This document discusses behavior management techniques for children in dental settings. It defines key terms like psychology and behavior management. It categorizes behavior management approaches as pharmacological or non-pharmacological. Non-pharmacological techniques include communication, behavior shaping methods like desensitization and modeling, and behavior management strategies such as audio analgesia and coping mechanisms. The document also addresses managing behaviors of children with conditions like mental retardation, convulsive disorders, cerebral palsy, and autism. It stresses the importance of understanding each child's needs and abilities to provide successful dental treatment.
The document provides an overview of non-pharmacological behavior management techniques for children in dental settings. It discusses:
1) Definitions of key terms like behavior shaping and behavior modification.
2) Classifications of children's behavior observed in dental clinics according to factors like age and various rating scales.
3) Major factors that can affect a child's reaction to dental treatment, including their relationship with parents and dental staff.
This document discusses various behavior management techniques used in pediatric dentistry. It describes the types of fear children may experience and factors that can influence a child's behavior like development, past experiences, and parental attitudes. Children's behaviors are classified as cooperative, lacking cooperation, or potentially cooperative such as uncontrolled, defiant, timid, tense, and whining. Behavior management can be achieved through non-pharmacological methods like preappointment conditioning, communication skills, and techniques like Tell-Show-Do modeling or use of audioanalgesia, aversive conditioning, implosion therapy, and retraining. Pharmacological methods like sedatives may also be used.
This document provides an overview of fear and its management in children. It defines fear and discusses the types, signs and symptoms, and response to fear. It also covers anxiety, phobias, and how to assess fear levels in children. The document concludes with a discussion of management strategies and references for fear in children.
Unfavorable Sequelae of Malocclusion discusses the negative psychological, social, developmental, and health impacts of malocclusion. Specifically, it notes that malocclusion can lead to introversion or overassertiveness in children due to speech defects, poor appearance and ridicule, improper growth and muscle function, issues with swallowing and breathing, improper chewing and potential nutritional deficiencies, speech defects, increased risk of dental caries and periodontal disease, temporomandibular joint disorders, higher risk of accidents, impacted teeth, and complications with dental prosthetics. The document provides supporting details for each of these potential unfavorable sequelae.
Introduction
Definitions
The goals of behavior guidance
Children’s behavior in the dental office
Documentation of children’s behaviors
Factors affecting children’s behavior
Strategies of the dental team
Preappointment behavior modification
Fundamental of behavior management
Behavior guidance techniques
Basic behavior guidance
Alternative communicative techniques
Advanced behavior guidance techniques
Recent advances in behavior guidance technique
Practical considerations
Behavior guidance for the infants/toddlers
Behavior guidance for the preschoolers
Behavior guidance for the school-aged children
Behavior guidance for the adolescent
Behavior guidance for the child with the previous negative dental experience
Behavior guidance for the special health care need
Behavior guidance for the child with special health care needs
Conclusion
References
Behaviour management is important for pediatric dentists treating cognitively, physically, mentally and emotionally developing children. The major difference between treating adults and children is that treating children involves a triad relationship between the child, dentist and parents. Dentists should counsel parents not to voice their own fears in front of children or use dentistry as a threat. Factors like the dentist's attitude, attire, and presence of parents can affect a child's behavior. Effective behavior management techniques for children include communication, modeling, desensitization, voice control, relaxation and hypnosis. Physical restraints should only be used as a last resort for uncooperative or handicapped patients.
The document provides an overview of non-pharmacological behavior management techniques for children in dental settings. It discusses:
1) Definitions of key terms like behavior shaping and behavior modification.
2) Classifications of children's behavior observed in dental clinics according to factors like age and various rating scales.
3) Major factors that can affect a child's reaction to dental treatment, including their relationship with parents and dental staff.
This document discusses various behavior management techniques used in pediatric dentistry. It describes the types of fear children may experience and factors that can influence a child's behavior like development, past experiences, and parental attitudes. Children's behaviors are classified as cooperative, lacking cooperation, or potentially cooperative such as uncontrolled, defiant, timid, tense, and whining. Behavior management can be achieved through non-pharmacological methods like preappointment conditioning, communication skills, and techniques like Tell-Show-Do modeling or use of audioanalgesia, aversive conditioning, implosion therapy, and retraining. Pharmacological methods like sedatives may also be used.
This document provides an overview of fear and its management in children. It defines fear and discusses the types, signs and symptoms, and response to fear. It also covers anxiety, phobias, and how to assess fear levels in children. The document concludes with a discussion of management strategies and references for fear in children.
Unfavorable Sequelae of Malocclusion discusses the negative psychological, social, developmental, and health impacts of malocclusion. Specifically, it notes that malocclusion can lead to introversion or overassertiveness in children due to speech defects, poor appearance and ridicule, improper growth and muscle function, issues with swallowing and breathing, improper chewing and potential nutritional deficiencies, speech defects, increased risk of dental caries and periodontal disease, temporomandibular joint disorders, higher risk of accidents, impacted teeth, and complications with dental prosthetics. The document provides supporting details for each of these potential unfavorable sequelae.
Introduction
Definitions
The goals of behavior guidance
Children’s behavior in the dental office
Documentation of children’s behaviors
Factors affecting children’s behavior
Strategies of the dental team
Preappointment behavior modification
Fundamental of behavior management
Behavior guidance techniques
Basic behavior guidance
Alternative communicative techniques
Advanced behavior guidance techniques
Recent advances in behavior guidance technique
Practical considerations
Behavior guidance for the infants/toddlers
Behavior guidance for the preschoolers
Behavior guidance for the school-aged children
Behavior guidance for the adolescent
Behavior guidance for the child with the previous negative dental experience
Behavior guidance for the special health care need
Behavior guidance for the child with special health care needs
Conclusion
References
Behaviour management is important for pediatric dentists treating cognitively, physically, mentally and emotionally developing children. The major difference between treating adults and children is that treating children involves a triad relationship between the child, dentist and parents. Dentists should counsel parents not to voice their own fears in front of children or use dentistry as a threat. Factors like the dentist's attitude, attire, and presence of parents can affect a child's behavior. Effective behavior management techniques for children include communication, modeling, desensitization, voice control, relaxation and hypnosis. Physical restraints should only be used as a last resort for uncooperative or handicapped patients.
This document discusses child behavior and behavior management techniques in dentistry. It defines concepts like fear, anxiety, and emotions commonly seen in children. It also describes various classification systems used to assess child behavior and factors that can influence it like parental attitudes. The document outlines non-pharmacological behavior management techniques including communication, modeling, desensitization and contingency management. It discusses practical considerations for behavior management in a dental clinic.
1. Behavior management in pediatric dentistry aims to reduce fear and anxiety in children undergoing dental procedures through various pharmacological and non-pharmacological methods.
2. Non-pharmacological methods include communication techniques like tell-show-do, modeling, positive reinforcement, distraction, voice control, and retraining. Pharmacological methods include conscious sedation using nitrous oxide.
3. The document discusses in detail various emotions in children, factors influencing their behavior, classification of child behaviors, objectives and considerations for nitrous oxide sedation, and contraindications for its use. Non-pharmacological behavior management techniques are emphasized as the primary approach.
Behavioural Management in Pediatric DentistrySwalihaAlthaf
This document provides information on behavioral management techniques used in pediatric dentistry. It defines key terms like behavior, behavior management, behavior shaping, and behavior modification. It then categorizes and describes various non-pharmacological behavior management techniques including communication, use of second language, tell-show-do, desensitization, modeling, behavior shaping, contingency management, distraction, assimilation and coping techniques.
Sigmund Freud's psychosexual theory of development proposed that personality forms from negotiations of psychosexual stages - oral, anal, phallic, latency, and genital. Erik Erikson expanded on this, proposing 8 psychosocial stages from infancy to late adulthood. The first stage, trust vs mistrust, involves infants developing trust if caregivers meet needs consistently. The second, autonomy vs shame and doubt, sees toddlers developing independence if given opportunities to do so with support. The third, initiative vs guilt, involves preschoolers initiating activities if successes are supported versus feeling guilt from failures.
pedodontics.....non pharmacological methods of behaviour managementSurabhi Desai
This document discusses various behavior management techniques used in pediatric dentistry. It defines behavior management as the means by which the dental team performs treatment to instill a positive dental attitude. Factors that influence a child's cooperative behavior like parental anxiety, medical experiences, and communication techniques are described. Methods of behavior shaping include desensitization, modeling, and contingency management. Specific behavior management techniques addressed include audio analgesia, biofeedback, voice control, hypnosis, humor, coping, and aversive conditioning.
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides guidance on effective behavior management techniques for treating child patients. It discusses the objectives of treating children, which include performing tasks efficiently and safely while instilling positive oral habits. Both pharmacological techniques like sedatives and general anesthesia as well as non-pharmacological techniques like restraint and behavior management are covered. Specific behavior management techniques discussed include humor, distraction, communication, positive reinforcement, and adverse reinforcement. The document emphasizes the importance of effective communication using skills like Tell-Show-Do, reflective listening, self-disclosing assertiveness, and descriptive praise. It provides examples of how to communicate verbally and non-verbally with children."
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
- Traumatic injuries to primary and permanent teeth are common, with maxillary central incisors most frequently affected. Injuries range from enamel fractures to luxations and avulsions.
- Epidemiological studies show that approximately 1/3 of children experience dental trauma to primary teeth and 1/5 experience trauma to permanent teeth. Injuries most often occur from falls at home for young children and from sports for adolescents.
- Proper classification and diagnosis of dental injuries is important to determine appropriate treatment and management. Conditions range from concussion with no displacement to intrusive luxation with tooth displacement into bone.
1. Several classifications of child behavior in dental settings are discussed, including Wilson's, Wright's, and Lampshire's classifications.
2. Factors like age, temperament, home environment, and past dental experiences can influence a child's behavior. Children's behaviors range from cooperative to disruptive.
3. Rating scales like Frankl's and the Houpt scale can be used to assess a child's level of anxiety or cooperation during dental treatment. Understanding a child's behavioral patterns is important for effective behavior guidance.
An Introduction to Special Needs DentistySyafiq Ali
Siti Zaleha Hamzah is a specialist in special needs dentistry based in Hospital Serdang in Malaysia. She provides clinical support for patients with intellectual, physical, medical, and psychiatric conditions. Special needs dentistry focuses on modifying dental treatment for patients with disabilities or medical complexities. It aims to improve oral health and well-being for those with conditions that make regular dental care difficult. Treatment is often provided using behavior management strategies and may involve specialists from other areas.
Non –pharmacological behavior management in childrenDr. Harsh Shah
Overview on nonpharmacological managent of behaviour in children
Presented by : Mayuri Karad
SDDCH Parbhani
Guided by : Dr. Rehan Khan
Dept, of Pediatric and preventive dentistry
Ethics is concerned with judging what is right and wrong in human conduct. Dental ethics refers to the moral duties of dentists towards patients, colleagues, and society. Key principles of dental ethics include non-maleficence (do no harm), beneficence (do good), respect for patient autonomy and informed consent, justice, truthfulness, and confidentiality. Unethical practices include using unregistered assistants, falsifying records, improper advertising, and undercharging to solicit patients. Historical events like the Nazi experiments, Tuskegee trials, and Declaration of Helsinki established standards to protect research participants through informed consent and review boards. Adherence to an ethical code is important for maintaining trust in the dental profession.
Behaviour modification techniques aim to reduce dental anxiety in children. Dessensitization involves gradually exposing children to stimuli related to dental treatment, from telling to showing to doing. Modelling allows children to observe appropriate behaviours. Contingency management uses reinforcement to modify behaviour by presenting or withdrawing rewards. Aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint are used as a last resort to manage disruptive behaviour and allow treatment.
This document discusses various behavior management techniques used for pediatric dental patients. It begins by describing behavior modification techniques like desensitization, modeling, and contingency management. It then discusses preappointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, and aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint. Finally, it briefly mentions implosion therapy and retraining approaches. The overall document provides an overview of both non-pharmacological and pharmacological behavior management strategies used in pediatric dentistry.
This document discusses child behavior and behavior management techniques in dentistry. It defines concepts like fear, anxiety, and emotions commonly seen in children. It also describes various classification systems used to assess child behavior and factors that can influence it like parental attitudes. The document outlines non-pharmacological behavior management techniques including communication, modeling, desensitization and contingency management. It discusses practical considerations for behavior management in a dental clinic.
1. Behavior management in pediatric dentistry aims to reduce fear and anxiety in children undergoing dental procedures through various pharmacological and non-pharmacological methods.
2. Non-pharmacological methods include communication techniques like tell-show-do, modeling, positive reinforcement, distraction, voice control, and retraining. Pharmacological methods include conscious sedation using nitrous oxide.
3. The document discusses in detail various emotions in children, factors influencing their behavior, classification of child behaviors, objectives and considerations for nitrous oxide sedation, and contraindications for its use. Non-pharmacological behavior management techniques are emphasized as the primary approach.
Behavioural Management in Pediatric DentistrySwalihaAlthaf
This document provides information on behavioral management techniques used in pediatric dentistry. It defines key terms like behavior, behavior management, behavior shaping, and behavior modification. It then categorizes and describes various non-pharmacological behavior management techniques including communication, use of second language, tell-show-do, desensitization, modeling, behavior shaping, contingency management, distraction, assimilation and coping techniques.
Sigmund Freud's psychosexual theory of development proposed that personality forms from negotiations of psychosexual stages - oral, anal, phallic, latency, and genital. Erik Erikson expanded on this, proposing 8 psychosocial stages from infancy to late adulthood. The first stage, trust vs mistrust, involves infants developing trust if caregivers meet needs consistently. The second, autonomy vs shame and doubt, sees toddlers developing independence if given opportunities to do so with support. The third, initiative vs guilt, involves preschoolers initiating activities if successes are supported versus feeling guilt from failures.
pedodontics.....non pharmacological methods of behaviour managementSurabhi Desai
This document discusses various behavior management techniques used in pediatric dentistry. It defines behavior management as the means by which the dental team performs treatment to instill a positive dental attitude. Factors that influence a child's cooperative behavior like parental anxiety, medical experiences, and communication techniques are described. Methods of behavior shaping include desensitization, modeling, and contingency management. Specific behavior management techniques addressed include audio analgesia, biofeedback, voice control, hypnosis, humor, coping, and aversive conditioning.
The presentation features the understanding of a special child i.e. a physically or mentally challenged child for better assessment of his/her medical and dental problems to provide a proper approach for the specific treatment.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
This document provides guidance on effective behavior management techniques for treating child patients. It discusses the objectives of treating children, which include performing tasks efficiently and safely while instilling positive oral habits. Both pharmacological techniques like sedatives and general anesthesia as well as non-pharmacological techniques like restraint and behavior management are covered. Specific behavior management techniques discussed include humor, distraction, communication, positive reinforcement, and adverse reinforcement. The document emphasizes the importance of effective communication using skills like Tell-Show-Do, reflective listening, self-disclosing assertiveness, and descriptive praise. It provides examples of how to communicate verbally and non-verbally with children."
Dental management of children with special health care needsaravindhanarumugam1
hope this will throw a light in understanding special children and dental management of the same particularly for pediatric dentistry PGs .children with genetic diseases and emotionally handicapped ( child abuse and neglect ) are not discussed here as they are separate topics.
dr. aravindhan
- Traumatic injuries to primary and permanent teeth are common, with maxillary central incisors most frequently affected. Injuries range from enamel fractures to luxations and avulsions.
- Epidemiological studies show that approximately 1/3 of children experience dental trauma to primary teeth and 1/5 experience trauma to permanent teeth. Injuries most often occur from falls at home for young children and from sports for adolescents.
- Proper classification and diagnosis of dental injuries is important to determine appropriate treatment and management. Conditions range from concussion with no displacement to intrusive luxation with tooth displacement into bone.
1. Several classifications of child behavior in dental settings are discussed, including Wilson's, Wright's, and Lampshire's classifications.
2. Factors like age, temperament, home environment, and past dental experiences can influence a child's behavior. Children's behaviors range from cooperative to disruptive.
3. Rating scales like Frankl's and the Houpt scale can be used to assess a child's level of anxiety or cooperation during dental treatment. Understanding a child's behavioral patterns is important for effective behavior guidance.
An Introduction to Special Needs DentistySyafiq Ali
Siti Zaleha Hamzah is a specialist in special needs dentistry based in Hospital Serdang in Malaysia. She provides clinical support for patients with intellectual, physical, medical, and psychiatric conditions. Special needs dentistry focuses on modifying dental treatment for patients with disabilities or medical complexities. It aims to improve oral health and well-being for those with conditions that make regular dental care difficult. Treatment is often provided using behavior management strategies and may involve specialists from other areas.
Non –pharmacological behavior management in childrenDr. Harsh Shah
Overview on nonpharmacological managent of behaviour in children
Presented by : Mayuri Karad
SDDCH Parbhani
Guided by : Dr. Rehan Khan
Dept, of Pediatric and preventive dentistry
Ethics is concerned with judging what is right and wrong in human conduct. Dental ethics refers to the moral duties of dentists towards patients, colleagues, and society. Key principles of dental ethics include non-maleficence (do no harm), beneficence (do good), respect for patient autonomy and informed consent, justice, truthfulness, and confidentiality. Unethical practices include using unregistered assistants, falsifying records, improper advertising, and undercharging to solicit patients. Historical events like the Nazi experiments, Tuskegee trials, and Declaration of Helsinki established standards to protect research participants through informed consent and review boards. Adherence to an ethical code is important for maintaining trust in the dental profession.
Behaviour modification techniques aim to reduce dental anxiety in children. Dessensitization involves gradually exposing children to stimuli related to dental treatment, from telling to showing to doing. Modelling allows children to observe appropriate behaviours. Contingency management uses reinforcement to modify behaviour by presenting or withdrawing rewards. Aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint are used as a last resort to manage disruptive behaviour and allow treatment.
This document discusses various behavior management techniques used for pediatric dental patients. It begins by describing behavior modification techniques like desensitization, modeling, and contingency management. It then discusses preappointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, and aversive conditioning techniques like voice control, hand-over-mouth exercises, and physical restraint. Finally, it briefly mentions implosion therapy and retraining approaches. The overall document provides an overview of both non-pharmacological and pharmacological behavior management strategies used in pediatric dentistry.
Behavior management in dentistry involves pharmacological and non-pharmacological techniques to effectively perform treatment while instilling a positive dental attitude in children. Non-pharmacological techniques include communication, behavior modification using desensitization, modeling and contingency management, and pre-appointment preparation. Behavior modification aims to alter behavior through reinforcement and is based on learning theory. Communication is important for building relationships and helping children feel at ease. Pre-appointment preparation involves preparing children and parents for upcoming visits.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes precautions that must be taken when using stabilization techniques. It then explains in detail various behavior modification techniques like desensitization, modeling, and contingency management. It also discusses aversive conditioning techniques like voice control, hand-over-mouth exercise, and physical restraint. Other topics covered include coping mechanisms, relaxation training, implosion therapy, and retraining approaches.
The document discusses various behavior management techniques used for pediatric dental patients, including desensitization, modeling, and contingency management. It describes in detail aversive conditioning techniques like voice control, hand-over-mouth exercise, and physical restraint. Precautions for patient safety and indications and contraindications for different techniques are provided. The goal is to modify uncooperative behavior and facilitate quality dental treatment.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes precautions that must be taken when using stabilization techniques. It then explains in detail techniques like desensitization, modeling, contingency management, preappointment preparation, coping strategies, relaxation, aversive conditioning including voice control, hand-over-mouth exercise and physical restraint, implosion therapy, and retraining. The goal is to modify undesired behaviors and facilitate quality dental treatment for children.
This document discusses various non-pharmacological behavior management techniques used in pediatric dentistry. It covers communication techniques, behavior modification including desensitization, modeling and contingency management. It also discusses pre-appointment preparation and techniques like voice control, hand-over-mouth exercise, physical restraint, implosion therapy, and retraining that aim to modify disruptive behaviors in children undergoing dental treatment.
This document discusses various non-pharmacological behavior management techniques used for pediatric dental patients. It covers communication strategies, behavior modification techniques like desensitization and modeling, and contingency management using reinforcement. It also discusses aversive conditioning techniques like voice control, the hand-over-mouth exercise, and physical restraint. The goal of these techniques is to establish rapport, modify undesired behaviors, and facilitate dental treatment for children.
This document discusses various non-pharmacological behaviour management techniques used for managing child patients in dentistry. It describes communication, behaviour modification techniques like desensitization, modelling and contingency management. It also discusses pre-appointment behaviour modification, aversive conditioning techniques like voice control, hand-over-mouth exercise and physical restraint. Other techniques mentioned include implosion therapy, relaxation and retraining. The document emphasizes establishing strong communication and using reinforcement to modify undesirable behaviours and help children cope with dental treatment.
This document discusses various behavior modification techniques used in dentistry, including desensitization, modeling, and contingency management. Desensitization involves gradually exposing patients to anxiety-provoking stimuli. Modeling allows patients to observe appropriate behaviors. Contingency management modifies behavior through reinforcement. Other techniques covered include pre-appointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, aversive conditioning using voice control or restraints, implosion therapy, and retraining.
This document discusses various behavior modification techniques used in dentistry, including desensitization, modeling, and contingency management. Desensitization involves gradually exposing patients to anxiety-provoking stimuli. Modeling allows patients to observe appropriate behaviors. Contingency management modifies behavior through reinforcement. Other techniques covered include pre-appointment preparation, audioanalgesia, hypnosis, coping mechanisms, relaxation, aversive conditioning using voice control or hand-over-mouth exercises, physical restraint, implosion therapy, and retraining.
This document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes techniques like voice control, hand-over-mouth exercise, and physical restraint that aim to redirect a child's attention and modify their behavior. It also explains behavior modification methods like desensitization, modeling, and contingency management that use reinforcement to encourage positive behaviors. The document provides details on how to implement these aversive and non-aversive approaches and notes appropriate and contraindicated uses of different restraint techniques.
The document discusses various behavior management techniques used for treating uncooperative pediatric dental patients. It describes techniques like voice control, hand-over-mouth exercise, physical restraint, aversive conditioning, implosion therapy, and retraining. It provides details on how each technique is performed and guidelines on their appropriate usage. The overall aim of these techniques is to modify undesired behaviors and facilitate quality dental treatment for children.
This document discusses various behavior management techniques used in pediatric dentistry. It covers non-pharmacological techniques like minimizing wait times and ensuring adequate pain control. It also discusses pharmacological techniques like local anesthetics and oral/enteral medications. The main behavior management techniques discussed are communication, behavior shaping through desensitization and modeling, and behavior management through voice control, distraction, positive and negative reinforcement, and selective exclusion of parents. Specific techniques like tell-show-do, praise, and rewards are explained in detail. The goals of behavior management are also stated as gaining compliance and redirecting inappropriate behaviors while ensuring patient safety.
1) The document discusses various behavior management techniques used in pediatric dentistry including desensitization, modeling, contingency management, voice control, hand-over-mouth exercise, physical restraint, implosion therapy, and retraining.
2) Desensitization involves exposing children to stimuli related to dental treatment in a gradual, repeated manner to reduce anxiety while modeling and contingency management use reinforcement to encourage positive behaviors.
3) Aversive techniques like voice control, hand-over-mouth exercises, and physical restraint aim to redirect disruptive behavior but require strict guidelines around appropriate use.
NON- PHARMACOLOGICAL BEHAVIOUR MANAGEMENT- part 2(1).pptxdrrishabhkapoor
This document discusses non-pharmacological behavior management techniques for pediatric dentistry. It begins by outlining the objectives of establishing effective communication, gaining the child's confidence, and providing a comfortable environment. Various techniques are described, including communication, behavior shaping, and behavior management methods. Behavior shaping involves modeling, contingency management, and desensitization. Behavior management includes audio analgesia, biofeedback, voice control, hypnosis, humor, coping mechanisms, relaxation, distraction, and aversive conditioning (as a last resort). Physical restraints may also be used in limited situations. The goal is to modify a child's behavior using reinforcement and allow for successful dental treatment.
This document discusses paediatric dentistry and techniques for managing child patient behavior in dental settings. It defines paediatric dentistry and lists its components. It also outlines general principles for child management, including establishing communication and explaining procedures, as well as specific techniques like behaviour shaping, tell-show-do, and protective stabilization. The document provides a historical overview of the field and describes pharmacological and non-pharmacological approaches to sedation and anxiety management in paediatric dental patients.
1) Various behavior management techniques are described including desensitization, modeling, contingency management, and aversive conditioning.
2) Aversive conditioning techniques include voice control, the hand-over-mouth exercise, and physical restraint to redirect a child's attention and reduce avoidance behavior.
3) Behavior modification aims to facilitate cooperation through techniques like preparing the child beforehand, using positive reinforcement, and exposing the child to anxiety-provoking stimuli in a gradual, controlled way until their negative response extinguishes.
This document discusses behaviour management techniques for treating children in a dental setting. It defines behaviour shaping and modification, and outlines the objectives of behaviour management. It describes several classifications of children's behaviour put forth by Frankel, Lampshire and Wright. Non-pharmacological behaviour management methods are outlined, including communication, behaviour shaping techniques like desensitization and modelling, and contingency management. Additional techniques discussed are audio analgesia, biofeedback, voice control, humour, coping strategies, relaxation, hypnosis, implosion therapy and aversive conditioning.
2. CONTENTS
• INTRODUCTION
• DEFINITION
• CLASSIFICATION
• PHARMACOLOGICAL
• NON PHARMACOLOGICAL
1. Communication
2. Behaviour shaping (modification)
i. Desensitization
ii. Modeling
iii. Contingency management
3. Behaviour management
i. Audio analgesia
ii. Biofeed back
iii. Voice control
iv. Hypnosis
v. Humor
vi. Coping
vii. Relaxation
viii. Implosion therapy
ix. Aversive conditioning
• BEHAVIOR MANAGEMENT OF CHILDREN WITH HANDICAPPING CONDITIONS
• CONCLUSION
3. INTRODUCTION
The key to successful orthodontic treatment
is a cooperative patient. To achieve this
prerequisite it is of utmost importance to
discover the actions that will produce the most
positive response from the patient. To determine
a child’s behavior in dental office and the factors
influencing it we must study a child’s mental and
emotional make up that constitute the
“psychology” of that child.
4. DEFINITIONS
PSYCHOLOGY is a branch of science which deals with
mind & mental processes in relation to human &
animal behaviour.
BEHAVIOR MANAGEMENT is defined as the means by
which the dental health team effectively and efficiently
performs dental treatment and thereby instills a
positive dental attitude (Wright 1975)
BEHAVIOR MODIFICATION: defined as the attempt to
alter human behavior and emotion in a beneficial way
and in accordance with the laws of learning.
5. Communication
Types:
Verbal Communication- Speech
Non verbal / Multisensory Communication
Body language
Smiling
Eye contact
Showing concern
Touching
Patting
Hugging
Both using nonverbal and verbal
6. Desensitization
It is accomplished by teaching the child a completing response
such as relaxation and then introducing progressively more
threatening stimuli.
Method popularly used nowadays – Tell shows Do (TSD)
technique (Addleslon 1959). Tell and show every step and
instrument and explain what is going to be done.
Continuously and in grades from the least fear promoting
object or procedure and move in higher grades to more
fearful objects.By having verbal (tell) and nonverbal (show
and do) interactions, available, one can overcome many
small dental related anxieties of any child.
7. Modeling
Introduced by (Bandura 1969) developed from social
learning principle procedure involves allowing a patient
to observe one or more individuals (models) who
demonstrate a positive behavior in a particular
situation.
Modeling can be done by:
Live models – siblings, parents of a child
Filmed models
Posters
Audiovisual aids
8. Contingency Management
It is a method of modifying behavior of children by
presentation or withdrawal of reinforcers.
These reinforcers can be: -
Positive reinforcer- whose contingent presentation
increases the frequency of behavior. (Henry W Fields
1984)
Negative reinforcer – whose contingent withdrawal
increases the frequency of behavior. (Stokes and
Kennedy 1980)
9. Behavior management
Audio analgesia: or “white noise” is a method of reducing Pain (pleasant
music)
This technique consists of providing a sound stimulus of such intensity that
the patient finds it difficult to attend to anything else. (Gardner Licklider
1959)
b) Biofeedback:
It involves the use of certain instruments to detect certain physiological
processes associated with fear (Buonomono 1979). Eg: -
electromyography.
C) Humor:
It helps to elevate the mood of the child, which helps the child to relax.
Functions of humor are – social, emotional, informative, Motivational,
cognitive.
10. Coping:
It is the mechanism by which a child copes up with the dental
treatment. It is defined as the cognitive and behavioral efforts
made by an individual to master, tolerate or reduce stressful
situations. (Lazaue 1980).
Signal system:
In this method as a part of coping, when it hurts, we ask the child to
raise his hand as suggested by Musslemann 1991.
e) Voice control:
It is the modification of intensity and pitch of one’s own voice in an
attempt to dominate the interaction between the dentist and the
child.
11. Aversive Conditioning
It can be a safe and effective way of managing
an extremely negative behavior. Those
dentists who contemplate using it should
obtain parental consent prior to its use
(Patricia P Hagan 1984).
Two Common Methods used are
• Home
• Physical restrains
12. Hand over mouth exercise (HOME)
The behavior modification method of aversive conditioning is also known as HOME.
Introduced by Evangeline Jordan 1920.
The purpose is to gain attention of the child so that communication can be
established.
Indications
A healthy child who can understand but who exhibits defiance and hysterical behavior
during treatment.
3-6 year old children.
A child who can understand simple verbal commands.
Children displaying uncontrollable behavior.
Contraindications
Child under 3 years of age.
Handicapped /immature/frightened child.
Physical, mental, and emotional handicap.
13. PHYSICAL RESTRAINTS
Restraints are usually needed for children who are
hypermotive, stubborn or defiant (Kelly 1976).
It involves restriction of movement of the child’s head,
hands, feet or body.
It is the last resort for handling uncooperative patients or
handicapped patients
It can be
Active – restraints performed by the dentist, staff
or parent without the aid of a restraining device.
Passive – with the aid of restraining device
14. TYPES OF RESTRAINTS
A) For body
Pedi wrap
Papoose board
Sheets
Beanbag with straps
Towel and tapes
For extremities
Velcro straps
Posey straps
Towel and tape
For the head
Head positioner
Forearm body support
Mouth
Mouth blocks
Banded tongue blades
Mouth props
15. PHARMACOLOGICAL METHOD OF
BEHAVIOUR MANAGEMENT
PRE-MEDICATION
• Sedatives and hypnotics
• Anti-anxiety drugs
• Antihistamines
• Conscious sedation
• General anesthesia
16. BEHAVIOR MANAGEMENT OF CHILDREN WITH HANDICAPPING
CONDITIONS
Mental Retardation
It affects 3% of the population, is the most common of the handicapping conditions. It may occur solely
as an intellectual deficiency, it may be one of a combination of disabilities, or it may be one
manifestation of a syndrome (Down’s syndrome).
By definition those who are mentally retarded have a tested intelligence quotient (IQ) of 69 and below.
It is vitally important for the dentist to accept the patient first as an individual and secondly as a patient
with a handicap (Album 1962) the practitioner should attempt to discover from the parents and
others as much as possible about the child. Parents should be asked how they mange the child.
For patients on the lower curve of the IQ scale the dental chair is positioned before the patient is
seated. These patients become easily alarmed when the dental chair is moved.
Since many mentally retarded children have short attention spans, the unmediated child usually does
not tolerate lengthy appointments well. Constant patter, television, or audiovisual instruction
programs can serve as distracters during treatment procedures.
Adapted behavior modification can be used with many mentally retarded children. (Eg: - body language
with the child deficient in verbal skills).
Because mentally deficient children may fail to comprehend they are prone to postoperative soft tissue
biting. Ultra short acting local anesthetics should be used. Nitrous oxide sedation benefits some of
these patients if they accept the mask.
Major sedation and restraints may be required for some mentally retarded children.
17. Convulsive Disorders.
Paroxysmal attacks of unconsciousness or impaired consciousness may occur, usually with a succession
of tonic or clonic muscular spasms.
The dentist should ask a parent if the child’s seizures are under control and if not, how frequently they
occur, when the last seizure occurred and how the parent manages the seizures.
The dentist should contact the child’s physician if the child is taking seizure-control medication.
Sometimes an increase in medication dose before a dental visit prevents seizure occurrence.
Care should be taken to avoid inducing seizures. (Hall 1982) suggests that anxiety, intense light and
intravascular local anesthesia are seizure triggers. Hall recommends sunglasses to reduce the glare
from the operatory light and an aspirating syringe to avoid injection into blood vessels.
A mouth prop consisting of tongue blades wrapped in gauze and heavily taped should be available when
treating epileptic children.
In the event of a seizure all instruments should be removed from the mouth immediately. A rubber dam
can be used with epileptic children.
A restraining device can also be an asset when treating such patients.
Epileptic children should never be left in the operatory unattended.
18. Cerebral Palsy
The incidence of neuromotor disorders ranges from one to five per 1000 live births (1971). Cerebrak
palsy one of the most common of these conditions, is a CNS disorder manifested by impaired motor
function.
While many children with cerebral palsy can walk into the operatory, others are unable to do so. (Parent
assistance should be sought).
The dental chair should be preset in the approximate position desired by the operator before the
patient is seated.
While examining new patients, the dentist should evaluate their muscle movements carefully. It may be
desirable to passively hold a mouth prop, consisting of taped tongue blades, in the oral cavity if
there is concern about the patient involuntarily closing the mouth.
Noise making instrument should be avoided if possible as it increases the involuntary contractions of
the athetoid patient.
Since these patients have poor control of their orofacial musculature, post operative soft tissue biting
can be a problem. Therefore whenever possible the dentist should use ultra short acting
anesthetics. Nitrous oxide sedation may help control movements.
19. Progressive Neuromuscular Disability
Eg: - myotonic dystrophy, muscular dystrophy.
Since these patients may have postural problems. A strap
to hold child on the dental chair is frequently
appreciated.
To provide realistic treatment plans for these patients,
the dentist has to know the prognosis of a child’s
condition.
Since dental health is of secondary importance for many
of these children, the dental hath team has to be
extremely patient and
20. Deafness
Children with hearing handicaps communicate visually through lip reading. In some instances parents
will be required to transmit long complex messages.
Tell show do TSD technique with the following changes is effective with the hearing handicapped :-
Remaining in the child’s view to maximize visual communication.
Speaking with good lip action to convey information from a distance of about 3 feet.
Substituting verbal reinforcement with smiles, squeezing the arm gently etc., to convey the dental
team’s appreciation of a child’s cooperation.
Using the tactile sense.
Because the deaf children can be very impatient with delays, an organized plan of procedure is of
paramount importance.
For older children “magic slate”, a small chalkboard should be available to enhance communication.
The hand mirror is an invaluable aid during most procedures, allowing communication through the
child’s available senses.
21. Blindness
Non sighted or the partially sighted children must
be introduced to foreign environments very
slowly.
Constant voice contact should be maintained with
the blind children.
The “show” portion of behavior shaping is greatly
limited or impossible with blind children. Some of
the modification are-increased use of auditory,
tactile olfactory and taste senses.
22. Autism
This condition which manifests itself early in childhood is characterized by certain
behavioral traits. These children are unresponsive and uncommunicative, take a
greater interest in inanimate objects than in people. Most do not use language
properly, and many do not speak at all.
The autistic child usually creates a difficult management problem from the beginning.
Repeated visits to the dental office for oral hygiene instruction before examination
procedures desensitize autistic children.
A quiet, modulated voice can have a calming effect. Some of them also appear to
accept positive reinforcement such as smile or a pat on shoulder.
The autistic child is distracted easily. Therefore only minimal movements should be
made during treatment.
Some become calm and highly cooperative with the use of a body restraint, which
protects the patient and the dentist.
Since most autistic children do not have medical complications, sedation can be used
with minimum risk.
23. CONCLUSION
A sound knowledge in child psychology and behavior management is essential
for a successful practice. Psychology and behavioral sciences have been an
integral part of orthodontics both in research and in clinical practice since
the early days of this century.
Throughout the course of orthodontic treatment, the orthodontist should
keep in mind the fact the psychological outcome of treatment are as
important as the occlusal and functional outcomes. Producing an excellent
finished result is the primary responsibility of an orthodontist, but
producing happy, self-assured patient is an added opportunity. While
undergoing orthodontic treatment, the child is expected to follow
instruction daily – to wear elastics, head gear, maintain ideal oral hygiene,
endure discomfort, keep regular appointments and refrain from eating
many foods that can be detrimental to the appliances. Therefore
successful child management can only ensure the child to be co-operative,
which in turn results in a complete and desired optimal treatment result.