BEHAVIOR MANAGEMENT DONE BY: Dr. AYAH WALEED SUPERVISED BY: Dr. LUBNA ABDUL-ELLAH
Behavior management meansby which the dental health teameffectively and efficientlyperforms treatment for achiledand at the same, installsapositive dental attitude.
FEAR Fear is primary emotion for survivalagainst danger, which is acquiredsoon after birth. TYPES OF FEAR:-1-objective fear2-subjective fear
OBJECTIVE FEAR:- They are the respons to stimuli that arefelt, seen, heard, smelt or tasted and arenot liked or accepted.SUBJECTIVE FEAR:- These are based on the feelings andattitudes that have been suggested tochild by others about dentistry without thechild having had the experiencepersonally.
PEDIATRIC DENTAL CLINIC
FACTORS INFLUENCING CHILD’S BEHAVIOR1-FACTOR INVOLVING THE CHILD:A. Growth and developmentB. I.Q of childC. Past dental experienceD. Social and adaptive skillE. Position of child in the family
2- FACTORS INVOLVINGTHE PARENTS:-A. Family influenceB. Parent-child relationshipC. Maternal anxietyD. Attitude of parents to dentistry
3- FACTORS INVOLVINGTHE DENTISTA. Appearance of the dental officeB. Personality of the dentistC. Time and length of appointmentD. Dentist’s skill and speedE. Use of fear promoting wordF. Use of subtle, flattery, praise andreward
CLASSIFICATION OF CHILDREN’S BEHAVIORS1- CO-OPERATIVE BEHAVIOR:- Reasonably relaxed, have minimalapprehension and can be treated by astraight forward behavior shapingapproach.2- LACKING CO-OPERATIVE BEHAVIOR:--This behavior is contrast to co-operativechild.-Includes very young child (<2.5) or withspecific debilitating or handicappingconditions.
3- POTENTIALLY CO-OPERATIVEBEHAVIOR- Differs from a child lacking cooperative ability inthat this child is able to cooperate and isphysically and medically fit.- Potentially cooperative group are furthercategorized as follows:A- Uncontrolled behavior:-• Seen in 3-6 years.• Tantrum may begin in the reception area or evenbefore.• Tears, loud crying, physical lashing out and flailingof hands and legs all suggestive of a state ofacute anxiety or fear.
B- Defiant behavior:-• Can be found in all ages, more typical inthe elementary school group.• Distinguished by “I don’t want to” or “Idon’t have to” or “I wont”.• Once won over, these children frequentlybecome highly cooperative.
C- Timid behavior:-• If they are managed incorrectly, theirbehavior can deterioate to uncontrolled.• May be from an overprotective homeenvironment or may live in an isolatedarea having little contact with strangers.• Needs to gain self confidence of the child.
D- Tense cooperative behavior:-• Accept treatment, but are extremely tense.• Tremor may be heard, when they speak.E- Whining behavior:-• Thay do not prevent treatment, but whinethroughout the procedure.• Great patience is required while treating suchchildren.
Behavior management can beachieved by basically two methods:-1- Non pharamcological methods.A- Preappointment behaviormodification.B- Communication.C- Behavior shaping. Tell-show do technique. Modeling.
Preappointment behavior modificationVarious methods used for preappointment behaviormodification includes letters, films and videotaps.COMMUNICATION The hallmark of successful dentist inmanaging children is his ability tocommunicate with them and win theirconfidence.
TELL-SHOW DO TECHNIQUE In this technique the child is told about thetreatment, showed the instruments andthen the treatment is performed.MODELING This prosedure involves, allowing patient toobserve one or more model whodemonstrate appropriate behavior in aparticular situation.
TELL-SHOW –DO TECHNIQUE
BEHAVIOR MANAGEMENT TECHNIQUE Audioanalgesia it is also called as‘white noise’. This consist ofproviding a sound stimulus of suchintensity that the patient finds itdifficult to attend to anything else.
AVERSIVE CONDITIONING1- Hand over mouth technique. Used for children with sufficientmaturity to understand simple verbalcommands. Contraindicated in immature frightened, orthe child with a serious physical, mental oremotional handicap.
HAND OVER MOUTH TECHNIQUE
2- Physical restraints Papoose board Triangular sheet Pedi wrap Mouth prop or bite block3- Voice control The dentist can raised his voice and instruct thechild in short but strict commands.
IMPLOSIN THERAPY In this technique the patient isflooded with many stimuli. Itcomprises of home technique, voicecontrol and physical restraintstogether.
RETRAINING If a child have an unpleasant experience inthe previous dental office, the child stilltends to generalized that an unpleasantevent will occur in his new dental officealso. This is non as stimulusgeneralization. To remove this the dentisthas demonstrate a difference and createnew stimulus which is pleasant andreplaces the old.