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 term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
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
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.
The term serial extraction describes an orthodontic treatment procedure that involves the orderly removal of selected deciduous and permanent teeth in a predetermined sequence
Stainless steel crowns in Pediatric DentistryRajesh Bariker
A crown is a tooth shaped covering which is cemented to the tooth structure & its main function is to protect the tooth structure & retain the function
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
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.
child management, child behavior, behavior management, age development, psychological development, child psychology, child psychological development, children in dentistry clinical management of children
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
Communication with Children and Young Patients in MedicinesNawras AlHalabi
مهارات التواصل مع الأطفال والمرضى الصغار في الطّبّ
كلية الطب البشري في الجامعة السورية الخاصة
Please LIKE my page! http://facebook.com/NawrasAlHalabi
2014
Faculty of medicine of Syrian Private University.
Behavioral Management Technique For Patient With Special Needs DrGhadooRa
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Stressor and effect of hospitaliztion on child and familymanishasammal
INTRODUCTION
It is a stressful experience for both children and their family. Hospitalization leads to interruption of child’s active growth and development. The child is removed from daily routine loss of contact with siblings, relatives and pers.
DEFINITION
A stressor is any event or stimulus that causes an individual to experience stress.
“Barbara kozier”
Stress is the pressure experienced by a person in response to life demands. Selye
This PowerPoint leads on from my other PowerPoint which talks about cognitive psychology. Now I provide you with everything you need to know for AQA students studying for PSYA1 (unit 1) AS PSYCHOLOGY
At the end of unit 2, the students will be able to:
Appreciate the differences between children and adult
Describe the hospital environment for a sick child
Explain the impact of hospitalization on child
Discuss the grief and bereavement
Outline the role of a child health nurse
Explain the principles of pre- and post-operative care for children
Perform pain assessment in children
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- 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
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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1. Psychological growth
• Every child has a rhythm & style of growth
and no two children, even in same family,
develop in exactly the same pattern
• The psychological & physiologic age of the
child must be considered in the diagnosis of
behavior problems& treatment planning
Infancy period (Birth to 1 year)
Toddler hood period (1 to 3 years)
Preschool period (3 to 6 years)
School period (6 to 12 years)
Adolescent years (12 to 19 years)
2. Infancy period (Birth to 1 year)
• Infancy represents the first critical period for
personality growth & the development of a
sense of trust. Then develop feelings of security
that last throughout life.
• At the age of 6 months (teething ,bite on
anything)
• Prenatal teeth
• Child clinical exam can be done by:
1) Seating on his mother's legs on the dental
chair, Or
2) The child is placed in-between the mother
&the dentist on other chair.
3. Toddler hood period (1 to 3 years)
• The child moves from the sensori-motor
stage (in infancy) to pre operational stage.
Objects are now grasped and put in order.
• In the dental clinic, the child takes orders
from his mother through her facial
expressions, also tone of voice.
• (tell-show-do technique).
• Without exception the child should be
accompanied by a parent to the treatment
room.
4. Preschool period (3 to 6 years)
• At the stage the child now grips with the
development of a sense of initiative and
imagination so the child explores the world
of people & things also imagines himself in
a variety of roles & activities.
• The 3-year old child (desire to talk ,enjoy
telling stories to the dentist & assistants)
• The child is closely attached to his parents
• During the late preschool period the child
now able to be easily separated from his
parents
• Waiting room (full of toys )
5. School period (6 to 12 years)
• At this age the child achieve enough
trust also initiative to become involved
in the private world of children.
• Becomes a part of peer group.
• He takes orders from dentist as he
takes orders from his teachers in
school
6. Adolescent years (12 to 19 years)
• Hormonal activity usually associated with
rapid physical growth, genital maturity
and changing environmental expectation
so adolescence is a period of uneven
biologic, psychological and social
development
• The dentist should deal with them through
firmness and authority.
7. BEHAVIOUR
Definition :
The term behavior is broadly used
to include the entire complex of
observable and potentially measurable
activities including cognitive and
physiological classes of response.
8. I. WRIGHT’S CLASSIFICATION
A) Co-operative (Positive behavior)
1. Co-operative behavior
Child is cooperative, relaxed with minimal
apprehension.
2. Lacking in Cooperative Ability
• Includes very young children with whom communication
cannot be established.
• Another group of children who lack in cooperative ability
is of those with specific debilitating or disabling
conditions.
• Physical and mental handicap children are also included
under this.
9. 3. Potentially Cooperative
• Has the potential to cooperate, but because of
the inherent fears (subjective/ objective) the
child does not cooperate.
B). UN- COOPERATIVE BEHAVIOUR
1. Uncontrolled /Hysterical/ Incorrigible
Usually seen in the preschool children
at their first dental visit.
Temper tantrums i.e. the physical
lashing out of legs and arms , loud
crying and refuses to cooperate with
the dentist.
10. 2. Definite/Obstinate behavior
• Can be seen in any age group.
• Usually in spoilt or stubborn children.
• These children can be made
cooperative.
3. Tense cooperative
• These children are the border line between the
positive and negative behavior.
• Does not resist treatment but the child is
tensed at mind.
11. 4. Timid Behavior/Shy
• Usually seen in a overprotective child at the first
visit.
• Is shy but cooperative.
5. Whining type
• Complaining type of behavior allow for treatment
but complains throughout the procedure.
6. Stoic type
• Seen in physically abused children .
• They are cooperative and passively accept all the
treatment without any facial expression.
12. 1. COOPERATIVE
• The child is physically and emotionally
relaxed .
• Is cooperative throughout the procedure.
2. Tense cooperative
• The child is tensed and cooperative at the same time.
Lampshier classification (1970)
3. Outwardly apprehensive
• Avoids treatment initially, usually hides behind the mother,
avoids looking or talking to the dentist.
• Eventually accepts dental treatment.
13. 4. Fearful:
Requires considerable support so as to
overcome the fears of dental treatment.
5. Stubborn/Defiant
Passively resists treatment by using
techniques that have been successful in other
situations.
6. Hypermotive
The child is acutely agitated and resorts
to screaming kicking etc.
7. Handicapped
Physically/mentally, emotionally handicapped.
14. III.FRANKEL’S CLASSIFICATION
(1962)
(Frankel’s behavior rating scale)
Rating Behavior
1. Definitely Refuses treatment, crises
negative (- -) forcefully extremely
negative behavior
associated with fear.
2. Negative (-) Reluctant to accept
treatment and displays
evidence of slight
negativism.
15. Rating Behavior
3. Positive (+) Accepts treatment,
but if the child has a bad
experience during treatment,
may become uncooperative.
4. Definitely Unique behavior, looks
positive (++) forward to and
understands the
importance of good
preventive care.
16. a). Normal or bold
The child is brave enough to face new situations, is
co-operative, and friendly with the dentist.
B). Tasteful or timid
The child is shy, but does not interfere with the
dental procedures.
IV. WILSON’S CLASSIFICATION
(1933)
c). Hysterical or rebellious
Child is influenced by home environment – throws temper-
tantrums and is rebellious.
d). Nervous or fearful
The child is tense and anxious, fears dentistry.
17. Reactions of the child to the dental
experience
• There are at least 5 negative reactions
to the dental experience:
1) Fear
2) Anxiety
3) Resistance
4) Timidity
5) Crying
18. Fear:
• Dentistry should never be employed by the parents as a
threat. Also, taking the child to the dentist should never
be implying punishment.
*** Types of fear ***
A- Native fear: it is an instinct present in every
human being
B- Objective fear: It originates from a frightening or
painful experience in the child's past that faced
the child himself
C- Subjective fear: it is based on feelings and
attitudes suggested to the child by others around
him without the child having had the experience
himself.
Subjective fear may be acquired by imitation and
may be transmitted from parents
19. Anxiety
• Anxious children are essentially
fearful of new experiences and their
reaction may be violently aggressive
such as temper tantrums in dental
office.
• Child is truly fearful the dentist may
be sympathetic and starting working
slowly but if the child demonstrating a
temper tantrum the dentist may
demonstrate authority & mastery of
situation.
20. • The child may display temper tantrums or head
beating or may develop vomiting habits or may make
no attempt to talk plainly.
• Withdrawal is another manifestation of anxiety
• This is observed in the case of the first time
patient. This is the child who tries to hide
behind his mother; he looks to the floor or
another direction.
• The timid child needs to gain self confidence
and confidence in dentist
Timidity
21. A- Obstinate crying:
Siren-like noises, temper tantrum, kicking, biting, usually no
lacrimation.
B-Frightened crying:
Profusion of tears, constant wailing sound, convulsive and
rasping, cry tends to hysteria rather than temper tantrum
C-Hurt crying:
lack of or very low volume tears may be the only manifestation
moaning, respiration may be affected if child hold his breath
D-compensatory crying:
Wailing or whining sound as the dentist makes sounds of
similar volume, not loud but consistent, no tears or sobs
22. • Behavior management problems are what the dentist
observe while the dental fear and anxiety is what the
patient feel.
• Some children present behavior management
problem without having fear and anxiety.
• Some Children having dental fear and anxiety but
able to cope up with situation.
• Some children experience dental anxiety and fear
and present behavior management problems
23. • Age
• Dentist
• Maternal anxiety
• Past medical history
• Time & length of app
• Patient awareness of the problem
• parents
24. 1. Personal Factors
A. Age B. General fear and anxiety.
C. Temperament. D. Other problems e.g.DAMP
2. External Factor
A. Parental Dental fear & anxiety.
B. Social Situation of the family.
C. Ethnic background of family.
D. Child rearing and child’s
role in society.
3. Dental Factor
A. Pain B. The Dental Problems
Factor affecting child Behavior in dental
clinic
25. Factor affecting child Behavior in dental
clinic
Factor involving Child
Growth and development of child
Personality & tempermant of child.
a) Type 1 Positive of mood.
b) Type 2 Difficult children.
c) Type 3 Slow to warm up
Formal learning experience
Social and adaptive skill.
I.Q. of child.
Past Dental & Medical Experience.
Awareness of dental problem.
1. Appearance of Dental Office.
2. Personality of Dentist
3. Dental’s skill & Speed
4. Dentist’s conversation
5. Attention to the Pts.
6. Use of praise and reward.
7. Dentist’s self control.
Factor involving Dentist
27. • Over Protective and dominant
prevent the natural development of the child toward
independence; for example, the parent insists on remaining
with the child,
• Over Indulgent (manipulative)
excessively demanding (appointment time; course of
diagnosis or treatment)
• Under affectionate
• Rejecting (neglectful)
• Authoritarian
• Hostile Parents :-
{A} poor personal experiences in the dental office,
{B} a general negativism toward health professionals,
{C} feelings of insecurity in a foreign environment, or
28. The functional inquiry
–During the inquiry, two primary goals:
(1) To learn about patient and parent
concerns and
(2) To gather information enabling a
reliable estimate of the cooperative ability of
the child
–Functional inquiries are conducted in
two ways:
(1) By a paper and pencil questionnaire
completed by the parent
(2) By direct interview with child and parent
29. Parent education
(instruction to parents)
• Not to voice their own personal fears in
front of their child toward dentistry.
• Not use dentistry as a threat of
punishment.
• Familiarize their children with dentistry by
taking the child to the dentist to become
accustomed to the dental office.
• Not bribing their child to go to the dentist.
• Parents shouldn't challenge the dentist's
authority or contact the operator filed
30. • It should be warm and stimulate homely
environment.
• Appointment should be short.
• Children should not kept waiting not more
than 30 minutes.
EFFECT OF DENTIST’S ACTIVITY:
• Data gathering and observation :- Should be
collect by child steps in dental clinic during
history taking and dental procedure being carried
out.
31. Child's first dental visit
• The ideal time of the first visit is at one year of age
• To safeguard against problems such as baby
bottle tooth decay, teething irritations, gum
disease, and prolonged thumb-sucking
• Preparation for the visit (Talk to child about what
to expect)
• What will happen on the first visit (examination,
prophy; OHI; fluoride application)
32. Fundamentals of behavior
management
• is means that the dental health team effectively and
efficiently performs treatment for a child and, at the
same time, instills a positive dental attitude.
{1} The team attitude (warmth and interest , pleasant
smile, using nick names )
{2} Organization (dental office staff , well organized,
written treatment plan )
{3} Tolerance ( dentist ability to tolerate any
misbehaviors from the child)
{4} Flexibility (Since children are children, lacking in
maturity, the dental team has to be prepared to
33. BEHAVIOUR MANAGEMENT
1 PRE APPOINTMENT BEHAVIOUR MODIFICATION.
A.Audiovisual modeling
B. Introductory appointment
C. Patient modeling
D.Pre-appointment mailing.
2. COMMUNICATION :
It can be verbal or non verbal
3. BEHAVIOUR MODIFICATION
A. Behavior shaping.
B. Tell, show & Do.
C. Desensitization
D. Modeling
E. Contingency Management
F. Retraining
34. 4. BEHAVIOUR MANAGEMENT
A. Distraction/ Externalization
B. Parental Presence or absence.
C. Audio analgesia
5. AVERSIVE CONDITIONS
A. Voice Control
B. Home (Hand Over mouth exercise
C. Hypnosis
D. Coping
E. Confusion
F. Implosion Therapy
35. • The Objectives are establish the good rapport with patient & to
develop the positive behavior.
Done by
A. Audiovisual modeling
B. Patient modeling
1. Sibling 2. Other Children
C. Reappointment e-Mailing Any greeting, cartoon, comic (
conveying the procedure
COMMUNICATION :- To establish good relationship with child.
1. Verbal (Steps
A. Establishment of
Communication
B. Establishment of
Communicator
C. Message Clarity
Use of the Euphuism :- Using Other words other
then original
D. Problem Ownership : take all blame on yourself.
E. Active listening of child.
F. Appropriate response.
2. Non Verbal : It is the reinforcement & guiding of behavior
through contact, posture & facial expression.
36. Instead of… We prefer to say…
Radiographs or x-rays Tooth pictures
Poke with explorer or sharp
instrument
Tooth counter
Suction Mr. Thirsty or Thirsty Straw
Cavities Sugar Bugs
Fluoride treatment Tooth vitamins
Laughing gas/Nitrous Oxide Happy Air
Give a shot or use a needle Spray sleepy juice
Mouth prop Tooth chair or pillow
Use a rubber dam
Keep the tooth dry with a
raincoat
Clamp Tooth hugger or ring
Drill the tooth Polish the tooth
Fillings Paint or polish
37. A. State General task/ Goal to child at the outset
B. Explain necessity for the procedure.
C. Divide Explanation for the procedure.
D. Make all explanation at the child’s level of understanding.
E. The successive approximation (T.S.A.)
1. Behavior Shaping: It is that procedure which very slowly
develops behavior by reinforcing successive approximation of
desired behavior until the desired behavior comes to be.
2. Tell show, and do : The dentist should demonstrate the various
instruments step by step before there application telling, showing
and doing.
3. Desensitization :- Patient is taught to relax while procedure is
going on with least anxiety evoking stimulus.
Sequence: 1. Introduction 2. Orientation
3. Clinical Examination 4. Oral Prophylaxis
5. Restoration 6. Extraction.
PROCEDURE
38. 4. Modeling A. Audiovisual Modeling B. Live
Modeling
5. Contingency Management :- It is a presentation or
withdrawal of reinforcement. It can be positive or negative.
Objective: To reinforce desired behavior It can be
3 Type: 1. Material reinforcement
2. Social Reinforcement 3. Activity Reinforcement
6. Retraining:- Designated to fabricate positive values
in place of negative behavior that has develop.
BEHAVIOUR MANAGEMETN TECHNIQUE
A. Distraction: Process by which the attention of child is focus away from
the sensation associated with dental treatment.
B. Parental Presence or absence
C. Audio analgesia – like pleasant music.
D. Visual fantasy – like Hypnosis & Day dreaming.
39. Distraction
• Five senses
• a CD-player
• watching a movie
• pleasant smell ,(smell of oil of cloves or
eugenol ), aromatherapy heaters
• Use of Choice-Based Distraction
• Taste (drinks from the refreshing (water,
fresh juice )
Contingent Escape
Allowing the child to stop treatment gives him a sense of control.
e.g.: raising hand when he wants to stop
- Tell the child that you will need him to let you work on his teeth for
a count of 10 & then stop & allow him to rest for a while
40. • Hypnotic language patterns are an effective instrument for supporting fear-
and pain-free treatment. Hypnosis has nothing to do with witchcraft or
submission but makes use of the child's natural state of relaxation and
imagination. It enables your child to focus more on pleasant things whilst
unpleasant things fade into the background and your child leaves our practice
feeling good.
• What do we do?
• Use positive concepts
• Explain in a language suitable for children
• Reinforce positive feelings with praise
• Tell stories
• Constant physical contact gives a feeling of safety and security
Your child's state:
• Reduced pain perception
• Altered perception of time
• Concentrated on inner self (introspection)
• Thus less distracted by external stimuli
• Positive memory of the treatment
41. 1. Voice Control : Should be controlled alteration
of voice volume.
2.(HOME:- Hand over mouth exercise): Use in
very uncooperative child. A hand is placed
over the child’s mouth and behavioral
expectation are calmly explained close to the
child’s ear.
When desired behavior comes than removal of
hand
In this procedure airway is not restricted
Modification of HOME is HOMAR (Hand over
mouth Airway restricted): Generally avoided
because restriction of airway.
42. (A) Hand -Over- mouth
• An extreme measure in dealing with an
uncooperative child.
• Involves holding the child in the dental
chair; the dentist should gently but firmly
places his hand over the child's mouth.
Then the dentist speaks quietly but clearly
into his ear to reassure him and explains
the procedures about to be done in an
attempt to establish confidence.
• Isn't a punishment measure
43. (B) Physical restraints
• Range from holding a child's hands during
injection procedure to full body restraint
• for patients who are not capable of understanding
the dental procedure ,some physically or mentally
handicapped patients.
(1) To control body movements:
* pedi-wrap: it is reinforced nylon mesh sheet with
Velcro fasteners and is supplied in small, medium
or large sizes. The child's arms are placed by his
side and the wrap is then fastened over his chest.
* Papoose board
*Triangular sheet
* Beanbag dental chair sheet
* Safety belt
* Extra assistant
44. (4) To control the oral cavity:
•intraoral mouth prop: like wraped
tongue blades, intraoral bite block (
is a medium hard rubber wedge that is
inserted between the occlusal surfaces
on the side of the mouth where the
treatment is not performed).
* extraoral mouth prop: like Molt
mouth prop which is constructed of
metal and covered with rubber tubing.
45. Practical considerations
Scheduling:-
• Time of the appointment may
influence child's behavior especially
young child, early morning hours. The
suggestion was based on the facts
that the child is alert and the dental
team is fresher in the morning.
• Appointment length should be short
not more than 30 minutes especially
for young and fearful child.