percent slightly or majorly increased), treatment enjoyment (63.4 percent increased), efficiency (70.5 percent increased), and patient compliance (70.1% increased). Effects on provider stress levels (49.9 percent reduced) and child anxiety were mixed. Nearly two-thirds of respondents agreed they would prefer parental absence but felt compelled to allow it.

Conclusions: Pediatric dentists perceive observer presence as potentially detrimental to provider performance, focus, patient cooperation and operatory dynamics, with inconsistent benefits for provider stress and child anxiety. These findings support tailored, evidence-informed policies on observer presence supplemented by parental education strategies.