Behavioural Management Techniques

Question 1

At age 2 children tend to be afraid of what? (3)

Answer 1

• unexpected movements
• Loud noises
• Strangers

Question 2

at age 3 children react favourably to what? (2)

Answer 2

*Positive comments about clothes and behaviour

Question 3

at age 3 children are generally less fearful of what? (1)

Answer 3

Separation from parents

Question 4

at age 4 childrens fear of what peaks? and their fear of what decreases? (3)

Answer 4

• fear of unknown and bodily harm increases

* fear of strangers decreases

Question 5

at age 5 children generally respond well to what? (2)

Answer 5

*compliments to clothes and possessions

Question 6

at age 6 a child begins to seek acceptance, so its important that a dentist doesn’t make them feel what? (1)

Answer 6

*belittled or inadequate

Question 7

at age 7 children learn to question what?(1)

Answer 7

*inconsistencies

Question 8

at age 7 how well do children cope with fear? (1)

Answer 8

*They still have fears but are better at managing them

Question 9

define anxiety (3)

Answer 9

• Occurs without a triggering stimulus
• Reactive to unknown danger
• can be anticipatory due to previous negative experiences

Question 10

define fear (1)

Answer 10

*normal emotional response to objects or situations deemed as life threatening

Question 11

define phobia (3)

Answer 11

• clinical mental disorder
• persistent extreme fear of objects or situations with avoidance behaviour
• interferes with daily life

Question 12

What physiological and somatic sensations might an anxious child feel? (4)

Answer 12

• Breathlessness
• Perspiration
• Palpitations
• Feeling of unease

Question 13

what cognitive features might an anxious child experience? (4)

Answer 13

• Struggling to concentrate
• Hypervigilance (looking around trying to see what’s happening)
• Inability to remember certain events whilst anxious
• Imagining the worst that could happen

Question 14

what behavioural changes might occur in an anxious child? (3)

Answer 14

• Avoidance - postponing appointments/disruptive behaviour/fierce negotiation
• Escape from the situation
• In extreme cases they might bite/become aggressive

Question 15

What exactly are children afraid of at the dentist? (5)

Answer 15

• choking
• injections/drilling
• PM/D experiences
• PM/D experience of friends/siblings
• parents attitudes towards dental care

Question 16

What useful tool can you use to assess dental anxiety in children aged 8+ ? (1)

Answer 16

MCDAS Questionnaire

Question 17

Why is the MCDAS questionnaire useful to have? (3)

Answer 17

• quick and easy to use
• rates the different aspects of dental experience
• base line levels of anxiety are established

Question 18

what dentist behaviours will increase child anxiety? (5)

Answer 18

• ignoring/denying feelings
• inappropriate reassurance (This won’t hurt)
• coercing/coaxing
• Humiliating
• Losing your patience

Question 19

Parent presence in the dentist has mainly shown to leave child behaviour unaffected with the exception of children aged? (1)

Answer 19

• 4 years old

Question 20

what behavioural management techniques are there to improve child anxiety? (8)

Answer 20

• Positive reinforcement
• tell show do
• acclimatisation
• desensitisation
• voice control
• distraction
• role modelling
• relaxation/hypnosis

Question 21

how can you provide positive reinforcement to a child? (2)

Answer 21

• Social reinforcers - facial expression, verbal praise, appropriate contact
• Non social reinforcers - stickers, colouring poster, clever certificates

Question 22

How does “Tell Show Do” work? (3)

Answer 22

Tell - an age appropriate explanation of the technique
Show - demonstrate for the patient aspects of the procedure in a non-threatening setting
Do- Initiate the procedure with minimal delay

Question 23

How does acclimatisation work? (1)

Answer 23

Introduce new things to the patient and show them how they work outside the mouth in a non threatening manner so that they better understand what they are and how they work.

Question 24

how does systemic desensitisation work? (3)

Answer 24

• assure child they are in control
• start with what they deem to be least anxiety provoking and work your way up
• Systemic needle desensitisation is a good example

Question 25

how does voice control work? (1)

Answer 25

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

Question 26

how does distraction work? (4)

Answer 26

• diverting patients attention away from what may be deemed as unpleasant
• Pulling upper lip
• telling a story whilst giving local
• Playing music

Question 27

how does role modelling work? (2)

Answer 27

• helps with an older sibling who can show how easy treatment can be
• works better aged 3-5

Question 28

How does relaxation work? (2)

Answer 28

• Breathing exercises

* space exercise

Question 29

how does hypnosis work? (2)

Answer 29

• dentist tries to get patient to focus on ideas and images in an attempt to influence the patients perception and feelings
• Dentists uses verbal cues in the form of suggestions

Question 30

In what order should you build a treatment plan for a dentally anxious child? (4)

Answer 30

• general introduction of dental equipment
• use tell show do to introduce instruments
• prioritise treatments that don’t require LA
• Use a painless technique when introducing LA (wand?)

Question 31

Success in treating children depends on what? (7)

Answer 31

• Dentist, parent and child working as a team
• Children are treated with empathy and care
• Explain what’s happening and be honest
• Use behaviour management techniques
• Be positive
• Go at childs pace
• Ensure LA and topical is used when required