Table 2:

Included Articles from Scoping Review

REFERENCE NUMBER	AUTHORS/ ORGANIZATION	YEAR	TYPE OF ARTICLE	COUNTRY OF ORIGIN	KEY FINDINGS
1	AAPD	2018	Policy Statement/ Best Practices Guidelines	US	These clinical guidelines outline the utilization of PS for pediatric dental patients.
2	AADMD	2017	Policy Statement	US	These clinical guidelines outline the use of stabilization/ restraint for adults, including indications, contraindications, and clinical considerations.
3	Glassman P	2008	Review Article	US	There are several options to facilitate dental treatment for PSHCN, and options depend on patient selection and dental needs.
4	AAPD	2015	Policy Statement/ Clinical Practice Guidelines	US	Proper communication, informed consent, and patient or clinician interventions can direct behavior guidance for pediatric patients
5	Karibe et al	2008	Observational Case Control Study	Japan	Diagnosis of profound cognitive disability may be an indication that PS is necessary to provide dental treatment in a clinic setting.
6	Martinez Mier EA et al	2019	Survey Study	US	Acceptance of different behavior techniques varies by parental ethnicity/ race/ background between Hispanic, black, and white parents.
8	Newton JT	2008	Review Article	UK	There is a place for restraint as a method of behavior management for PSHCN, but there are several considerations, including benefits outweighing the risk, legal concerns of consent/ assent, and efficacy of its use for care.
11	Frankel RI	1991	Survey Study	US	Parents of pediatric patients who were stabilized with a papoose board for dental procedures believed it to be helpful for the completion of dentistry, safer for their child than no restraint for the dental procedure, and 78% did not think there was a later negative effect of use of the papoose board.
12	Glassman P et al	2009	Consensus Statement	US	There are several options that may be utilized to facilitate dental care for PSHCN - choosing which method to use must take into consideration the patient’s health status, support system, financial status, and patient safety
13	Romer M	2009	Review Article	US	There are several confounding factors that impact the use of restraint for dental treatment for PSHCN including informed consent, patient communication, availability/ efficacy of other methods of behavior management, and patient condition/ health.
14	Kupietzky A	2004	Review Article	Israel	PS in combination with conscious sedation can be a viable option to provide dental treatment for an otherwise uncooperative child. It should be clearly explained to parents, and used prior to general anesthesia for option to facilitate treatment.
15	Costa LR et al	2020	Survey Study	UK/ Brazil	Among pediatric dentists surveyed the majority utilize PS for patients with dental fear and dental anxiety, while fewer routinely use, feel comfortable, or are training in pharmacologic based methods for behavior management. Brazil lacks in a balanced curriculum of general anesthesia/ sedation for pediatric dentists
16	Adair SM, Rockman RA, Schafer TE, Waller JL	2004	Survey Study of Pediatric Residency Programs	US	All surveyed pediatric residency programs in the US teach sedation techniques as acceptable behavior management, most teach active and passive sedation as acceptable methods of behavior management.
17	White et al	2016	Survey Study	US	Parental understanding of sedation and restraint options/ techniques is variable but the majority of parents surveyed believe sedation is safe and puts their child to sleep without the need for PS for dental procedures.
18	Weaver JM	2010	Editorial Article	US	With the availability of modern anesthesia and its prolific use for medical procedures, restraint should not be tolerated to facilitate dental care.
19	Bridgmann AM	2000	Review Article	UK	In the UK, restraint constitutes battery and is of particular concern if a patient is competent to consent and does not consent to the use of restraint. For patients who cannot consent clinical judgement with an assessment of “reasonableness” can justify its use.
21	Peretz B, Gluck GM	2002	Review Article	Israel/ US	Restraint is an option for facilitating dental treatment for the uncooperative patient, but dentists should focus on methods that allow for effective and efficient provision of care, as well as methods that support a positive attitude of the dentist. More research is required to evaluate the use of restraint.
23	AAPD	2015	Policy Statement/ Clinical Practice Guidelines	US	These guidelines outline the necessity for and methods of obtaining informed consent for pediatric patients/ incompetent adults.
24	Kupietzky A, Ram D	2005	Survey Study	Israel	Parents of pediatric patients who received positive explanation of PS were more accepting than parents who received a neutral explanation.
32	Romer M, Filanoa V.	2006	Review Article	US	For persons with developmental disabilities, obtaining an accurate medical history, informed consent, and the provision of care with aids/ restraint may be complicated by the need to seek the information through a third party.
34	Nelson T	2013	Review article	US	Behavior guidance techniques exist within a continuum of options that should be attempted and selected based on patient factors such as age, temperament, patient health, parental preferences.
37	Hirayama A, Fukuda K, Koukita Y, Ichinohe T	2019	Case Series	Japan	The addition of IV ketamine to propofol for sedation for dental procedures for intellectually disabled patients aids in patient stabilization without a negative impact on recovery.
38	Saxen MA, Tom JW, Mason KP	2019	Case Series/ Review Article	US	Appropriate planning and preparation, patient pre-operative evaluation and selection, emergency preparedness, and experience are critical to consider when administered office based sedation/ anesthesia for dental care.
40	Dougall A, Fiske J	2008	Review Article	UK	Mental capacity, literacy, and comprehension of a procedure, risks, benefits, alternatives, and process are necessary for valid informed consent for procedures as well as physical intervention/ restraint.
43	Lee JY, Vann WF, Roberts MW	2001	Cost effectiveness study	US	For patients who require multiple conscious sedation appointments for treatment, the break even point for conscious sedation versus general anesthesia is >3 appointments.
44	Cote CJ, Wilson S	2006	Clinical Report	US	The goals of sedation are to safely and effectively complete dental care in a manner to limit dental anxiety and discomfort. The process should include appropriate patient selection, adequate facilities, proper monitoring and emergency services, documentation, and proper use of equipment for sedation and stabilization.
45	Acs G, Musson CW, Burke MJ	1990	Survey Study of Pediatric Residency Programs	US	Among pediatric programs surveyed, oral sedation use increased, other sedation types roughly remained the same, other restraint besides hand over mouth roughly remained the same.
46	Crossley ML, Joshi G	2002	Survey Study	UK	Active and Papoose restraint not well regarded by parents of pediatric patients or pediatric dentists, tell- show-do was the most well accepted and used among survey participants.
50	Oliver K, Manton DJ	2015	Review Article	Australia	Behavior management techniques span a continuum with different modalities and levels of severity. The acceptance and utilization of these modalities are fluid and evolve with different demographics, ages, and over time.