Behavioural Management Techniques Flashcards
At age 2 children tend to be afraid of what? (3)
- unexpected movements
- Loud noises
- Strangers
at age 3 children react favourably to what? (2)
*Positive comments about clothes and behaviour
at age 3 children are generally less fearful of what? (1)
Separation from parents
at age 4 childrens fear of what peaks? and their fear of what decreases? (3)
- fear of unknown and bodily harm increases
* fear of strangers decreases
at age 5 children generally respond well to what? (2)
*compliments to clothes and possessions
at age 6 a child begins to seek acceptance, so its important that a dentist doesn’t make them feel what? (1)
*belittled or inadequate
at age 7 children learn to question what?(1)
*inconsistencies
at age 7 how well do children cope with fear? (1)
*They still have fears but are better at managing them
define anxiety (3)
- Occurs without a triggering stimulus
- Reactive to unknown danger
- can be anticipatory due to previous negative experiences
define fear (1)
*normal emotional response to objects or situations deemed as life threatening
define phobia (3)
- clinical mental disorder
- persistent extreme fear of objects or situations with avoidance behaviour
- interferes with daily life
What physiological and somatic sensations might an anxious child feel? (4)
- Breathlessness
- Perspiration
- Palpitations
- Feeling of unease
what cognitive features might an anxious child experience? (4)
- 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
what behavioural changes might occur in an anxious child? (3)
- Avoidance - postponing appointments/disruptive behaviour/fierce negotiation
- Escape from the situation
- In extreme cases they might bite/become aggressive
What exactly are children afraid of at the dentist? (5)
- choking
- injections/drilling
- PM/D experiences
- PM/D experience of friends/siblings
- parents attitudes towards dental care
What useful tool can you use to assess dental anxiety in children aged 8+ ? (1)
MCDAS Questionnaire
Why is the MCDAS questionnaire useful to have? (3)
- quick and easy to use
- rates the different aspects of dental experience
- base line levels of anxiety are established
what dentist behaviours will increase child anxiety? (5)
- ignoring/denying feelings
- inappropriate reassurance (This won’t hurt)
- coercing/coaxing
- Humiliating
- Losing your patience
Parent presence in the dentist has mainly shown to leave child behaviour unaffected with the exception of children aged? (1)
- 4 years old
what behavioural management techniques are there to improve child anxiety? (8)
- Positive reinforcement
- tell show do
- acclimatisation
- desensitisation
- voice control
- distraction
- role modelling
- relaxation/hypnosis
how can you provide positive reinforcement to a child? (2)
- Social reinforcers - facial expression, verbal praise, appropriate contact
- Non social reinforcers - stickers, colouring poster, clever certificates
How does “Tell Show Do” work? (3)
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
How does acclimatisation work? (1)
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.
how does systemic desensitisation work? (3)
- 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
how does voice control work? (1)
*controlled alteration of voice volume, tone or pace to influence and direct the patients behaviour
how does distraction work? (4)
- diverting patients attention away from what may be deemed as unpleasant
- Pulling upper lip
- telling a story whilst giving local
- Playing music
how does role modelling work? (2)
- helps with an older sibling who can show how easy treatment can be
- works better aged 3-5
How does relaxation work? (2)
- Breathing exercises
* space exercise
how does hypnosis work? (2)
- 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
In what order should you build a treatment plan for a dentally anxious child? (4)
- 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?)
Success in treating children depends on what? (7)
- 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
