2. INTRODUCTION
behavioural dentistry is an interdisciplinary science
which needs to be learned, practiced and reinforced.
The objective is to develop in a dental practitioner an
understanding of interpersonal, intrapersonal, social
forces that influence the patients behaviour.
3. DEFINITION OF BEHAVIOUR
Behaviour is defined as any change in the
functioning of an organism.
Behaviour refers to changes that we can see and
count.
4.
5. Contra indicated
Long-term exposure (more then 24 hours) can produce
transient bone marrow depression.
Patient’s inability to perform nasal respiration because of
obstruction from a cold, deviated septum, enlarged adenoids
prevents its use.
PREGNANCY - Fetal resorption
- Congenital abnormalities
- Fetal growth retardation
Long surgical procedure
(more then 30 min)
6. DURING TREATMENT
1.The practitioner should be trained in the
use of conscious sedation methods.
2. Two members of the dental team should be
present.
3. Blood pressure, heart, and respiratory rates
should be continuously monitored by trained
personnel and intermittently recorded.
4.Child’s color should be visually checked,
especially oral mucosa and nailbeds for
cyanosis.
5. Head position should be evaluated
constantly
7. POSTOPERATIVE CARE
1. Vital signs should be recorded at intervals after the
procedure.
2. Discharge of patient should occur only when a vital signs
are stable and patient is alert, can talk, and can sit up unaided.
9. Patient with certain physical, mental, or medically
compromising condition.
Patient wherein local anesthesia is not effective or
allergic to it.
Fearful, uncooperative, anxious patient with no
expectation that behaviour will improve.
Patients who have sustained extensive orofacial trauma.
10. PREANESTHETIC EVALUATION
AND PROCEDURES-APD 1985
Instruction to patients
Preoperative health assessment
Clinical examination
Doctors order
INSTRUCTION TO PARENTS
The practitioner should provide verbal and
written instruction to the parents. It should
include explanation of potential/
anticipated postoperative behaviour and
limitation of activities along with dietary
precautions.
11. PEROPERATIVE HEALTH ASSESMENT
It should be done within 2 days prior to procedure to be reviewed at the time of
treatment.
CLINICAL EXAMINATION
VITAL SIGNS -Pulse and BP to be recorded
LABORATORY INVESTIGATION-
BLOOD-TC,DC,HB,PS,ESR,HIV,HBS,ELISA. URINE- urea and
keratinine.
TEMPERATURE AND BODY WEIGHT
CHILD PHYSICIAN- Name and address of child’s physician.
DOCTOR’S ORDERS
1. To parents
2. TO ASSISTANT-
To inform the OT, Anesthesian, Pradiatrition.
Premedication with a systemic background
Patient with subacute bacterial endocarditis and abscess – antibiotic
prophylaxis is needed.
12. PRE-MEDICATION (in a normal child)
OBJECTIVES
-To block unwanted autonomic reflexes.
-To prevent excessive secretions.
-To produce sedation & allay anxiety.
-To facilitate induction of anesthesia & to supplement & reduce
the amount of the same to be administered.
13. DRUGS USED FOR PRE-MEDICATION
ANTICHOLINERGICS
Atropine
Glycopyrrolate
SEDATIVES
Benzodiazepines
Barbiturates
ANTI-EMITICS
Hydroxyzine
Metaclopromide
15. GUIDELINES FOR USE D BEFORE G A
TREATMENT
1. Verbal and written instruction should be given
to parents about preoperative and postoperative
care.
2. No milk or solid foods should be eaten after
midnight before procedure. [NPO]
3. Only clear liquids should be ingested up to 4 to
8 hours before appointment, depending on age.
4. Vital statistics should be recorded (weight and
height).
5. Medical history should be completed.
6. Status of airway should be confirmed.
7. Vital signs, including pulse and blood
pressure, should be recorded.
16. POST OPERATIVE PERIOD
Procedure performed should be
explained to patient.
The presence of any bleeding from the
oral cavity, extra oral swelling should be
checked for.
The patient can de start of with analgesic
if pain is present.
The child should be evaluated for the
various system like cardiovascular
function.
Any instructions regarding the
restorative procedure performed should
be given.
