An updated survey on the utilization of hand over mouth (HOM) and restraint in postdoctoral pediatric dental education.

A survey of directors of advanced educational programs in pediatric dentistry, identical to one conducted in 1979, was undertaken to examine the utilization of and indications for various physical restraint techniques. Updated results indicated that there is still a high acceptance of the hand-over-mouth (HOM) technique. Only 11.1% of programs never use the technique. However, the acceptance of airway restriction is significantly lower than in 1979. Program directors currently report increased situations in which other physical restraint techniques, such as the Papoose Board, are recommended. Despite the continued acceptance of physical restraint techniques, a significant number of directors report that they are less certain that these techniques do not induce psychological problems. Although the current survey data indicates that there may be a discrepancy between professional standards as espoused by program directors, and material standards, that discrepancy is greatest for those program directors with tenures in excess of 10 years. These directors were much more likely to believe that HOM was indicated in situations other than for the control of hysterical and tantrum-like behavior and were much less likely to tell the child why HOM was being used. Additionally, such directors were as likely to use airway restriction as were 1979 respondents, although directors with tenures of less than 10 years were significantly less likely to use airway restriction.