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Pediatric Dentistry > Behavior Management > Flashcards

Behavior Management Flashcards

1
Q

variables influencing children’s dental behavior

A
  • maternal anxiety
  • medical history
  • awareness of dental problem
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2
Q

maternal anxiety: characteristics

A
  • high parental anxiety = negative child behavior
  • can affect children of all ages
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3
Q

age where maternal anxiety effects are greatest

A

under 4 years of age

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4
Q

factors under medical history that can affect child’s cooperativeness with the dentist

A
  • children who view medical experiences positively
  • emotional quality of past visits
  • past medical pain
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5
Q

how to mitigate negative behavior for awareness of dental problem during a child’s first dental visit

A

educate parents about value of arranging child’s first dental visit

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6
Q

can be used for modeling

A
  • live patient models
  • audiovisual aids
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7
Q

modeling (according to Rimm and Masters)

A
  • stimulation of new behavior
  • facilitation of behavior in a more appropriate manner
  • disinhibition of inappropriate behavior due to fear
  • extinction of fears
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8
Q

involved in behavior management

A

total dental health team

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9
Q

2 means behavior management accomplishes for the child

A
  • allows dental health team to effectively and efficiently perform treatment
  • instills positive dental attitude
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10
Q

types of communication & communicative guidance

A
  • tell-show-do
  • distraction
  • non-verbal communication
  • positive reinforcement
  • voice control
  • parental presence or absence
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11
Q

tell-show-do

A

used with communication skills (verbal and non verbal) and positive reinforcement

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12
Q

tell-show-do: tell

A

behavior shaping which involves verbal explanation of procedure and phrases

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13
Q

tell-show-do: show

A

demo for the patient of the visual,
auditory and olfactory aspects of the procedure in a carefully defined, non-threatening manner

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14
Q

tell-show-do: do

A

completing the procedure on the patient

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15
Q

tell-show-do: objectives

A
  • teach the patient important aspects of dental visits
  • familiarize the patient to the dental setting
  • shape patient response to procedure to desensitization and well-described expectations
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16
Q

tell-show-do: indications

A

may be used in almost all patients

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17
Q

tell-show-do: contraindications

A

none

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18
Q

distraction

A

technique of diverting the patient’s attention from what may be perceived as an unpleasant procedure

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19
Q

distraction: examples

A
  • watching TV/Youtube videos
  • use of gadgets
  • toys
  • listening to music
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20
Q

distraction: objectives

A
  • decrease unpleasantness
  • avert negative behavior
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21
Q

non-verbal communication

A

reinforcement and guidance of behavior through appropriate contact, posture, facial expression and body language

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22
Q

non-verbal communication: indications

A

any patient

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23
Q

non-verbal communication: contraindications

A

none

24
Q

positive reinforcement

A

process of establishing desirable patient behavior

25
Q

2 types of positive reinforcement

A
  • social reinforcement
  • non-social reinforcement
26
Q

social reinforcement: examples

A
  • positive voice modulation
  • facial expressions
  • verbal phrase
  • appropriate physical demonstration of affection
27
Q

non-social reinforcement: examples

A
  • toys and tokens (reward)
28
Q

reward

A

recognition of good behavior after completion of the operation

29
Q

bribery

A

promised to induce desired behavior

30
Q

voice control

A

controlled alteration of voice, volume, tone or pace to influence and direct the patients behavior

31
Q

voice control: benefit

A

avoids misunderstanding with parents

32
Q

voice control: indications

A

any patient

33
Q

voice control: contraindications

A

patients with hearing impairment

34
Q

voice control: objectives

A
  • gain patient attention and compliance
  • avert negative or avoidance behavior
  • establish appropriate adult-child roles
35
Q

parental presence or absence

A
  • requires good communication among dentist, parent and patient
  • child response can be very beneficial or very detrimental
36
Q

parental presence or absence: contraindications

A

parents who are unwilling or unable to extend effective support when asked

37
Q

parental presence or absence: objectives

A
  • gain patient attention and improve compliance
  • avert negative or avoidance behavior
  • establish appropriate adult - child roles
  • enhance effective communication among dentist child
    and parent
  • minimize anxiety and achieve a positive dental
    experience
38
Q

aversive conditioning aka

A

hand-over-mouth exercise (HOME)

39
Q

aversive conditioning: purpose

A

gain attention of highly appositional child to establish cooperation for sage course of treatment

40
Q

aversive conditioning

A

not routinely used; method of last resort

41
Q

aversive conditioning: requirement

A

informed consent

42
Q

advanced behavior guidance: indication

A
  • children who cannot cooperate
  • children with physical and emotional immaturities
43
Q

types of advanced behavior guidance

A
  • protective stabilization
  • knee-to-knee/lap-to-lap
44
Q

protective stabilization

A

restriction of patient’s freedom of movement with or without the patient’s permission

45
Q

protective stabilization: purpose

A

to decrease risk of injury and deliver procedure safely

46
Q

protective stabilization: considerations

A
  • alternative behavior guidance modalities
  • dental needs of patient
  • effects of quality of dental care
  • patient’s emotional development
  • patient’s medical and physical considerations (i.e. scoliosis)
47
Q

protective stabilization: indications

A
  • patient requires immediate diagnosis and for limited treatment
  • safety of the patient, staff, dentist or parent would be at risk
  • sedate patient
48
Q

protective stabilization: contraindications

A
  • cooperative non-sedated patient
  • patient who cannot be immobilized safely (associated medical or physical conditions)
  • patient who has experienced previous physical or psychological trauma
49
Q

protective stabilization: objectives

A
  • reduce or eliminate untoward movements
  • protect patient, staff, dentist or patient from injury
  • facilitate delivery
50
Q

protective stabilization: precautions

A
  • careful review of patient’s medical history
  • tightness and duration of stabilization
  • not actively restrict circulation or respiration
  • stabilization should be terminated as soon as possible in patient whose experience is severe
51
Q

knee to knee/lap to lap

A

advanced behavior guidance that works for most younger children

52
Q

knee to knee/lap to lap: procedures

A

(non-invasive)
- oral exam
- fluoride application

53
Q

3 practical considerations

A
  • scheduling
  • patient-child separation
  • dental attire
54
Q

best appointment for pediatric patients

A

short (30 mins or less) morning appointments

55
Q

practical consideration: dental attire

A

child-friendly

56
Q

practical consideration: scheduling

A

child should not be kept waiting in the reception area

57
Q

occurs when patient-child separation is not followed

A
  • parent often repeats orders
  • parent injects orders, becomes barrier to development
  • dentist unable to use voice intonation
  • child divides attention between parent and dentist
  • dentist divides attention between parent and child

Pediatric Dentistry (10 decks)

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