What reward does a child prefer for behaving well at the dentist?

Background: Paediatric dentists often report using positive reinforcement to encourage their young patients to show co-operative behaviour. For effective reinforcement to take place the reward should be salient to the individual. To date, there is little research into what reward a young patient will choose when attending the dentist.

Aim: To identify what reward children between the age of 4-8 years will choose when attending the dentist, and to determine the extent of agreement between children and caregivers in reward choice.

Method: Observational study. Fifty-two children from different age groups (4-5 years, 6-7 years and 8 years) attending a primary-care dental clinic were asked to choose between a range of different rewards. The caregiver attending with them was also asked to anticipate the child's preferred choice.

Results: There was no clear favourite reward for children from both genders and different age group. However, no child chose the 'sticker' reward that is traditionally given out at the dentist. Overall carers agreed with the child's choice of toy on 18 occasions (34.6%), but there were significant differences across the age groups with carers of older children showing less agreement.

Conclusion: To ensure that rewards are salient, children should be given a choice of rewards when attending the dental clinic. Parents ability to predict their child's preferred rewards decreases as the child ages.

Clinical Relevance: A child's motivation to co-operate during dental treatment can be increased by offering a range of rewards. Asking children to choose their reward from a limited range will increase the saliency of the reward for the child.