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“To suffering, there is a
limit; to fearing, none”
Sir Francis Bacon
THE FRIGHTENED CHILD
DEEPTHI P. R.
PUSHPAGIRI COLLEGE OF
DENTAL SCIENCES
CONTENTS
• Introduction
• Misbehaving child dental patients
• Definitions
• Causes of fear of dentistry
• Management
• Conclusion
• Bibliography
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
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
THE FRIGHTENED CHILD
• Formidable challenge to everyone who
encounters – dentist
• Intense, enormous cooperation
• Problem of fear is contended more
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
THE FRIGHTENED CHILD
• Misbehaviour is attributed to fear or other
cause- difficult
• Information, experience & common sense
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
CAUSES OF FEAR OF DENTISTRY
Intellectually unable
Not relieved even when educated
Chronologic age <36-40 months
Slow development
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
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
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
CAUSES OF FEAR OF DENTISTRY
Emotionally ill
Undiagnosed
Not noticed by the parents
Broken homes
Daily observing teacher
may notice
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
MANAGEMENT
• The most appropriate measures to be taken
regardless of :
-cost
-inconvenience
-loss of efficiency
MANAGEMENT
• Emotional illness:
-Refer to psychiatrist,
psychologist, counselor
-establish whether the child
is emotionally healthy to go
through dental appointment
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.
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
The frightened child

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The frightened child

  • 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