Behavioral Guidance #2 Flashcards
what are the three classifications of childhood behavior?
- cooperative
- lacking cooperative behavior
- potentially cooperative
what constitutes a cooperative childhood behavior?
- relaxed with minimal apprehension
- enthusiastic
- listens to instructions well - can be treated with relatively straightforward behavior guidance techniques
what constitutes a child who is lacking in cooperative ability/
- NOTE they are NOT uncooperative
- very young (PREcooperative)
- special health care needs
- basic behavior guidance techniques unlikely to work
what constitutes a kid who is POTENTIALLY COOPERATIVE
- these are the kids who may be UNcooperative
- physically, mentally, emotionally they should be ABLE to cooperate
- bad kids
what are the ratings of the Frankl Behavior Rating Scale?
- definitively negative
- negative
- positive
- definitively positive
rank of frankl behavior rating scale, refusal of tx, forcefully crying, fearfullness, or any other overt evidence of extreme negativism
definitively negative
rank of frankl behavior rating scale, reluctance to accept treatment, uncooperative, some evidence of negative attitude but not pronounced
negative
rank of frankl behavior rating scale, acceptance of tx, cautious behavior at times, willingness to comply with the dentist with reservation, follows directions
positive
rank of frankl behavior rating scale, good rapport with the dentist, interest in the dental procedures, laughter and enjoyment
definitively positive
what is crucial to successful behavior guidance?
pain managment
under age ___ kids are more sensitive to painful stimuli and more difficult for them to communicate
4
what is the name of pain scale with the faces 1-10?
wong- backer FACES pain scale
when dealing with child pts, what is the more important than the words coming out of your mouth?
- tone of voice
- facial expressions
- body language
what are questions that are dealt with during informed consent?
- indications and contraindications
- significant risks - including risk of no treatment
- alternative txs
- answer all questions
when dealing with kids, ________ does NOT require specific consent, BUT EVERYTHING ELSE DOES
communicative managemnt
what are some ways of communicative guidance?
- smile
- eye contact (win them over)
- dont stop talking
- have simple rules and tell them their job
what is Dr. Erin’s #1 tip for communication?
don’t give kids a choice if there isnt one
are there any contraindications for tell show do?
no
what are the contraindications for voice control?
hearing impared
what are the objectives to voice control?
- gain pts attention and compliance
- avert negative or avoidance behaviors
- establish appropriate adult-child roles
what are the objectives for nonverbal communication?
- enhance the effectiveness of other communicative management techniques
- gain or maintain the pts attention and compliance
what are the contraindications for nonverbal communications?
none
how does distraction work?
- divert the pts attention away from what might be perceived as unpleasant. even giving a break during a stressful procedure can be an effective destraciton.
- DONT STOP TALKING
what are the indications to give nitrous to a child?
- fearful/ anxious pt
- certain pts with special health care needs
- gag reflex interfers with dental care
- profound LA can be obtained
- coop child but long procedure
type of stabilization where another person immobilizes the pt
active stabilization
type of stabilizaiton where a restrictive device is used (pappoose board)
passive stabilization
what are the indications for stabilization?
- immediate dx and/or limitied tx and lacks ability to coop
- safety of pt or others would be at risk without it
- sedated pts to reduce unwanted movement
what are the contraindications for stabilization?
- coop, non-sedated pts
- cant be immobilizes for medical conditions
- previous trauma from protective stabilizaiton
- NON-SEDATED PTS WITH NON-EMERGENT TX REQUIRING LENGTHY APPTS
do you need informed consent for stabilization/
yes
what is the documentation for stabilzation?
- informed consent
- indicaiton
- type
- duration
- behavior rating
what education do you need in order to do sedation?
-predoc or CE instruction of at least 60 hrs didactic and 20 cases OR residency with equal training
what are the indications for sedation?
- fearful, anxious pts for whom basic behavior guidance techniques haven’t worked
- pts that lack the ability to coop
- pts for whom sedation may protect developing psyche and reduce medical risk
what are the contraindications for sedation?
- coop pt with minimal dental needs
- predisosing medical and physical conditions that dec saftey
what are the indications for GA?
- pt lacks ability to coop
- LA is inefffective (acute infection, allergy)
- extremely uncoop, fearful
- sig surgical probs
