July 8, 2021

Question 1

How many Children per year that visit dentist need sedation? (%)

Answer 1

20-30% (this may be an underestimate)

Question 2

Main limitation of non-intravenous parenteral and enteral sedation techniques?

Answer 2

Unable to titrate drugs

Question 3

Psychological Space

Answer 3

An area in which and individual feels comfortable with his/her surroundings and situation

Question 4

3y.o. behavioral expectation in dental office

Answer 4

Short attention spans, fearful of strangers, lack sufficient cognitive and language skills. Will require deeper levels of sedation

Question 5

Factors that are the biggest creator of disruptive behavior in dental office?

Answer 5

Fear and Anxiety

Question 6

Part of CNS where fear response mediates from?

Answer 6

Amygdala of midbrain, initially in limbic system of CNS.

Question 7

Key concepts of behavior associated with sedation. There are 6 concepts.

Answer 7

Temperament, Attachment, Age, Experience, parenting, dental team.

Question 8

What is temperament?

Answer 8

A child’s overt response as a basic and daily expression pattern to solitary and social situation. May aid in predicting how child will respond while under therapeutic doses of sedation

Question 9

What is attachment?

Answer 9

Psychological concepts wherein presence and strength of emotional bonds to caregivers affects child’s response in different contextual situations.

Question 10

What is Age?

Answer 10

Cognitive development associated with pt age.

Question 11

What is Baumrind parenting triangle?

Answer 11

Where parenting styles as a major influence on a child’s behaviors. Correlation between authoritarian, authoritative, and permissive.

Question 12

What is Authoritarian in Baumrind triangle?

Answer 12

Used harsh, controlling technique to control children and less compassion and dominates conversations.

Question 13

What is Authoritative in Baumrind traingle?

Answer 13

compassionate and warm but sets limits on behavior and permits interactive communications.

Question 14

What is permissive parent in Baumrind triangle?

Answer 14

Rarely sets limits on behavior and spoils the child.

Question 15

What is the difference between active restraints and passive restraints?

Answer 15

Active implies human is involved in physically restraining the child. Passive is the use of a restraining device (papoose board) or mouth prop. Must gain informed consent for active/passive.

Question 16

Will sedation only control the patient’s behavior?

Answer 16

No, must use behavior management techniques in addition to sedation.

Question 17

Key factors that determine a patient’s behavior in dental setting?

Answer 17

temperament, age, cognitive development, fears/anxiety, family relationships, past experiences.

Question 18

Child characteristics to assess prior to sedation?

Answer 18

Age-cognitive interactions consistent with cooperativeness.
Temperament-Activity, approachability, shyness, emotionality
Airway-presence and size of tonsils, normal respiratory sounds
Risk status- ASA I.

Question 19

Advanced behavioral guidance techniques?

Answer 19

Protective stabilization, sedation, general anesthesia

Question 20

Behavioral techniques in AAPD

Answer 20

TSD, voice control, nonverbal communication, positive reinforcement, distraction, parent presence/absence, N2O, protective stabilization, sedation, general anesthesia.

Question 21

Infant Behavior in dental settings

Answer 21

Birth-1 y.o
Cognitive-basic receptive and expressive language
Emotional-calm, quiet, degree/intensity of crying
Behavior-social smile, grimace, sitting up, crawling
Dental needs-extraction natal/neonatal teeth, trauma
Intervention-G.A, topical

Question 22

Toddler behavior in dental settings

Answer 22

Age 1-3 y.o
Cognitive-rapid evolving, language acquisition and purposeful use
Emotional- Calm, quiet, laughter, crying to screaming, anger, joy, surprise, shyness
Behavior-smiles, crying/temper tantrum, kicking, hitting
Dental needs- caries, trauma
Intervention- Short TSD, distraction, positive reinforcement, rewards, sedation (moderate to deep), G.A.

Question 23

Preschooler behavior in dental setting

Answer 23

Age 3-6 y.o
Cognitive-Language skills rapidly progressing, speaks what he/she hears, imagination and magic dominate
Emotional-Calm, quiet, laughter, crying w/purpose, anger, sadness, recognition of others emotions
Behavior- smiles, cries, kicking, hitting, spitting, obstinacy
Dental- caries, trauma, space maintenance
Interventions- TSD, distraction, positive reinforcement, rewards, voice control, nitrous oxide, mild to deep sedation, G.A.

Question 24

Primary school behavior in dental settings

Answer 24

Age 6-12 y.o
Cognitive- language skills approaching adult level, general compliance with authority figures begins to dominate
Emotional-calm, quiet, laughter w/purpose, crying w/purpose, anger, sadness, compassionate, interactive
Behavior-smiles, cries, obstinacy, moody, cooperative
Dental- caries, trauma, space maintenance, orthodontics
Interventions- TSD, distraction, positive reinforcement, nitrous oxide, mild to moderate sedation

Question 25

High school and teenager behavior in dental settings

Answer 25

Age 13-19
Adult cognition
Emotional- calm, quiet, laughter, moody, anger, avoidance, challenging, peer orient
behavior-smiles, obstinacy, moody, cooperative
dental needs- caries (rampant) trauma, space maintenance, orthodontics, tabacco-related periodontal issues
Interventions- TSD, distraction, positive reinforcement, nitrous oxide, mild to moderate sedation