Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 paeds > Behavioural Management > Flashcards

Behavioural Management Flashcards

1
Q

behaviour management

A

continuum of interaction with a child/parent directed toward communication and education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

goal of behaviour management

A

ease fear and anxiety

promoting an understanding of the need for good dental health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

communication between dentist and pt

A

built on a dynamic process of dialogue, facial expression and voice tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

dentist communication role to pt

A

allay fears and anxiety, teach appropriate coping mechanisms and guide the child to be cooperative, relaxed and self confident in the dental setting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

5 different aspects of behaviour management

A

Age and its relationship to behaviours in the dental surgery

Dental fear and anxiety in children and predisposing factors

The role of the dentist and the parent

Behavioural management techniques

Building a treatment plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

age 2 normal childhood development

A

Fear of unexpected movements, loud noises and strangers

The dental situation can produce fear in the child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

age 3 normal childhood development

A

Reacts favourably to positive comments about clothes & behaviour

Less fearful of separation from parents (due to nursery placement)

Experience will however dictate reaction to separation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

age 4 normal childhood development

A

More assertive but can be bossy & aggressive

Fear of the unknown and bodily harm is now at a peak

Fear of strangers has now decreased.

With firm and kind direction will be excellent patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

age 5 normal childhood development

A

Readily separated from parents.

Fears have usually diminished.

Proud of possessions – can be used to engage with them and build rapport

Comments on clothes will quickly establish a rapport

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

age 6 normal childhood development

A

Seeks acceptance

Success in this can affect self –esteem

If while at dentist child develops a sense of inferiority or inadequacy behaviour may regress to that of a younger age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

age 7-12 normal childhood behaviour

A

Learn to question inconsistencies and conform to rules of society - engage

Still have fears but are better at managing them
- Ask obvious Qs to see if they can be addressed – e.g. why do you not like the chair – might be as of movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

anxiety V behaviour V compliance link

A

Age 3-8 they will be linked

Older children use way to assess (MCDAS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

dental anxiety

A

Occurs without a present triggering stimulus and may be a reaction to an unknown danger or anticipatory due to previous negative experiences.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dental fear

A

Is a normal emotional response to objects or situations perceived as genuinely threatening.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

dental phobia

A

Is a clinical mental disorder where subjects display persistent and extreme fear of objects or situations with avoidance behaviour and interference of daily life – avoid going to dentist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 components of dental fear and anxiety (DFA)

A
  1. physiological and somatic sensations
  2. cognitive features
  3. behavioural reactions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

physiological and somatic sensations of DFA

A

Breathlessness
Perspiration
Palpitations
Feeling of unease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

cognitive features of DFA

A

(how changes occur in the thinking process):-
Interference in concentration

Hypervigilance – swivel heads, explain that you will show everything to them before doing anything

Inability to remember certain events while anxious – as mind racing

Imagining the worst that could happen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

behavioural reactions of DFA

A

Avoidance i.e. the postponing of a dental appointment, or with children disruptive behaviour in an effort to stop treatment being undertaken

Escape from the situation which precipitates the anxiety

Anxiety may manifest with aggressive behaviour especially in adolescents who are brought by their parents but do not want to be there.
- Feel not listened to
Explain that you will not do anything until you know how they are feeling, dentistry is second

The dentist should always ensure the safety of patients and staff if this type of behaviour happens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

signs of DFA in children

A

Some anxious children are easy to spot

Some signs are more subtle

  • Younger children may time delay by asking questions
  • School age children may complain of stomach aches/or ask to go to the toilet frequently
  • Older children may complain of headaches or dizziness, may fidget or stutter, can’t be “bothered”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

facts that influence fear and anxiety

A

useful to know what is causing it as then able to specifically reassure

  • Fear of choking
  • Fear of injections/drilling
  • Fear of the unknown
  • Past medical and dental experience
  • Dental experience of friends and siblings
  • The attitudes of parents towards dental experience
  • Preparation at home before the dental visit
  • The child’s perception that something is wrong with their teeth.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

DFA

A

dental fear and anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

examples of control related items to help pt influence course of treatment

A

rest breaks

signals to stop

the patients need for information

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how control related items can be used to assess child’s DFA

A

their desire to influence course of tx

need for control and info

25
Q

health history items to get from pt to assess DFA

A

ask about previous dental treatment

Ask about past experience

Items relating to trust include attention to the dentist/patient relationship, and perception of vulnerability

good use of precious time

26
Q

Faces Version of Modified Child Dental Anxiety Scale

A

Validated age 8+

Likert scale 1-5
Can be given out in waiting room to be done with medical history
- quick & easy to use

different aspects dental experience rated

base line levels of anxiety are established
(Humphries, Morrison & Lindsay 1995)

27
Q

4 reasons for good dentist/patient communication

A

Improves the information obtained from the patient
- More you know about them the better the Tx as more adapted to them

Enable the dentist to communicate information to the patient

Increases the likelihood of patient compliance – feel safe, listened to

Decreases patient anxiety

28
Q

3 components of communication

A

Verbal Communication (5%)

Paralinguistic (30%)

Non-verbal communication (65%)

29
Q

ways to reduce patients anxiety

A

Preventing pain

Being friendly & establish trust

Working quickly

Having a calm manner

Giving moral support

Being re-assuring about pain

Empathy

30
Q

good way to address pain in DFA

A

Main fear is pain

Tell them to expect something and it varies from person to person – can they tell you what they feel after
So don’t anticipate pain

31
Q

5 things that increase fear related behaviours

A

Ignoring or denying feelings

Inappropriate reassurance

Coercing/Coaxing

Humiliating

Losing your patience with the patient
- If cannot complete Tx, place a dressing and stop so child doesn’t get distressed

32
Q

what to do if unable to complete Tx in DFA

A

If cannot complete Tx, place a dressing and stop so child doesn’t get distressed

33
Q

expression of pain

A

Screwing up the eyes and lowering the eyebrows with the mouth open in a squarish appearance

Can be seen in drilling with LA failure

34
Q

expression of fear

A

Opening eyes widely and raising eyebrows with mouth open and tense

35
Q

“Letter to dentist” role

A

Precipitator to conversion
Focuses on why they are worried or fearful of dentist
Parents experience too

Can give information for prior to Tx

Qs

  • How worried are they?
  • How painful do they think treatment will be?
  • What do they want to happen?
  • How will they cope?
  • What is their stop signal?
36
Q

role of parent in DFA

A

Research suggests that the child’s behaviour is unaffected by parental presence or absence
- exception would appear to be children less than 4 years of age who have been shown to behave better with a parent present.

esp when young (knee to knee exam)

37
Q

benefits of parental presence for infant/toddler

A

Patient is incapable or unwilling to sit for examination (positioning the child in the lap of the dentist and parent permits the child to be in direct visual and physical contact with the parent – need to knee to knee examination )

Opportunity exists for the parent to witness the behaviour the clinician must contend with
- Can see how child behaves and why may need referred for behaviour

38
Q

8 behavioural management techniques

A

positive reinforcement

tell show do

Acclimatisation

desensitisation

voice control

Distraction

role modelling

relaxation / hypnosis

39
Q

positive reinforcement

A

The presentation of a stimulus that will increase the likelihood of a behaviour being repeated

Social reinforcers- facial expression, verbal praise & appropriate physical contact

Nonsocial reinforcers- stickers, colouring poster and clever certificates
- Not brave – expected of them but also to do them

40
Q

social reinforcers

A

facial expression, verbal praise & appropriate physical contact

41
Q

non social reinforcers

A

stickers, colouring poster and clever certificates

- Not brave – expected of them but also to do them

42
Q

Tell Show Do

A

Used to familiarise a patient with a new procedure.

The tell involves an age appropriate explanation of the technique.

The show is demonstrating for the patient aspects of the procedure in a non-threatening setting.

The do phase is initiated with minimal delay

E.g. slow speed on fingernail

43
Q

acclimatisation

A

e.g., inhalation sedation, new instrument

The planned, sequential introduction of environment, people, instruments and procedures.
- An integral part of the treatment plan

Introduce the 3:1, suction & cotton rolls on the visit before you plan a fissure sealant

Use the slow speed first with a prophy cup, later with a bur and later introduce the high-speed

Introduce topical one visit before using LA for the first time

Give rubber dam home on the visit before you plan to use it

44
Q

systematic desensitisation

A

always making sure child is calm and in control

This is based on the assumption that repeated non-distressing exposure to an anxiety-provoking stimulus will eventually reduce anxiety

The child must be reassured that they are in control

  • This is done in an ordered manner from what they perceive as the least anxiety provoking to the most anxiety provoking, in imagination of in real-life until no anxiety is produced
  • Relaxation techniques taught or strategies like mental maths in head, So child knows able to cope with that so willing to try next stage

e.g. Systematic Needle Desensitisation

45
Q

voice control

A

A controlled alteration of voice volume, toneor pace to influence and direct the patient’s behaviour.

  • To gain the patients attention & compliance
  • To avert negative or avoidance behaviour
46
Q

distraction

A

The technique of diverting the patient from what may be perceived as an unpleasant procedure

  • pulling the upper lip
  • telling a story while giving local anaesthetic
  • letting an older child bring in music to listen to
47
Q

role modelling/imitation of others

A

sometimes similar age

same/similar treatment

presence of an older sibling is best for children aged 3-5 yrs

see other can cope therefore nothing to be anxious of

48
Q

relaxation techniques

A
  • Progressive muscle relaxation
  • Space exercise
  • breathing techniques

Practice yourself so can teach well

49
Q

hypnosis

A

An interaction between one person, the “hypnotist” and another person or people, the “subject”

The hypnotist attempts to influence the subjects’ perception, feelings, thinking and behaviour by asking them to concentrate on ideas and images.

The verbal communications that the hypnotist uses to achieve these effects are termed “suggestions”

The response is experienced by the subject as having a quality of involuntariness or effortlessness.

50
Q

HOM/HOMAR

A

HAND OVER MOUTH - unacceptable

problems

  • adverse psychological effects
  • parental consent
  • professional acceptance
  • litigation
51
Q

painless treatment

A

Care should be taken not to hurt any child.

Restorative care is usually carried out under local anaesthesia.

A painless technique of administering LA is of vital importance with topical an integral part of treatment.

Upper carious teeth are normally restored with L.A. before lower.

52
Q

which teeth restored first for painlessness

A

upper before lower

with LA

53
Q

painless LA administration

A

topical anaesthetic first

54
Q

how to approach Tx plan for DFA

A

gradual introduction of dental equipment and procedures
- E.g. suction from cup first

This is done in a predetermined manner

Some aspects can be completed while other instruments and procedures are being introduced

Tell-Show-Do is an effective way to introduce instruments, in this way the child is acclimatised as treatment progresses

Simple first then complex

  • OHI
  • Fissure sealants
  • Upper before lower teeth restorations
55
Q

steps in Tx plan for DFA

A
  1. Simple exam, fluoride varnish application, give diet sheet, ask child to bring toothbrush next visit. Take radiographs or explain for next visit.
  2. Brush teeth using child’s brush, invite to sit on chair. Check diet. Take radiographs. Polish teeth and dry teeth, and so introduce slow speed and air syringe. Explain F/S process.

THIS MAY TAKE 1 OR 2 VISITS TO COMPLETE DEPENDS ON THE CHILD

3, Fissure sealants or dressings. Introduce the saliva injector

  1. Remove carious tissue with hand excavator if immediate temporisation is required. Use slow speed drill, for small buccal and cervical cavities. Introduce topical & give rubber dam home to play with. (e.g. pulpotomy needed, do before extractions)

THIS MAY TAKE 1 OR 2 VISITS TO COMPLETE DEPENDS ON THE CHILD

  1. Restore upper teeth with local anaesthesia, using topical prior to injection
  2. Restore lower teeth with local anaesthesia, again using topical prior to this
  3. Pulp treatments and then extractions last if patient is pain free
56
Q

success in treating children needs

A

The patient, dentist and parent all working as a team are key to ensuring that children are treated at their level in an empathic and caring manner.

57
Q

how dentist should always act around children and DFA

A

honest & explain what is happening, using a combination of behaviour management techniques.

Be positive

58
Q

Tx plan pace

A

allows for acclimatization at the CHILD’S pace

BDS3 paeds (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions