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
This seminar contains a brief introduction followed by objectives of bahavior management,various definitions,classification,pedodontic triangle,parenting types,Non-pharmacological methods of behavior management in detail with modifications followed by conclusion.
This document provides information on educating and motivating periodontal patients. It discusses the importance of patient education, methods of instruction including demonstrating proper brushing technique and using disclosing agents. Motivation is key to changing patient behavior and various theories of motivation are covered such as self-efficacy and locus of control. Reinforcement is needed over multiple visits to help patients develop good oral hygiene habits. The document also addresses establishing rapport and communication with patients to help them learn.
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.
This document discusses non-pharmacologic behavior management for children in dental settings. It covers goals of behavior guidance which include establishing communication, delivering quality care, building trust, and promoting positive attitudes. Types of fear and how they change with age are described. Behavior management techniques are also outlined, such as communication, desensitization, modeling, distraction, and protective stabilization. The document emphasizes that behavior management is key to acquiring and maintaining a child's cooperation during dental procedures.
The document discusses behavior management in pediatric dentistry. It covers several topics including:
1) The objectives of behavior management which aim to provide painless dental care for children through various techniques.
2) Child development which involves physical, intellectual, social, and emotional growth from conception through young adulthood. Understanding development aids effective communication with children.
3) Factors that influence a child's behavior in the dental setting including their age, the dentist, parental anxiety, past experiences, and the appointment timing and length. Behavior management techniques aim to provide positive dental experiences for children.
This document discusses techniques for managing a child's behavior during dental treatment. It begins by explaining the importance of building trust and guidance for children during dental experiences. There is a focus on understanding age-related traits and skills to improve communication and cooperation. Behavior scales are presented to classify cooperation. Non-pharmacological methods like communication, modeling, positive reinforcement and distraction are outlined. Physical immobilization techniques may be needed in some cases to provide care safely. The goal is to promote positive attitudes towards dentistry from an early age.
This document provides an introduction to pediatric dentistry. It discusses how the field has shifted from extraction-focused to prevention-focused. Pediatric dentistry is still developing in India, with outdated views that baby teeth don't need care. The increasing number of pediatric dentists may help change these views. Key aspects of pediatric dentistry include prevention, early diagnosis/treatment, space maintenance, and managing children with special needs. The importance of primary teeth and the "pedodontic triangle" relationship between the child, parent and dentist are also explained. The document outlines the scope and challenges of pediatric dentistry in areas like prevention, behavior guidance, and caring for disabled children.
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
This seminar contains a brief introduction followed by objectives of bahavior management,various definitions,classification,pedodontic triangle,parenting types,Non-pharmacological methods of behavior management in detail with modifications followed by conclusion.
This document provides information on educating and motivating periodontal patients. It discusses the importance of patient education, methods of instruction including demonstrating proper brushing technique and using disclosing agents. Motivation is key to changing patient behavior and various theories of motivation are covered such as self-efficacy and locus of control. Reinforcement is needed over multiple visits to help patients develop good oral hygiene habits. The document also addresses establishing rapport and communication with patients to help them learn.
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.
This document discusses non-pharmacologic behavior management for children in dental settings. It covers goals of behavior guidance which include establishing communication, delivering quality care, building trust, and promoting positive attitudes. Types of fear and how they change with age are described. Behavior management techniques are also outlined, such as communication, desensitization, modeling, distraction, and protective stabilization. The document emphasizes that behavior management is key to acquiring and maintaining a child's cooperation during dental procedures.
The document discusses behavior management in pediatric dentistry. It covers several topics including:
1) The objectives of behavior management which aim to provide painless dental care for children through various techniques.
2) Child development which involves physical, intellectual, social, and emotional growth from conception through young adulthood. Understanding development aids effective communication with children.
3) Factors that influence a child's behavior in the dental setting including their age, the dentist, parental anxiety, past experiences, and the appointment timing and length. Behavior management techniques aim to provide positive dental experiences for children.
This document discusses techniques for managing a child's behavior during dental treatment. It begins by explaining the importance of building trust and guidance for children during dental experiences. There is a focus on understanding age-related traits and skills to improve communication and cooperation. Behavior scales are presented to classify cooperation. Non-pharmacological methods like communication, modeling, positive reinforcement and distraction are outlined. Physical immobilization techniques may be needed in some cases to provide care safely. The goal is to promote positive attitudes towards dentistry from an early age.
This document provides an introduction to pediatric dentistry. It discusses how the field has shifted from extraction-focused to prevention-focused. Pediatric dentistry is still developing in India, with outdated views that baby teeth don't need care. The increasing number of pediatric dentists may help change these views. Key aspects of pediatric dentistry include prevention, early diagnosis/treatment, space maintenance, and managing children with special needs. The importance of primary teeth and the "pedodontic triangle" relationship between the child, parent and dentist are also explained. The document outlines the scope and challenges of pediatric dentistry in areas like prevention, behavior guidance, and caring for disabled children.
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.
Behavioral sciences and its application to pedodontics
Behavior modification
Behavior Shaping
Communication and communicative guidance
Tell-show-do
Voice control
Nonverbal communication
Positive reinforcement
Distraction
Nitrous oxide/oxygen inhalation
Protective stabilization
Sedation
General anaesthesia
This document discusses various behaviour management techniques used in pediatric dentistry. It begins by defining behaviour management as the means by which the dental team performs treatment to instill positive dental attitudes. Both non-pharmacological and pharmacological methods are discussed. Non-pharmacological methods include communication techniques like behaviour shaping and behaviour management strategies like voice control and relaxation. Pharmacological methods include premedication with sedatives or anti-anxiety drugs and conscious sedation. Effective communication is emphasized as the most fundamental form of behaviour management in dentistry for both cooperative and uncooperative children.
This document provides information on health promotion and education for dental hygienists. It discusses the responsibility of dental hygienists to educate patients on oral health. It also covers principles of learning, motivation, and behavior change theories like the health belief model and transtheoretical model. Examples of effective teaching tools and therapeutic communication techniques are presented. Throughout the document, there is an emphasis on meeting patients where they are at and facilitating behavior change through education and empowerment.
This document summarizes behavioral science concepts related to patient motivation in dentistry. It discusses behavioral theories like classical conditioning, operant conditioning, and social learning theory. It then examines patient behaviors and motivations at different life stages - children, adolescents, adults, and geriatric patients. For each group, factors affecting their behavior are explored along with techniques for behavior management, communication, and motivation. These include psychological approaches like desensitization and modeling as well as pharmacological methods. The goal is to effectively perform treatment while instilling positive dental attitudes.
This document discusses various behavioral management techniques for use with pediatric dental patients. It describes goals of building a relationship through communication between the dentist and patient. Techniques discussed include using voice control, nonverbal cues, the Tell-Show-Do approach, positive reinforcement, distraction, and determining whether parents should be present or absent during treatment. Effective communication is key to establishing authority while preventing uncooperative behavior and creating a positive dental experience for children.
This document discusses psychological growth and development in children from infancy to adolescence. It covers the key periods of development and important behaviors and milestones at each stage. For example, it notes that infancy from birth to 1 year is a critical period for personality development and trust building. It also discusses common behaviors seen in children during dental visits, such as crying, anxiety, resistance and timidity. The document provides several classifications of child behaviors and factors that can influence their behavior, such as their age, dental experiences and parental influences. It emphasizes the importance of effective communication and behavior management techniques in caring for children, such as modeling, positive reinforcement and distraction.
The document provides guidelines for behavior guidance techniques used in pediatric dentistry. It discusses the importance of communication between the dental team and patients/parents to help ease fear and anxiety. A variety of behavior guidance approaches should be tailored to each individual patient based on an assessment of factors like age, dental attitudes, temperament, and previous experiences. When a child's behavior prevents routine care, treatment may be deferred based on dental needs and risks versus benefits. Informed consent is required for techniques beyond communication. The goal is to safely provide quality dental care and promote positive dental attitudes.
This document defines and classifies different types of handicapped children, including those who are physically, mentally, medically, emotionally, or socially handicapped. It discusses the importance of prevention for these children through dietary advice, oral hygiene instruction, fluoride treatment, fissure sealants, and regular checkups. It also emphasizes the need to carefully assess each child's medical history and abilities, consult their physician, and create a treatment plan tailored to the child and family's specific needs and capabilities. Behavioral management may require various techniques depending on the child's cooperation level, from mild sedation to general anesthesia in some cases.
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.
Transforming Care: Share and Learn Webinar – 29 March 2018NHS England
Topic One: "The ERIN Initiative"
Guest speakers: Susan Holloway, NHS Chorley & South Ribble CCG and NHS Greater Preston CCG and Sheila Roberts, Lancashire Care NHS Foundation Trust
The aim of "The ERIN (Education, Resources, Interventions and Networking) Initiative" is to provide a local, accessible, responsive, early assessment and intervention service for children aged 0-5 years who may be placed on the pre-school Autism Spectrum Disorder (ASD) pathway.
This webinar reports on the progress made during a pilot which commenced on 1st October 2017 to implement a service which deals with complex/challenging behaviors of children who may or may not go on to have a diagnosis with autism.
Topic Two: An introduction and brief overview of the Source4Networks platform
Session led by Rob Cockburn, Sustainable Improvement Team, NHS England
This topic provides an introduction and brief overview of the Source4Networks platform and its potential to support the Transforming Care Programme.
Patient management 1 /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document discusses issues related to behavior management for children receiving cochlear implants. It begins by outlining topics covered in pre-implant psychological evaluations, such as family support and expectations. These evaluations help identify children who may benefit from intervention to address behavioral challenges. The document then describes two common childhood disorders, oppositional defiant disorder and ADHD, that can impact success. Finally, it overviews behavioral treatment approaches like modeling, reinforcement, and punishment that can help manage behaviors and facilitate positive implant outcomes.
Sharing Learning and Best Practices Between Professionals Working with Young ...BASPCAN
Assessment and Intervention.
Dora Pereira, PhD and Isabel Silva, PhD
Faculty of Psychology and Education Sciences
University of Coimbra, Coimbra, Portugal
Early childhood dental caries occurs in all racial and socioeconomic groups; however, it tends to be more prevalent in children in families belonging to the low-income group, where it is seen in epidemic proportions. Dental caries results from an overgrowth of specific organisms that are a part of normally occurring human flora. Human dental flora is site specific, and an infant is not colonized until the eruption of the primary dentition at approximately 6 to 30 months of age. The most likely source of inoculation of an infant's dental flora is the mother, or another intimate care provider, shared utensils, etc. Decreasing the level of cariogenic organisms in the mother's dental flora at the time of colonization can significantly impact the child's redisposition to caries. To prevent caries in children, high-risk individuals must be identified at an early age (preferably high-risk mothers during prenatal care), and aggressive strategies should be adopted, including anticipatory guidance, behavior modifications (oral hygiene and feeding practices), and establishment of a dental home by 1 year of age for children deemed at risk.
Non Pharmacological Behavior Management.pptmalti19
This document discusses non-pharmacological behavior management in dentistry. It begins with definitions of key terms like behavior management, behavior modification, and behavioral pedodontics. It then examines factors that influence a child's behavior in the dental office, like the child's medical history, maternal anxiety levels, socioeconomic status, and the dental office environment. The role of the dentist in managing a child's behavior and how the presence or absence of parents can affect treatment is also explored. Physiological responses to anxiety and classifications of child behavior are covered as well.
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.
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.
Behavioral sciences and its application to pedodontics
Behavior modification
Behavior Shaping
Communication and communicative guidance
Tell-show-do
Voice control
Nonverbal communication
Positive reinforcement
Distraction
Nitrous oxide/oxygen inhalation
Protective stabilization
Sedation
General anaesthesia
This document discusses various behaviour management techniques used in pediatric dentistry. It begins by defining behaviour management as the means by which the dental team performs treatment to instill positive dental attitudes. Both non-pharmacological and pharmacological methods are discussed. Non-pharmacological methods include communication techniques like behaviour shaping and behaviour management strategies like voice control and relaxation. Pharmacological methods include premedication with sedatives or anti-anxiety drugs and conscious sedation. Effective communication is emphasized as the most fundamental form of behaviour management in dentistry for both cooperative and uncooperative children.
This document provides information on health promotion and education for dental hygienists. It discusses the responsibility of dental hygienists to educate patients on oral health. It also covers principles of learning, motivation, and behavior change theories like the health belief model and transtheoretical model. Examples of effective teaching tools and therapeutic communication techniques are presented. Throughout the document, there is an emphasis on meeting patients where they are at and facilitating behavior change through education and empowerment.
This document summarizes behavioral science concepts related to patient motivation in dentistry. It discusses behavioral theories like classical conditioning, operant conditioning, and social learning theory. It then examines patient behaviors and motivations at different life stages - children, adolescents, adults, and geriatric patients. For each group, factors affecting their behavior are explored along with techniques for behavior management, communication, and motivation. These include psychological approaches like desensitization and modeling as well as pharmacological methods. The goal is to effectively perform treatment while instilling positive dental attitudes.
This document discusses various behavioral management techniques for use with pediatric dental patients. It describes goals of building a relationship through communication between the dentist and patient. Techniques discussed include using voice control, nonverbal cues, the Tell-Show-Do approach, positive reinforcement, distraction, and determining whether parents should be present or absent during treatment. Effective communication is key to establishing authority while preventing uncooperative behavior and creating a positive dental experience for children.
This document discusses psychological growth and development in children from infancy to adolescence. It covers the key periods of development and important behaviors and milestones at each stage. For example, it notes that infancy from birth to 1 year is a critical period for personality development and trust building. It also discusses common behaviors seen in children during dental visits, such as crying, anxiety, resistance and timidity. The document provides several classifications of child behaviors and factors that can influence their behavior, such as their age, dental experiences and parental influences. It emphasizes the importance of effective communication and behavior management techniques in caring for children, such as modeling, positive reinforcement and distraction.
The document provides guidelines for behavior guidance techniques used in pediatric dentistry. It discusses the importance of communication between the dental team and patients/parents to help ease fear and anxiety. A variety of behavior guidance approaches should be tailored to each individual patient based on an assessment of factors like age, dental attitudes, temperament, and previous experiences. When a child's behavior prevents routine care, treatment may be deferred based on dental needs and risks versus benefits. Informed consent is required for techniques beyond communication. The goal is to safely provide quality dental care and promote positive dental attitudes.
This document defines and classifies different types of handicapped children, including those who are physically, mentally, medically, emotionally, or socially handicapped. It discusses the importance of prevention for these children through dietary advice, oral hygiene instruction, fluoride treatment, fissure sealants, and regular checkups. It also emphasizes the need to carefully assess each child's medical history and abilities, consult their physician, and create a treatment plan tailored to the child and family's specific needs and capabilities. Behavioral management may require various techniques depending on the child's cooperation level, from mild sedation to general anesthesia in some cases.
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.
Transforming Care: Share and Learn Webinar – 29 March 2018NHS England
Topic One: "The ERIN Initiative"
Guest speakers: Susan Holloway, NHS Chorley & South Ribble CCG and NHS Greater Preston CCG and Sheila Roberts, Lancashire Care NHS Foundation Trust
The aim of "The ERIN (Education, Resources, Interventions and Networking) Initiative" is to provide a local, accessible, responsive, early assessment and intervention service for children aged 0-5 years who may be placed on the pre-school Autism Spectrum Disorder (ASD) pathway.
This webinar reports on the progress made during a pilot which commenced on 1st October 2017 to implement a service which deals with complex/challenging behaviors of children who may or may not go on to have a diagnosis with autism.
Topic Two: An introduction and brief overview of the Source4Networks platform
Session led by Rob Cockburn, Sustainable Improvement Team, NHS England
This topic provides an introduction and brief overview of the Source4Networks platform and its potential to support the Transforming Care Programme.
Patient management 1 /certified fixed orthodontic courses by Indian dental ac...Indian dental academy
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.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
This document discusses issues related to behavior management for children receiving cochlear implants. It begins by outlining topics covered in pre-implant psychological evaluations, such as family support and expectations. These evaluations help identify children who may benefit from intervention to address behavioral challenges. The document then describes two common childhood disorders, oppositional defiant disorder and ADHD, that can impact success. Finally, it overviews behavioral treatment approaches like modeling, reinforcement, and punishment that can help manage behaviors and facilitate positive implant outcomes.
Sharing Learning and Best Practices Between Professionals Working with Young ...BASPCAN
Assessment and Intervention.
Dora Pereira, PhD and Isabel Silva, PhD
Faculty of Psychology and Education Sciences
University of Coimbra, Coimbra, Portugal
Early childhood dental caries occurs in all racial and socioeconomic groups; however, it tends to be more prevalent in children in families belonging to the low-income group, where it is seen in epidemic proportions. Dental caries results from an overgrowth of specific organisms that are a part of normally occurring human flora. Human dental flora is site specific, and an infant is not colonized until the eruption of the primary dentition at approximately 6 to 30 months of age. The most likely source of inoculation of an infant's dental flora is the mother, or another intimate care provider, shared utensils, etc. Decreasing the level of cariogenic organisms in the mother's dental flora at the time of colonization can significantly impact the child's redisposition to caries. To prevent caries in children, high-risk individuals must be identified at an early age (preferably high-risk mothers during prenatal care), and aggressive strategies should be adopted, including anticipatory guidance, behavior modifications (oral hygiene and feeding practices), and establishment of a dental home by 1 year of age for children deemed at risk.
Non Pharmacological Behavior Management.pptmalti19
This document discusses non-pharmacological behavior management in dentistry. It begins with definitions of key terms like behavior management, behavior modification, and behavioral pedodontics. It then examines factors that influence a child's behavior in the dental office, like the child's medical history, maternal anxiety levels, socioeconomic status, and the dental office environment. The role of the dentist in managing a child's behavior and how the presence or absence of parents can affect treatment is also explored. Physiological responses to anxiety and classifications of child behavior are covered as well.
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.
Similar to Factors Affecting child behavior in Pediatric Dentistry (20)
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Spontaneous Bacterial Peritonitis - Pathogenesis , Clinical Features & Manage...Jim Jacob Roy
In this presentation , SBP ( spontaneous bacterial peritonitis ) , which is a common complication in patients with cirrhosis and ascites is described in detail.
The reference for this presentation is Sleisenger and Fordtran's Gastrointestinal and Liver Disease Textbook ( 11th edition ).
Debunking Nutrition Myths: Separating Fact from Fiction"AlexandraDiaz101
In a world overflowing with diet trends and conflicting nutrition advice, it’s easy to get lost in misinformation. This article cuts through the noise to debunk common nutrition myths that may be sabotaging your health goals. From the truth about carbohydrates and fats to the real effects of sugar and artificial sweeteners, we break down what science actually says. Equip yourself with knowledge to make informed decisions about your diet, and learn how to navigate the complexities of modern nutrition with confidence. Say goodbye to food confusion and hello to a healthier you!
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
2. Introduction
Successful dentistry for children depends not only upon the dentist's
technical skills but also upon his ability to acquire and maintain a child's
cooperation. Most children strive to be cooperative; in these instances,
the dentist should support the child's behaviour.
When a child is uncooperative, however, his behaviour must be altered
and controlled.
2
3. • Behaviour- is any activity that can be observed, recorded, and measured. It is an
observable act or any change in the functioning of an organism.
• Behavioral pedodontics- is the study of science that helps to understand
development of fear, anxiety, anger, and associated acts as it applies to the child in
the dental situation.
• Behavior guidance- is a continuum of interaction involving the dentist, the dental
team, the patient, and the parent directed toward communication and education
“which ultimately builds trust and allays fear and anxiety”
• Behavior management- is the means by which the dental health team effectively
and efficiently performs treatment for a child and, at the same time, instills a
positive dental attitude (Wright, 1975)
• Behavior modification -is defined as the attempt to alter human behavior and
emotion in a beneficial manner according to the laws of modern learning theory
(Eysenck, 1964)
• ™
Behaviour shaping is the procedure, which slowly develops behavior by reinforcing
a successive approximation of the desired behavior until the desired behavior
comes into being, for example, desensitization, tell–show–do (TSD), modeling,
distraction, contingency management.
3
4. Classification of child behavior in dental office-
One of the cornerstones in practicing pediatric dentistry is
the ability to guide children positively throughout their dental
experience and encourage a positive dental attitude to
improve their oral health.
Assessment and management of children based on their
behavior are the most important skills for a pediatric dentist.
It is important for pediatric dentists to assess and evaluate
psychological, personal traits, and behavioral responses of the
child, as they play a major role in the management of dental
anxiety and fear.
Evaluation of the child’s behavior serves as an aid in directing
individualized behavior guidance approach that facilitates
dental treatment and provides a means for systematically
recording behaviors for future appointments.
4
5. • Numerous systems have been developed for
classifying children’s behavior in the dental
environment. The knowledge of these systems holds
more than academic interest and can be an asset to
clinicians in two ways: it can assist in evaluating the
validity of current research, and it can provide a
systematic means for recording patients’
behaviours.
• When a clinician treats a child patient, the first issue
of concern is the child’s behavior. The clinician has
to classify the behavior (mentally at least) to help
guide the management approach.
• There is wide variation between classification
systems. One of the first was described by Wilson
(1933), who listed four classes of behavior— normal
or bold, bashful or timid, hysterical, and rebellious.
During the same year, sands wrote that children
were of five types—hypersensitive or alert, nervous,
fearful, physically unfit, and stubborn.
5
6. One of the most widely used systems was introduced by Frankl et al. in 1962. It is
referred to as the Frankl Behavioral Rating Scale.
• The Frankl classification method is often
considered the gold standard in clinical rating
scales.
• Its popularity as a research tool has stemmed
from 3 features.
• First, it is functional, as has been demonstrated
through repeated usage.
• Second, it is quantifiable. Since it has four
categorizations, numerical values can be assigned
to the observed behavior.
• Finally, it is reliable. A high level of agreement
among observers can be obtained. In fact, many
investigations using this tool have shown the level
of agreement to be 85% or higher—a very
acceptable level in this type of research. These are
the criteria for a measurement tool that are
necessary for a successful investigation. 6
7. • Wright in 1975 suggested that a symbol be added to this
rating scale, permitting the dentist to record a behaviour
base at the inception of dental treatment and to keep a
progressive record of the child’s behaviour.
• Wright (1975) gave the symbols to Frankl’s four types of
behaviour. They also gave a right sided arrow mark (→)
indicating the change in behaviour in the dental operatory
(due to fear or behaviour guidance)
7
9. Wright’s Classification (1975)
1. Cooperative behavior
2. Lacking cooperative behavior
3. Potentially cooperative behaviour( 5 subtypes )
• Incorrigible/uncontrolled behaviour: This is typically presented by 3–4 years old children at their first dental visit
or by older children at the time of injection. There is loud crying, kicking, and temper tantrums.
• Defiant/obstinate behaviour: This child has been termed as “spoiled kid” by Lampshire in 1970. He controls his
behavior in a sense by challenging the authority of the dentist. Typical responses are “I do not want my teeth
fixed” or “you cannot make me open my mouth.” These children have potentially severe emotional problems
that are manifested at home, school, and other areas of life.
• Timid behaviour: Often expressed by young children, particularly at the initial dental appointment. It is a result
of child’s anxiety about the dental experience and how he is expected to perform in the office. The child’s
anxiety may prevent him from listening attentively to the dentist, so instruction must be given slowly, quietly,
and repeated when necessary. Once the child gains confidence in the dentist, he can become excellent patient.
9
10. • Tense cooperative- borderline behaviour: They are extremely tensed; body language is different;
tremor in voice; sweating palms, hands. They can be cooperative if behaviour is managed well.
• Whining behaviour- The child with this type of behaviour can be extremely frustrating to treat. He
allows treatment, but he whines throughout the entire procedure.
4. Stoic behaviour- is a type of behaviour commonly mistaken to be a part of potentially
cooperative group. The child is generally cooperative, sits quietly, and accepts all dental
treatment including the injection without protest or any sign of discomfort. This behavior is
characteristic of children who have been physically abused.
10
11. Pinkham’s Classification-
• Category I: Emotionally compromised child
• Category II: Shy, introvert child
• Category III: Frightened child
• Category IV: Child who is adverse to authority
11
13. Pedodontic Treatment Triangle
• Conventional Model-
Patient-doctor relation in adults is linear, but in
pedodontics, the relation is triangular. This is
because in pedodontics, the parent and the child
both are involved and child is at the apex of triangle
as he is the focus of attention. This was first
elaborated best in the pediatric dentistry treatment
triangle given by Wright in 1975. The arrows
indicated that the communication is not only limited
to the benefit of the child but is reciprocal in nature.
13
14. Modified Model
• As community has become a major
part of all components of environment;
therefore, recently, a new parameter
has also been added, that is, society.
• This depiction looked complete with
the fact that the communication is
reciprocal and society came into the
center of the triangle indicating that
management methods acceptable to
society and the litigiousness of society
are important factors influencing
treatment modalities
14
15. • An authoritative or over indulgent
parent always tries to interfere in
the conversation between the
dentist and the child by answering
on behalf of the child.
• As a consequence, there is more
interaction between the parent
and the dentist hence the
equilateral triangle is replaced by
isosceles triangle .
15
16. • If the parent is negligent, then the conversation between the parent
and the dentist may not be reciprocal effectively; hence, right-angled
triangle replaces the normal equilateral triangle.
16
17. Pediatric Dentistry Treatment Model
• Padmanabhan et al. have proposed a new model based on the
pedodontic triangle and have termed it pediatric dentistry treatment
model.It presents the former triangle as a square which has the pediatric
dentist, pediatrician, family and society playing important roles and
definitely the child patient is the center of attention.
• Pediatric dentistry is an amalgamation of all the branches of dentistry and
most of its components have been either derived from or associated with
other dentistry branches, but the four principles that stand out in this
specialty are prevention, risk assessment and management, child
psychology and behavior management.
17
18. Factors which affect child’s behavior at the dental office
Under control of the dentist Out of control of the dentist Under the control of parents
Effect of dental office environment. Growth & Development Home environment
Effect of dentist’s activity & attitude Nutritional factors Family development & peer
influence
Dentist’s attire Past dental experiences Maternal behavior
Presence/Absence of parents in the
operatory
genetics
Presence of an older sibling School environment
Socioeconomic status
18
19. Dental Office Environment-
Bohuslov (1970) stated that psychological preparation of the child is based on the physical environment. Since the
child may enter the dental office with some fear, the first objective of the dentist should be to put the child at his
ease and make him realize that his experience is not unusual.
Finn summarized the following factors related to the dental office which influence child’s behaviour:
Waiting room should be made in respect to home environment
Make the reception room comfortable, so that the room is not foreign to them
Have library with books for children of all ages
Simple but sturdy toys must be kept to amuse very small children
A handy record player with well-chosen records will provide comfort for a frightened child
Appointment cards and announcements should be made attractive to children
A sketch of some cartoon on card helps
Operating room may be made more appealing to the child if a few pictures on the wall are suggestive of child at
play. A portrait of a carefree and laughing child is good
Have an assistant skilled in making animals object out of cotton rolls
Try to avoid the child patient, seeing anybody expressing in pain or sight of blood on others
19
20. Effect of dentist’s activity and attitudes
• The dentist should form a good impression on the child.
• The dentist should avoid jerky and quick movements and should be fluent
in his words and actions.
• Jenks (1964) has described 6 categories of activities by which the dentist
can enhance co-operation in children.
A) Data gathering and observation-
This involves collecting the type of information about a child and his parents
that can be obtained by a formal or informal office interview or by a written
questionnaire . Observation includes noting the behavior of the child as he
steps into the dental office during history taking and while the dental
procedure is being carried out.
20
21. B) Structuring- Refers to establishing certain guidelines of behaviour set by
the dentist and his team to the child so that the child knows what to expect
and how to react.
C) Externalization- It is the process by which child’s attention is focused away
from the sensations associated with the dental treatment . There are 2
components of externalization- Distraction, involvement
The objective is to interest and involve the child, but at the same time not to
let him into verbal or motor discharges, which might interfere with the
necessary procedure.
D) Empathy and support- Empathy is the capacity to understand and to
experience the feelings of another without losing one’s own objectivity .
Dentist must have the sensitivity and capacity to respond to the child’s
feelings.
E) Flexible authority- This includes compromises made by the dentist to meet
the needs of the particular patient.
F) Education and training 21
22. Effect of dentist’s attire
• If a child has previously
experienced a stressful situation ,
which includes the presence of
someone in white attire such as a
physician , the mere presence of a
white clothed individual would be
sufficient to evoke a negative
behaviour.
22
23. Presence of an older sibling
• An older sibling serves as a role model in a dental situation.
Presence of an older sibling has-
• Little effect on behavior of a 3 yr. old patient.
• No effect in case of 5 yr. old patients
• Most noticeable effect among 4 yr. olds
23
24. • Medical History- When studying a child’s medical experience, it is the emotional quality of past visits rather than
the number of visits to the physician that is significant. If the patient views a physician favourably, then the child is
likely to have less apprehension when visiting the dentist. Fears can thus be transferred from one situation to
another.
• Maternal Anxiety -In past years, it has been customary for mothers more often than fathers to accompany
children on a visit to the dentist; therefore, maternal anxiety was considered important. Highly anxious mother
had a negative influence on the child.
• Family and Peer Influence- Socioeconomic status of the family directly affects child’s attitude toward the values of
the dental health process. Those of low socioeconomic class, below average education, have a tendency to attend
dental needs when symptom dictates. These families harbour anxiety from dental treatment and these children
take on these fear and tend to be less cooperative. On the other hand if financial and educational means are
ample, families value good dental health easily established in preventive program.
24
25. Growth and Development-
A child’s chronological age plays a significant role in growth and developmental patterns. Younger the child, more atypical
will be the response. The intellectual age of 3 years signifies a maturational readiness to accept dental treatment.
Personal Factors-
Temperament and general fearfulness are some of the personal characters which are known to influence the behavior of the
child.
Environmental Factors-
Toxic stress is the “result of strong, frequent, or prolonged activation of the body’s stress response systems in the absence
of the buffering protection of a supportive adult relationship. "This type of stress may be a result of child abuse and
neglect, exposure to violence, poverty, or maternal depression. Exposure can begin prenatally and can result in lasting
changes to the neural architecture, resulting in persistent developmental and physiologic harm and increasing risks for
lifelong chronic diseases.
Evidence suggests individual differences are present in physiologic reactivity to stress, as measured by the amount of
corticotropin hormone released in stressful situations. Some children, dubbed dandelion children, are low reactors and
exhibit little physiologic change when presented with toxic stress, but other children, dubbed orchid children, exhibit
extreme physiologic changes (i.e., high reactors).
Various environmental factors like age of the child, socioeconomic status, family situation, frequent exposure to invasive
medical care, past experience of operative dental care, etc. have been identified to influence the child’s behaviour.
However, parental dental fear has been noted to be the most influencing factor amongst all environmental factors.
Klingberg (2007) observed cooperative children were fearful and uncooperative children were non-fearful. This indicated
that the children with behaviour management issues need not always be fearful. 25
26. Parenting styles & child behaviour
Baumrind defined following specific parenting styles—
• Positive behavior has been associated with
children of authoritative parents compared
with children of authoritarian and permissive
parents.
• Aminabadi et al. found a positive correlation
between authoritative parenting style and
positive child behavior and a correlation
between permissive parenting and negative
behaviors.
• Krikken et al. did not find an impact on child
behavior and anxiety associated with
parenting style, although for one group of
children, they did find increased anxiety with
authoritarian parenting style.
26
27. Cultural Influence on Parenting Style-
• Parenting styles and practices hold psychological and cultural meanings and vary between cultures.
For example, parental harshness (hostile behavior and/or physical punishment) carries a message of
care and concern within a culture valuing strict behavior controls and high expectations for children’s
behavior. However, in a less strict culture holding lower expectations for children’s behavior, it
carries a message of unsympathetic criticism (Ho et al. 2008). It was initially suggested that
Authoritative parenting likely would result in good psychosocial outcomes for children from all
ethnic and cultural groups.
• Some studies, however, have found better outcomes associated with the Authoritarian parenting
style, depending on family context and culture (Deater-Deckard et al. 1996; Ho et al. 2008).
• No investigation in any culture has reported consistent positive social outcomes for children of any
age with the Permissive or Neglectful parenting styles; this may be due to lack of rules and limits
upon the child’s conduct, which communicate which child behaviors are desired and expected and
which actions are unacceptable.
• Sociologists and educators have noted an increase in the Permissive parenting type in many
countries, including the United States (Long 2004).
27
28. • In traditional parenting models (Authoritarian, Authoritative), the adult
determines, communicates, clarifies, and enforces rules for the child.
In families with the Permissive parenting style, children question adult
authority and a “the child should feel good” ethos permeates family
life and parent decisions. Permissive parents are generally well-
intentioned, want to be nice, and would like their children to be happy
doing what they want to do. In some cases, the Permissive parent
attempts to become a friend to their child, abrogating the traditional
parental role of socialization.
• The term “helicopter parent” is employed in the popular lexicon to
describe a parent who is attentive, hovering, and available to rescue
their child from the consequences of any poor decisions or actions
(Cline and Fay 1990). Today’s ever-present cell phones have made it
inexpensive and simple for parents to stay connected to their child,
even when physically separated. It is theorized that the extension of
the usual time period of parent-child close connection may prolong
the child and young adult’s dependence upon parent and family
resources.
• There is no single “best” parenting style universal to all children. It is
believed that a child’s internal state of fear, arousal, and anxiety is
integral to their receptiveness to social learning; the best child
outcomes appear to result when a parent’s style is in harmony with
the child’s temperament.
28
29. Child Influence on the Parent
• The parent-child relationship is reciprocal, with each influencing the other’s thoughts, feelings, and behavior.
Parents and children develop a long history of interaction; each acquires a set of expectations concerning the
other’s behavior and establishes a method of interpreting the other’s reactions.
• Disruptive behavior in a toddler holds less consequence, risk to the child, and threat to the parent than
disruptive behavior in a teenager. Parenting affects children’s behavior most strongly during early childhood
(Slagt et al. 2012) while problematic adolescent behavior strongly affects parenting (Reitz et al. 2006). Parental
sense of competence is defined as a parent’s opinion of her ability to positively influence the behavior and
development of her child (Coleman and Karraker 1998).
• Social relations theory views children as active agents in their interactions with parents and assumes that
disagreements, conflicts and changes occur frequently. It is developmentally normal for children to resist some
of the socialization demands of their parents (Goh and Kuczynski 2009). A parent’s philosophy of parenting
(style) and behaviors (parenting practices) will determine the degree of parent accommodation and submission
to the natural resistance of the child.
• It has been observed that a child’s status and power is higher in single-child homes.
29
30. Application in Clinical Dental Practice-
• The dentist and staff should continually monitor the ambient emotional tone in the office and quickly intervene
in cases of negative emotional expression by parents. A parent who verbally or nonverbally expresses the stress
of a bad day is not emotionally available to help his child and may unintentionally sabotage that child’s dental
appointment.
• If the dentist or staff member’s sincere and respectful attempt to redirect the parent to the intended positive
purpose of the dental appointment is unsuccessful, the parent should be offered the opportunity to reschedule
at a time when they are more in control.
Sibling Influences-
Throughout life, the sibling relationship may be cooperative, ambivalent, or antagonistic. The child grows and
develops within a dynamic and variable family context across time. Multiple studies have confirmed that families
differentially distribute such resources as parental time, attention, money, nurturance, and love among the
children in a family. Parents tend to concentrate resources on some children and not on others.
Parent resource inequity between siblings has been examined based on birth order, child gender, sibling gender,
birth spacing, and birth intention (wanted versus unwanted pregnancy). Unintended children have been found to
receive fewer parent resources than intended siblings (Barber and East 2009).
Unwanted children are more likely to receive critical, punitive, abusive, and/or neglectful parenting (Barber et al.
1999). Inequitable treatment by parents has been found to have significant long-term negative effects on the
adjustment and self-esteem of the slighted child. (McGuire et al. 1995; Volling and Elins, 1998).
30
31. • Arrival of an infant has been found to adversely affect mother-to-older-sibling
interactions with decreased maternal attention, positive affection, and
attachment security, and often results in confrontations with the older child. It
is theorized that increased behavior problems of the older child are mediated
through changes in the mother-child relationship, particularly through
increases in the mother’s use of physical discipline (Volling 2005).
• It is important for the dentist to recognize the disruption and stress caused by
new sibling(s) in the home and to realize that the transition of a child to the
role of “big brother or big sister” comes at the cost of diminished parental
attention. The child patient may show signs of stress in their new role and
behave in a negative way to capture their parent’s attention. The goal should
be to keep the focus and nurturing of the dental team directed toward the
child patient, rather than on the newest family member and parent. The child
patient can be invited to introduce his new sibling to the dentist or staff
member. Examples of child-focused responses are: “It is nice to meet your
new sister, but today, you are the special one!” and “This is a very lucky baby
to have you for their own big brother!” 31
32. Maternal influence on child’s dental behaviour-
• While both the father and mother play important roles in their children's
psychologic development , emphasis has usually been placed on the role of
the mother. This is because mothers generally have more contact with their
children than do fathers.
• Maternal influences on children's mental, physical, and emotional
development begin even before birth. It is well known that a mother's
nutritional status as well as the state of physical health can affect the
neurologic and somatic development of the foetus.
• The expectant mother’s emotional state has also been correlated with
certain postnatal behavioural patterns of the child.
• It is believed that the foetus may be influenced by changes in the mother's
neurohormonal system, which are transmitted through the placenta.
Montagu has emphasized the importance of the prenatal environment on
the later development of the child. He cites a study linking stimulation of the
foetus to postnatal feeding difficulty, and another study in which mothers
who underwent severe emotional stress during pregnancy tended to have
excessively active, irritable infants.
32
33. MATERNAL INFLUENCE ON PERSONALITY DEVELOPMENT-
• While children's behaviour can influence the behaviour of mothers, research into parent-child
relationships usually views the parent as the independent variable and the child as the
dependent one. Bell has termed this relationship "one-tailed," since parental characteristics are
viewed as having a unilateral influence on those developing in the child.
• Bayley and Schaefer indicate that most of the relevant mother-child relationships fall into two
broad çategories: autonomy vs control and
hostility vs love .
• Maternal attitudes and behaviors have been described and rated in relation to these two
categories, and Schaefer has developed a model in which gradations of maternal behavior are
arranged sequentially around the two reference pairings of autonomy vs control and hostility vs
love.
33
34. o The behaviour of mothers who participated in the
Berkeley Growth Study was rated according to the
attitudes depicted in the Schaefer model. The
mothers' attitudes were then correlated with the
behaviour of their sons. While there were some
differences associated with the children's ages and
other variable it was found that loving mothers
tended to have calm, happy sons, while hostile
mothers had sons who were excitable and
unhappy.
In general, mothers who allowed autonomy and
who expressed affection had sons who were
friendly, cooperative, and attentive.
Conversely, punitive mothers and those who
ignored their children did not have sons who
exhibited these positive behavioural characteristics.
The dental implications of the effects of maternal
attitudes-in moulding children's personalities are
apparent, as the friendly, cooperative child will
probably also exhibit these traits in the dental
office.
34
Love
35. EFFECT OF THE MOTHER'S PRESENCE IN THE OPERATORY-
• Many dentists prefer to exclude parents from the operatory. This attitude was confirmed in a
study by Roder and co-workers, who sent questionnaires to 910 dentists to determine whether
they preferred to treat children with the parent’s presence or absence. Nearly 70% of the dentists
responded that they preferred to treat children with the parents absent; only 40 preferred the
parents present.
• It was concluded that the presence of the mother during the treatment of a well-behaved child
does not increase the dentist's anxiety; thus, anxiety is probably not the reason the majority of
dentists prefer to exclude parents from the operatory, it is quite probable that dentists generally
prefer to have parents absent from the operating room while children are being treated because
children behave satisfactorily without a parent present.
35
38. Effect of the Parental Presence in the Operatory-
• It is quite probable that dentists generally prefer to have parents absent from the operating room while
children are being treated because most children behave satisfactorily without parental presence. In fact,
as children get older and develop emotional independence, they themselves prefer they have their parent
remain in the waiting room.
• If a child exhibits uncooperative behaviour, the presence of the parent will sometimes lend support to this
type of behaviour and it can also limit the range of behaviour control techniques of the dentist. Parent
should not, however, be routinely excluded from the operatory as there are certain occasions when their
presence is desirable and actually enhances positive behaviour on the part of child
• Frankl found that children in age group of 42–49 months are benefited from mother’s presence.
• Young children are more prone to a number of fears, like fear of unknown, and hence exhibit anxiety
during short-term separation and the degree of response is affected by length of separations.
38
39. Crying in the dental office-
• It is not uncommon to witness a child who is crying while in the dental
chair. All crying, however, should not communicate the same message
to the dentist.
Elsbach has described four types of children's cries:
• Obstinate cry- child who ""throws a temper tantrum" to thwart dental
treatment exhibits the obstinate cry. This cry is loud, high-pitched, and
has been characterized as a siren-like wail. This form of belligerence
represents the child's external response to his anxiety in the dental
situation.
• Frightened cry- The frightened cry is usually accompanied by a torrent
of tears and convulsive, breath-catching sobs. The child emitting this
type of cry has been overwhelmed by the situation. This child cannot
be managed with the same techniques that would be used for the
belligerent child. It is the dentist's responsibility to instill confidence in
the frightened child by providing a series of carefully structured dental
experiences that will allow the child to cope. 39
40. • Hurt cry- The hurt cry may be loud; more frequently, however, it
is accompanied by a small whimper. The first indication that the
child is in discomfort may be a single tear welling from the corner
of the eye and running down the child's cheek. The hurt cry is
easily identified because the child will state, either voluntarily or
when asked, that he is being hurt. Some children may be in pain
but may control their physical activity so that the dentist is
unaware of a problem.
• Compensatory cry- compensatory cry as "not really a cry at all. It
is a sound the child makes to drown out the noise of the dentist's
drill.*"* Usually the sound is a droning monotone. While it may
be annoying to the dentist, it is the child's way of coping with
what he considers unpleasant auditory stimuli. The dentist
should recognize the compensatory as a strategy the child has
developed to cope with the anxiety that he is experiencing. It is a
successful coping stratagem, and therefore the dentist should
make no attempt to stop it.
40
41. Parental Behaviour in the Dental Office -
• Parental behaviour in the dental office also plays an important role in child management. Parents must
understand that once the child is in the office, the dentist knows how to prepare the child emotionally for
the necessary treatment. If a parent is invited into the treatment room, he must assume the role of a passive
guest and either sit or stand away from the chair.
Some instructions that should be told to the parents are:
• Tell the parents not to voice their own personal fears in front of the child
• Tell the parents never to use dentistry as a threat of punishment
• Parents should familiarize their children with dentistry by taking the child to the dentist to
become accustomed to the dental office and the dentist.
• Explain to the parent that an occasional display of courage on his part in dental matters will build
courage in the child
41
42. • Consult the parent about the home environment and the importance of moderate
parental attitudes in building well-adjusted child
• Parents should stress the value of regular dental care, not only in preserving the teeth
but also in formation of good dental patients
• Discourage parents from bribing their child to go to the dentist
• The parent should be instructed never to shame or ridicule to overcome the fear
• The parent should not promise the child what the dentist is or is not going to do
• Several days before the appointment, the parent should be instructed to convey to the
child in a casual manner that they have been invited to visit the dentist.
42
43. Parent–Child Separation
• Wright noted that excluding the parent from the operating room could contribute in controlling the
child’s positive behavior. Most dentists probably are more relaxed and comfortable when parent
remains in the reception area and their action has positive effect on children’s behavior.
• Some factors which influence the dentist not to include parent in the operatory are:
Parents often repeat orders, creating an annoyance for both dentist and child patient
Parents impose orders, becoming a barrier to the development of rapport between the dentist and
child
Dentist is unable to use voice intonation in the presence of the parent because he may be offended
Child divides attention between parent and dentist
Dentist’s attention is divided between parent and child.
43
44. Demographics-
Most studies find that negative behavior in the dental office is most intense in younger children and
decreases as children grow older. Dental anxiety also decreases as the child grows older, as does needle
phobia, most likely due to maturing communication and coping skills. However, it is important to assess the
patient’s degree of psychological development because that may be more important than chronologic age
when predicting disruptive behavior.
The role of gender in dental anxiety and misbehavior is not as clear. The majority of studies found increased
anxiety in females, particularly after children pass early school age,while others found no difference.
Klingberg and Broberg concluded in a 2007 review of the literature that a clear trend exists, with girls being
both more dentally anxious and exhibiting more behavior management problems, which was in contrast
with an early 1982 review where no clear difference in gender was found. This may be in part due to
increased willingness for females to verbalize fears because of cultural norms for gender.
44
45. ROLE OF DENTIST IN CHILD’S BEHAVIOUR-
Appearance of dental office:
Make one corner of waiting room for the child
only where he can play, sit, and read
Record player playing soothing music to ease fear
Appointment cards to be appealing to the child
Operating room should be appealing to the child
having cartoon and pictures on walls
Time and length of appointment: Better to have
morning appointments and also prevent
appointments during the child’s sleeping, playing,
or eating time. Duration should be short.
45
46. • Dentist’s skill and speed: Dentist should be skilled or he will lose the child’s
confidence
• Attention to patient: Treat the patient as he is the only one seen during that day.
Never leave him alone in chair and do not change rooms as all this increases
anxiety
• Dentist’s conversation: Keep talking to the child to gain his confidence. Use
simple words and answer all questions.
• Use of simple words: Do not use fear promoting words like needle, injection
• Reasonableness of dentist: Be realistic and reasonable. Try to put yourself in the
child’s place and see why he behaves in this particular way.
• Use of admiration, subtle flattering, praise, and reward: Enforces the behavior
for future
• Self-control of dentist: Dentist should never lose his temper. It is a mark of
defeat and indication to child that he has succeeded in undermining your dignity
46
47. References
• Behavior Management in Dentistry for Children , Edited by Gerald Z. Wright
Ari Kupietzky
• Ripa LW, Barenie JT. Management of Dental Behavior in Children. 1979.
• Casamassimo PS, Fields HW, McTigue DJ, Nowak A. Pediatric Dentistry -
,Infancy through Adolescence,5. Elsevier Health Sciences; 2012.
• Dean JA. McDonald and Avery’s Dentistry for the Child and Adolescent - E-
Book. Elsevier Health Sciences; 2021.
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• Arathi Rao, Principles & practice in Pedodotics
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