The frightened child
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  • 1. “To suffering, there is a limit; to fearing, none” Sir Francis Bacon
  • 2. THE FRIGHTENED CHILD DEEPTHI P. R. PUSHPAGIRI COLLEGE OF DENTAL SCIENCES
  • 3. CONTENTS • Introduction • Misbehaving child dental patients • Definitions • Causes of fear of dentistry • Management • Conclusion • Bibliography
  • 4. INTRODUCTION • Pediatric dentist- avoidance behaviors • Frustrates ; guilt & anxiety, discomfort • Management skills refined with time & dedication • Ways to manage-”embarrassment of riches” by Dr. David Chambers in 1977
  • 5. MISBEHAVING CHILD DENTAL PATIENTS Can‟t or won‟t cope with the stimuli & behavioral demands of the dental experience Category I: The emotionally compromised child Category II: The shy, introverted child Category III: The frightened child Category IV: The child who is aversive to authority
  • 6. THE FRIGHTENED CHILD • Formidable challenge to everyone who encounters – dentist • Intense, enormous cooperation • Problem of fear is contended more
  • 7. THE FRIGHTENED CHILD • Study in the US by Agras et al(1969): snakes>heights>storms>dental visit • Fear of needles, handpiece, rubber dam placement • Fear of bodily harm • Fear of the uncertain & strangers- infants & toddlers • Fear of separation- 3 year old
  • 8. THE FRIGHTENED CHILD • Misbehaviour is attributed to fear or other cause- difficult • Information, experience & common sense
  • 9. DEFINITION • Fear is an unpleasant emotion or effect consisting of psychophysiological changes in response to realistic threat or danger to one’s own experience • Fear & anxiety interchangeably used • Anxiety is a vague unpleasant feeling accompanied by a premonition that something undesirable is going to happen - Kent
  • 10. CAUSES OF FEAR OF DENTISTRY Intellectually unable Not relieved even when educated Chronologic age <36-40 months Slow development
  • 11. CAUSES OF FEAR OF DENTISTRY Emotional upsets in life Acute chaos at home Abused children Grieving close one‟s death Other health problems Self limiting Resolve in time Rigorous procedures- difficult to endure
  • 12. CAUSES OF FEAR OF DENTISTRY Acquired fears „sold‟ to the child by peers, siblings or parents Subjective Fears Based on feelings & attitudes that have been suggested by others Not experienced personally
  • 13. CAUSES OF FEAR OF DENTISTRY Learned fears Previous painful or difficult experience at physician‟s or dentist‟s office Objective Fears Direct physical stimulation of the sense organs Not of parental origin
  • 14. CAUSES OF FEAR OF DENTISTRY Emotionally ill Undiagnosed Not noticed by the parents Broken homes Daily observing teacher may notice
  • 15. MANAGEMENT • Easily identified except the emotionally ill • Make certain-misbehavior is out of dread of dentistry • Parent & dentist obliged to avoid increasing the anxieties - postponing dental work - using drugs - perform under G/A
  • 16. MANAGEMENT • The most appropriate measures to be taken regardless of : -cost -inconvenience -loss of efficiency
  • 17. MANAGEMENT • Emotional illness: -Refer to psychiatrist, psychologist, counselor -establish whether the child is emotionally healthy to go through dental appointment
  • 18. CONCLUSION • Misbehaving children encountered in pediatric dental practice on a day to day basis • A careful and intelligent identification of the actual cause behind the behavior • The management techniques to be adopted • Reveal any unidentified psychological condition suffered by the child.
  • 19. BIBLIOGRAPHY • Pediatric Dentistry- Infancy through adolescence, Edition 4 -Pinkham, Casamassimo, Fields, McTigue,Nowak • Clinical Pedodontics, Edition 4-Finn • Pediatric Dentistry, Edition 3 -Welbury, Duggal,Hosey • Textbook of Pedodontics, Edition 2 -Shobha Tandon