4. Behaviour Management & Anxiety Flashcards
What are 5 pharmacological behaviour management approaches ?
LA techniques.
Pre-medication.
Inhalation sedation with nitrous oxide.
IV sedation with midazolam or propofol.
GA.
From what age onwards can IV sedation be used ?
12+ y/o.
Who are pre-cooperative children ?
Young children with whom communication of anxiety cannot be established.
Who are children who lack cooperative ability ?
Specific intellectual learning disabilities i.e. severe autism, cerebral palsy.
Who are children who are potentially cooperative ?
Previous GA treatment but never had treatment under normal anaesthetic measures.
What % of communication is body, movements, face arms ?
55%
What % of communication is voice, tone, modulation, pauses ?
38%
What % of communication is words ?
7%
Describe dental anxiety.
Reaction to unknown danger - common when proposed treatment never experienced before.
Describe dental fear.
Reaction to known danger - involving flight-fight-freeze response when confronted with threatening situation - common when previous bad experience at dentist before.
What is dental phobia.
Same as dental fear -
Reaction to known danger - involving flight-fight-freeze response when confronted with threatening situation - common when previous bad experience at dentist before.
Must stronger response.
What are physiological and somatic sensations which are caused by dental fear and anxiety ?
Breathlessness.
Perspiration.
Palpitations.
Feeling unease.
What are cognitive features which are caused by dental fear and anxiety ?
Interference with concentration.
Hyper vigilance.
Inability to remember events when anxious.
Catastrophising.
What are behavioural reactions which are caused by dental fear and anxiety ?
Avoidance of treatment and appointments.
Escape situations.
Aggression.
What factors might affect child and adolescent anxiety ?
Previous MH and DH.
SH factors.
Parental anxiety.
Parenting style.
Child awareness of dental problem.
Behaviour of dentist and staff and environment.
Child temperament.
What scale can be used to measure dental fear and anxiety ? And when can it be given ?
Modified child dental anxiety scale (faces) - MCDASf.
While child is in waiting room when completing medical history.
What are examples of non-pharmacological behaviour management techniques ?
Preparatory information.
Non-verbal communication and role modelling.
Voice control.
Tell-show-do.
Enhanced control.
Positive reinforcement.
Behaviour shaping.
Distraction.
Relaxation and breathing techniques.
Systematic densensitization.
What is the lidocaine maximum dosage ?
1 x 2.2ml per 10kg patient.
What is articaine maximum dosage ?
0.8 x 2.2ml per 10kg patient.
