behavioral guidance

Question 1

barriers

Answer 1

1) PAIN!! and fear of pain
2) environmental barriers
- access to care, financial, lack of care providers in neighborhood, transportations, sibling care
3) epigenetics of anxiety

Question 2

parenting styles

Answer 2

1) authoritative
- warm, control
2) authoritarian
- no warm, control
3) permissive
- warm, no control
4) neglectful
- neither

Question 3

general characteristics

Answer 3

1) most prevalent in younger children, dissipate with age
2) imagination -> age
3) trust -> honesty
4) perceptions of others no dependent on appearance -> being sincere
5) act on emotions -> immediate reaction to stimuli

Question 4

infant 0-15 mo

Answer 4

1) object permanence
- lacking
2) play
3) receptive language
4) expressive language
- babbling
5) maternal Abs go down
6) can be seen for pathology and trauma
- SDF is good

Question 5

toddler 15 mo - 2 years

Answer 5

1) object permanence
- better
2) expressive language and receptive language
3) sensorimotor stage
4) pre-cooperative
5) learning to walk (trauma cases)
6) lap to knee-knee exams
7) SDF, SMART ,ITR (minor caries)
8) sedation or GA for major caries and oral surgery

Question 5

pre-schooler 2-6 years

Answer 5

1) preoperational stage
2) social and language skills
3) euphemisms are super important
4) lap > chair
5) toothbrush > prophy angle
6) minimal restoration > routine + N2O

Question 6

transition 6-11 years

Answer 6

1) concrete operational
2) routine, radiographs, tell show do

Question 6

adolescence 11-18

Answer 6

1) heightened self awareness, peer status, priorities shift, preventive habits deteriorate
2) procedures similar to adults but may be excrious
3) sports, trauma risk

Question 7

kid friendly office

Answer 7

1) kids area
2) toys
3) videos
4) small patient mirrors
5) euphemisms

Question 8

communication with parents

Answer 8

1) do not ask child if they are in pain!
2) no use of fears or threats, scolding, ridiculing

Question 9

AM appointments

Answer 9

1) minimal waiting room time
2) short appointments
3) flexible goals, back up plans

Question 10

approching patient

Answer 10

1) evaluate the pt at eye level
2) nickname
3) talk to parent
4) separate
5) distract

Question 11

communication style

Answer 11

1) one thing at a time
2) gender influences
3) voice modulations
4) non verbal communications
- facial expression and body language

Question 12

positive reinforcement

Answer 12

1) praise them specifically

Question 13

distraction

Answer 13

1) can be obvious or subtle
2) often during LA
3) story telling, singing, movie, etc.

Question 14

tell show do

Answer 14

1) tell what will be done
2) show on finger
3) do the procedure

Question 15

passive physical restraint

Answer 15

1) staff or parent
2) hands over patient hands or arms
3) during key points in procedure
4) papoose board: specific consent required

Question 16

active restraint

Answer 16

1) holding hands, legs, shoulders
2) hand holding is done a lot

Question 17

mouth prop

Answer 17

tooth pillow
1) molt mouth prop or the bite block (not used a lot)

Question 18

injections

Answer 18

1) topical
2) inject slowly
3) distract

Question 19

nitrous oxide

Answer 19

1) cooperative ability
2) no eating pre op
- nausea
3) silly gas, space gas

Question 20

conscious sedation and general anesthesia

Answer 20

1) usually in patients with disability or pre-cooperative

Question 21

behavior rating and documentation

Answer 21

1) document