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INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.com
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The successful practice of orthodontics is
significantly dependent on the interaction between the...
THE ORTHODONTIST-PATIENT RELATIONSHIP:
Orthodontist-patient relationships have significant
effects on the success of ortho...
PSYCHOLOGY:
is the science dealing with the human nature,
function, and phenomenon of his soul in the main.
CHILD PSYCHOLO...
BEHAVIOR:
is an observable act, it is defined as any change
observed in the functioning of an organism.
Learning as relate...
THE NEED FOR ORTHODONTIC TREATMENT:
1. Discrimination because of facial appearance.
2. Problems with oral function, (diffi...
CREATING A COMPLIANT PATIENT
(JCO 1996 Sep MELVIN MAYERSON, DDS, MSD, R.G.
“WICK” ALEXANDER, DDS, MSD, C..)
•Patient Educa...
Patient Education
They need to know the costs and benefits of
treatment, in time, money, and effort.
Patient education boo...
INFORM BEFORE WE PERFORM

Procedures and appliances explained to patient by Dr. Wick
Alexander before treatment.

www.indi...
Patient Motivation
WILLIAM JAMES “The most important discovery of the
20th century is that the attitudes of an individual ...
Office Environment
Every office reflects the personality of the orthodontist.
• The goal is to maintain a friendly, warm, ...
Communication Techniques
An effective communication technique is to look in
their eyes before you look in their mouths.

"...
Monitoring Progress
Each patient’s progress must be monitored constantly
to maintain motivation and compliance throughout
...
EARLY TREATMENT :
Psychological advantage to the children, whose
• self image has been shattered by peer group
teasing.
•S...
Habit correction
(AJO-DO 1979 Nov; Psychology and early orthodontic
treatment – Jacobson)
Two main schools of thought prev...
In treating habits in this age group, it is necessary to
determine whether the habit is "meaningful" or
''empty."24 If the...
BEHAVIOUR MANAGEMENT OF CHILD
1. Non-pharmacological (psychological approach)
2. Pharmacological
Non- pharmacological:
1. ...
3. Behavior management
• Audio analgesia
• Biofeed back
• Voice control
• Hypnosis
• Humor
• Coping
• Relaxation
• Implosi...
Pharmacological:
1. Pre-medication
• Sedatives And Hypnotics
• Anti-anxiety Drugs
• Anti-histamines
2. Conscious sedation
...
PRACTICAL PSYCHOLOGY TO THE CLINICAL
PRACTICE OF ORTHODONTICS
DIVIDED INTO TWO BROAD CATEGORIES:
1. SOCIAL PSYCHOLOGY OF O...
SOCIAL PSYCHOLOGY
Why patient’s seek orthodontic treatment ?
• Adolescents : my mom thinks I need braces, to look
better
•...
“WHY DO PEOPLE WANT TO LOOK BETTER”
Adams suggested
1. Physical attractiveness stimulates differential expectations
toward...
PSYCHOLOGICAL OUTCOME OF ORTHODONTIC
TREATMENT
The precise role that dentofacial esthetics plays in the
development of a c...
DEVELOPMENTAL PSYCHOLOGY OF
ORTHODONTICS:
SHAW et al
BENEFIT OF SOCIAL PSYCHOLOGIC WELL BEING IN
TERMS OF THREE SUB GROUPS...
PATIENT COMPLIANCE:
The success of orthodontic therapy frequently depends
on patient compliance.
EGOLF and others describe...
UNDERSTANDING THE ADOLESCENT PATIENT:
Peterson and Kuipers described adolescence as a
period in life between childhood and...
MOTIVATING THE ADOLESCENT PATIENT:
“COOPER and SHAPIRO” Features of adolescent
behavior used to ascertain a particular beh...
They suggested that more successful motivation can
be accomplished by individualizing the patient and
recognizing adolesce...
PERSONALITY TESTING AND COMPLIANCE:
Major orthodontic treatment decisions are based on an
anticipated level of patient com...
ORTHODONTIST AND PATIENT COMMUNICATION:
KLAGES, SERGL, and BURUCKER – found strong
relationships between clinician’s encou...
EDUCATIONAL PSYCHOLOGY:

One of the most promising areas of current research in
patient cooperation is the area of educati...
The learning styles inventory developed by KOLB, 4 learning
styles.
1. ACCOMODATOR
2. DIVERGER
3. ASSIMILATOR

Concrete ex...
ACHIEVING PATIENT COMPLIANCE:
ROSEN provided a practical patient-oriented
approach to creating a compliant patient.

Healt...
WHITE suggested
1. Use of soft-bristle tooth brush and, if necessary,
chlorhexidine rinses.
2. Us the simplest appliance n...
Methods of improving patient compliance
A.O. 1998 No. 2, T. Mehra, R.S. Nanda, P.K Sinha.
(1) verbally praising the patien...
PSYCHOLOGY – ORTHOGNATHIC SURGERY:
Psychological impact• Some patients are under prepared for change in
appearance.
• some...
 Pre operative counseling with patients, relatives,
and friends.
The importance of detailed preoperative discussions
is ...
RESULTS OF NON COMPLIANT PATIENT:

 It is necessary to compromise treatment
methods and treatment objectives.
 Increase ...
ACHIEVEMENTS THROUGH ADHERENCE BY
PATIENT : (compliant patient)
 Achieve the treatment objectives in minimum
treatment ti...
CONCLUSION
One golden thread that runs through out the
literature of orthodontic psychology is the
importance of the docto...
Thank you
For more details please visit
www.indiandentalacademy.com

www.indiandentalacademy.com
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Psychological management

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Transcript of "Psychological management"

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. I N T R O D U C T I O N The successful practice of orthodontics is significantly dependent on the interaction between the orthodontist and the patient. Doctor-patient relationships in orthodontics can positively influence treatment outcomes by encouraging the patient to cooperate in following prescribed instructions related to appliance wear and maintenance of oral hygiene. Successful orthodontic treatment requires active cooperation from the patient throughout the necessary lengthy orthodontic procedures. www.indiandentalacademy.com
  3. 3. THE ORTHODONTIST-PATIENT RELATIONSHIP: Orthodontist-patient relationships have significant effects on the success of orthodontic treatment. In the practice of orthodontics today, time invested in creating and maintaining the important patient-doctor bond. Patients must be treated as people who have malocclusions, not malocclusions attached to people. Orthodontist behaviors such as listening, empathy, and explanation are important in achieving that goal. www.indiandentalacademy.com
  4. 4. PSYCHOLOGY: is the science dealing with the human nature, function, and phenomenon of his soul in the main. CHILD PSYCHOLOGY: is the science that deals with the mental power or an interaction between the conscious and sub conscious element in a child. BEHAVIOR: is any change in the functioning of the organism. www.indiandentalacademy.com
  5. 5. BEHAVIOR: is an observable act, it is defined as any change observed in the functioning of an organism. Learning as related to behavior is a process in which past experience or practice results in relatively permanent changes in an individuals behavior. BEHAVIOR MODIFICATION: it is the attempt to alter human behavior and emotion in a beneficial manner according to the laws of modern learning theory. www.indiandentalacademy.com
  6. 6. THE NEED FOR ORTHODONTIC TREATMENT: 1. Discrimination because of facial appearance. 2. Problems with oral function, (difficulty in jaw movements, TMJ dysfunction,swallowing or speech). 3. Greater susceptibility to trauma, periodontal disease, or tooth decay. www.indiandentalacademy.com
  7. 7. CREATING A COMPLIANT PATIENT (JCO 1996 Sep MELVIN MAYERSON, DDS, MSD, R.G. “WICK” ALEXANDER, DDS, MSD, C..) •Patient Education •Patient Motivation •Office Environment •Communication Techniques •Monitoring Progress www.indiandentalacademy.com
  8. 8. Patient Education They need to know the costs and benefits of treatment, in time, money, and effort. Patient education booklets, used to reinforce instructions throughout treatment, are written in positive tone to encourage and motivate patients. www.indiandentalacademy.com
  9. 9. INFORM BEFORE WE PERFORM Procedures and appliances explained to patient by Dr. Wick Alexander before treatment. www.indiandentalacademy.com
  10. 10. Patient Motivation WILLIAM JAMES “The most important discovery of the 20th century is that the attitudes of an individual can change”. The only truly motivational technique is self-motivation www.indiandentalacademy.com
  11. 11. Office Environment Every office reflects the personality of the orthodontist. • The goal is to maintain a friendly, warm, caring, professional atmosphere in which patients know that they will receive the highest-quality treatment. www.indiandentalacademy.com
  12. 12. Communication Techniques An effective communication technique is to look in their eyes before you look in their mouths. "Horizontal communication": Dr. J. Moody Alexander looking in patient's eyes before looking in the mouth. Good communication should be honest as well as two-way, the orthodontist should be “askable” www.indiandentalacademy.com
  13. 13. Monitoring Progress Each patient’s progress must be monitored constantly to maintain motivation and compliance throughout treatment. When improvement is seen, praise the patient and share the achievement with the parent. If slow progress is due to non-compliance, it is crucial that the patient and parents be informed as early as possible in a “mini-consultation”. www.indiandentalacademy.com
  14. 14. EARLY TREATMENT : Psychological advantage to the children, whose • self image has been shattered by peer group teasing. •Self conscious. •Timid or •Sensitive about their dental appearance. www.indiandentalacademy.com
  15. 15. Habit correction (AJO-DO 1979 Nov; Psychology and early orthodontic treatment – Jacobson) Two main schools of thought prevail. The psychoanalysts regard the habit as a symptom of emotional disturbance, and the behaviorists view the act as a simple learned habit with no underlying neurosis. Thumb-sucking in the schoolchild (6 to 12 years) is usually a manifestation of a general emotional and social immaturity. www.indiandentalacademy.com
  16. 16. In treating habits in this age group, it is necessary to determine whether the habit is "meaningful" or ''empty."24 If the sucking habit is one of a galaxy of symptoms of an abnormal behavior problem, a consultation with a psychiatrist is the first consideration. The habit in these instances would be regarded as ''meaningful." www.indiandentalacademy.com
  17. 17. BEHAVIOUR MANAGEMENT OF CHILD 1. Non-pharmacological (psychological approach) 2. Pharmacological Non- pharmacological: 1. Communication 2. Behavior shaping (modification) • Desensitization • Modelling • Contingency management www.indiandentalacademy.com
  18. 18. 3. Behavior management • Audio analgesia • Biofeed back • Voice control • Hypnosis • Humor • Coping • Relaxation • Implosion therapy • Aversive conditioning. www.indiandentalacademy.com
  19. 19. Pharmacological: 1. Pre-medication • Sedatives And Hypnotics • Anti-anxiety Drugs • Anti-histamines 2. Conscious sedation 3. General anesthesia. www.indiandentalacademy.com
  20. 20. PRACTICAL PSYCHOLOGY TO THE CLINICAL PRACTICE OF ORTHODONTICS DIVIDED INTO TWO BROAD CATEGORIES: 1. SOCIAL PSYCHOLOGY OF ORTHODONTICS. 2. ORTHODONTIC MOTIVATIONAL PSYCHOLOGY. A RELATIVELY NEW AREA OF APPLICATION 3. EDUCATIONAL PSYCHOLOGY. www.indiandentalacademy.com
  21. 21. SOCIAL PSYCHOLOGY Why patient’s seek orthodontic treatment ? • Adolescents : my mom thinks I need braces, to look better • Adults : own initiative; to improve facial appearance.  Clearly a person’s dento facial appearance can have a significant effect on their overall quality of life. www.indiandentalacademy.com
  22. 22. “WHY DO PEOPLE WANT TO LOOK BETTER” Adams suggested 1. Physical attractiveness stimulates differential expectations toward another. 2. An individual’s attractiveness appears to elicit differential social exchanges from others. 3. An important developmental outcome results from this social exchange. 4. Attractive people are more likely to manifest confident interpersonal behavior patterns than lesser attractive individual. www.indiandentalacademy.com
  23. 23. PSYCHOLOGICAL OUTCOME OF ORTHODONTIC TREATMENT The precise role that dentofacial esthetics plays in the development of a child’s self-concept and self-esteem remains controversial. DANN et al ALBINO www.indiandentalacademy.com
  24. 24. DEVELOPMENTAL PSYCHOLOGY OF ORTHODONTICS: SHAW et al BENEFIT OF SOCIAL PSYCHOLOGIC WELL BEING IN TERMS OF THREE SUB GROUPS: 1. Nick names and teasing. 2. Evaluation of dental appearance and social attractiveness. 3. Self esteem and popularity. www.indiandentalacademy.com
  25. 25. PATIENT COMPLIANCE: The success of orthodontic therapy frequently depends on patient compliance. EGOLF and others described a compliant patient as one who practices good oral hygiene, wears appliances as instructed without abusing them, follows an appropriate diet, and keeps appointments. www.indiandentalacademy.com
  26. 26. UNDERSTANDING THE ADOLESCENT PATIENT: Peterson and Kuipers described adolescence as a period in life between childhood and adulthood when considerable change is occurring. Under standing adolescent development can allow the orthodontist to help overcome obstacles in treating patients in this age group. www.indiandentalacademy.com
  27. 27. MOTIVATING THE ADOLESCENT PATIENT: “COOPER and SHAPIRO” Features of adolescent behavior used to ascertain a particular behavior. 1. Adolescents are concerned with self-image and identity, which can be useful in motivating them. 2. Independence and autonomy are important to an adolescent therefore achieving an adult like status could motivate the adolescent. 3. Peer relationships are important, so this feature motivate behaviors that meet social needs. www.indiandentalacademy.com
  28. 28. They suggested that more successful motivation can be accomplished by individualizing the patient and recognizing adolescent values and issues. The orthodontist should understand that adolescents are not influenced strongly by health specific goals. www.indiandentalacademy.com
  29. 29. PERSONALITY TESTING AND COMPLIANCE: Major orthodontic treatment decisions are based on an anticipated level of patient compliance. PERSONALITY TEST: SOUTHARD et al “The Millon Adolescent personality inventory” (MAPI) (MILLON, GREEN, and MEAGHER-1982) To predict the behavior of adolescent patients in an orthodontic practice. www.indiandentalacademy.com
  30. 30. ORTHODONTIST AND PATIENT COMMUNICATION: KLAGES, SERGL, and BURUCKER – found strong relationships between clinician’s encouraging behavior and patient communication cooperation, and concluded that the orthodontist's behavior may be relevant for patient verbal cooperation. The doctor-patient interaction is the best predictor of how well a patient could be expected to comply with the doctor’s instructions. www.indiandentalacademy.com
  31. 31. EDUCATIONAL PSYCHOLOGY: One of the most promising areas of current research in patient cooperation is the area of educational psychology. www.indiandentalacademy.com
  32. 32. The learning styles inventory developed by KOLB, 4 learning styles. 1. ACCOMODATOR 2. DIVERGER 3. ASSIMILATOR Concrete experience 4. CONVERGER. Accommodator Active experimentation Converger Diverger Reflective observation Assimilator Abstract conceptualization www.indiandentalacademy.com
  33. 33. ACHIEVING PATIENT COMPLIANCE: ROSEN provided a practical patient-oriented approach to creating a compliant patient. Health care providers should develop a compliance model that is patient-centered rather than cliniciancentered. www.indiandentalacademy.com
  34. 34. WHITE suggested 1. Use of soft-bristle tooth brush and, if necessary, chlorhexidine rinses. 2. Us the simplest appliance necessary to achieve treatment objectives with forces that are continuous and of low magnitude. 3. Prescribe analgesics when needed. 4. Expedite treatment time. 5. Let the fees reflect the challenges of a difficult patient. www.indiandentalacademy.com
  35. 35. Methods of improving patient compliance A.O. 1998 No. 2, T. Mehra, R.S. Nanda, P.K Sinha. (1) verbally praising the patient, (2) educating the patient about the consequences of poor compliance, (3) discussing treatment goals with the patient, (4) educating the patient about the proper use of elastics, (5) educating the parent about the consequence of poor compliance, (6) discussing poor patient cooperation with the patient, (7) educating the patient about the proper use of headgear, (8) discussing poor patient cooperation with the parent, (9) discussing treatment goals with the parent, and (10) educating the parent about the use of orthodontic appliances. www.indiandentalacademy.com
  36. 36. PSYCHOLOGY – ORTHOGNATHIC SURGERY: Psychological impact• Some patients are under prepared for change in appearance. • some were surprised by the degree of reaction of others to the results. • further surprised by the amount of change they subsequently realized in their own attitudes and personality. www.indiandentalacademy.com
  37. 37.  Pre operative counseling with patients, relatives, and friends. The importance of detailed preoperative discussions is very evident in this series of patients. These discussions must cover technical aspects of treatment and inconveniences that the patient will encounter during treatment. www.indiandentalacademy.com
  38. 38. RESULTS OF NON COMPLIANT PATIENT:  It is necessary to compromise treatment methods and treatment objectives.  Increase of expenses involved in orthodontic treatment. www.indiandentalacademy.com
  39. 39. ACHIEVEMENTS THROUGH ADHERENCE BY PATIENT : (compliant patient)  Achieve the treatment objectives in minimum treatment time.  Reduction of expenses involved in orthodontic treatment.  Improved oral hygiene can minimize damage to the periodontal tissues, limit the deleterious effects of decalcification, and even frank caries. www.indiandentalacademy.com
  40. 40. CONCLUSION One golden thread that runs through out the literature of orthodontic psychology is the importance of the doctor-patient relationship. Once the orthodontist has earned the trust and respect of the patient by establishing a good rapport , the task of achieving a good treatment result is made remarkably easier. www.indiandentalacademy.com
  41. 41. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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