behavioural management Flashcards
give examples of pharmacological behaviour management
inhalation sedation with N20
intravenous sedation with midazolam or propofol
general anaesthetic
describe the use of inhalation sedation with nitrous oxide
will not change child’s wish or want to avoid something
will allow sufficient anxiolysis to increase suggestibility and relaxation
helps with ability to tolerate treatment
describe the use of intravenous sedation with propofol or midazolam
good option for complex treatment in anxious adolescents
depending on maturity and size, usually used from age 12
when is the term ‘pre-cooperative’ used?
very young children with whom communication can’t be established
what are the 4 categories of cooperativeness?
pre cooperative
children who lack cooperative ability
potentially cooperative
cooperative
describe the behaviour and development of a child aged 3-4 months
interested in people, places and objects
describe the behaviour and development of a child aged 6-8 months
share and express emotions
crawling and discover surroundings
fear and stranger awareness becomes important
understanding of spoken words and non-verbal communication develops
describe the behaviour and development of a child aged 9-12 months
two way conversations about feelings
become aware of others sharing their thoughts and feelings
separation anxiety begins until 18 months
describe the behaviour and development of a child aged 1-3 years
develop sense of self and explore autonomy
may become noncompliant
begin to assert themselves and gain independence
language develops
sharing and cooperative play challenging
fear of movements, strangers, loud noises
dental environment can invoke fear
too young to be reached by words alone- hand them objects to help understanding
describe the behaviour and development of a child aged 3 years
less egocentric- like to please adults
active imagination and like stories
some capacity for reasoning
praise for adherence and distraction to capture attention helpful
describe the behaviour and development of a child aged 4-5 years
exploring new environment and relationships
prefer 1-2-1 friendships
like fantasy play
familiar with please and thanks
labelled praise helpful
direct commands helpful
describe the behaviour and development of a child aged 6-8 years
established at school and move away from security of family
increasingly independent (can cause anxiety and distress)
seek acceptance
describe the behaviour and development of a child aged 8-12 years
part of larger social groups- strongly influenced by them
growing concerns of embarrassment
become ‘followers’
can hide feelings
intellect becomes important
respond well to discussions about need to engage in independence
describe the behaviour and development of a child in adolescence
can be perceived incorrectly as self-absorbed
believe they are invulnerable and their actions wont have consequences
greater rapport developed with dentists who are nonjudgemental, non-preaching and respectful
treat them as their own person- separate from parent
emphasise importance of self-dental care to maintain their smile
what methods work best in order to communicate effectively with a child?
treat them as an individual
use their name often to develop rapport
only use jargon with an older child with interest
only one person speak at a time- younger children can only concentrate on one individual
non-verbal communication is key
name physiological and somatic sensations of dental fear and anxiety
breathlessness
perspiration
palpitations
feeling of unease
name cognitive features of dental fear and anxiety
interference in concentration
hypervigilance
inability to remember events when anxious
catastrophising
name behavioural reactions of dental fear and anxiety
avoidance of treatments and appointments
escape from situations
aggression
name factors affecting child and adolescent anxiety (9)
previous medical history
previous dental history
social history factors
parental anxiety
parenting style
parental presence
child awareness of dental problem
behaviour of dental staff
child temperament
how do we measure dental fear and anxiety?
MCDASf modified child dental anxiety scale- faces
explain tell-show-do
T- age appropriate explanation of procedure
S- demonstration of procedure
D- perform procedure with minimal delay
explain enhanced control
allows the child a degree of control over your behaviour
give the child stop, go and rest signals
let them know you might not always be able to stop immediately
ask them which tooth they want to start with etc.
giving options makes the child feel more in control
describe positive reinforcement
the strengthening of a pattern of behaviour, increasing the probability of that behaviour being displayed in the future
includes social stimuli (e.g. smiling/verbal praise), stickers, dental charts etc.
name common behaviour management techniques
use of the word ‘magic’
cognitive behaviour therapy
hypnosis
systematic desensitisation
motivational interviewing
gamification
