Lec 1.5 Nonpharmacological BMT

Question 1

• Is the technique of behavior shaping
• Used with communication skills (verbal & nonverbal) and positive reinforcement.
• Teach the patient important aspects of the dental visit and familiarize the patient with the dental setting.
• Shape the patient’s response to procedures through Desensitization and well-described expectations.

Answer 1

Tell Show Do

Question 2

__________ → Verbal explanations of procedures in phrases appropriate to the developmental level of the patient.

__________ → Demonstrations for the patient of the visual, auditory, olfactory, and tactile aspects of the procedure in a carefully defined, non-threatening setting.

__________ → Completion of the procedure, without deviating from the explanation and demonstration.

Answer 2

Tell
Show
Do

Question 3

Euphemism for:
1. Amalgam
2. Local anesthesia
3. Rubber dam
4. Dental caries
5. Mouth mirror
6. Explorer
7. Dental chair

Answer 3

1. Silver star/ filling
2. Magic / sleepy juice
3. Raincoat / blanket
4. Tooth worm
5. Baby mirror
6. Tooth counter / pointer
7. Airplane / spaceship

Question 4

• Is the technique of diverting the patient’s attention from what may be perceived as an unpleasant procedure.
• A short break during a stressful procedure can be an effective use of distraction.

Answer 4

Distraction

Question 5

2 objectives of distraction?

Answer 5

(1) Decrease the perception of unpleasantness.
(2) Avert negative or avoidance behavior.

Question 6

• Is an effective technique to reward desired behaviors and strengthen the recurrence of those behaviors.
• Objective: To reinforce desired behavior.

Answer 6

Positive reinforcement

Question 7

What are the two kinds of reinforcement?

Answer 7

1. Nonsocial reinforcers
2. Social reinforcers

Question 8

Example of nonsocial reinforcers

Answer 8

Tokens and toys

Question 9

Example of social reinforcers

Answer 9

• Very good, good job, thank you, etc.
• include positive voice modulation, facial expression, verbal praise, and appropriate physical demonstrations of affection.

Question 10

Another term for “reassuring touch”

Answer 10

Nonverbal Communication

Question 11

Is the reinforcement and guidance of behavior through appropriate contact, posture, facial expression and body language.

Answer 11

Reassuring Touch

Question 12

2 objectives of reassuring touch

Answer 12

1. Enhance the effectiveness of other communicative management techniques.
2. Gain or maintain the patient’s attention and compliance.

Question 13

• Is based on the psychological principle that people learn about their environment by observing others
• Using a model, either live or by video to exhibit appropriate behavior in the dental environment.
• Models should be the same age* as the target child, should exhibit appropriate behavior.

Answer 13

Modeling / Imitation

Question 14

• Is given a degree of control over their dentists’ behavior through the use of a stop signal.
• Raising an arm, should be rehearsed and the dentist should respond quickly when it is used.
• Such signals have been shown to reduce pain during routine dental treatment and during injection.

Answer 14

Flexible authority / Enhancing control

Question 15

• Is a controlled alteration of voice volume, tone, or pace to influence and direct the patient’s behavior.
• WARNING! Parents unfamiliar with this technique may benefit from an explanation prior to its use to prevent misunderstanding.

Answer 15

Voice control

Question 16

3 objectives of voice control

Answer 16

1) Gain the patient’s attention and compliance.
2) Avert negative or avoidance behavior.
3) Establish appropriate adult-child roles.

Question 17

Other terms for “Restraints”

Answer 17

• Physical Intervention
• Protective Stabilization

Question 18

Is the restriction of patient’s freedom of movement, with or without the patient’s permission.

Answer 18

Restraints

Question 19

2 types of restraints?

Answer 19

1. Active
2. Passive

Question 20

Examples of active restraints

Answer 20

Dentist, Dental Assistant, Parents or Guardian

Question 21

Example of passive restraints

Answer 21

Mouth props/gag, papoose board, strap

Question 22

• May involve another human(s), a patient stabilization device, or a combination thereof.
• Should use the least restrictive, but safe and effective.
• Use of a mouth prop in a compliant child is not considered protective stabilization.
• Requires informed consent from a parent, an explanation to the patient regarding the need for restraint.
• WARNING! potential to produce serious consequences, such as physical or psychological harm, loss of dignity, and violation of a patient’s rights.

Answer 22

Restraints

Question 23

A contraindication of voice control?

Answer 23

Patients who are hearing impaired

Question 24

3 objectives of Restraints

Answer 24

1. Reduce or eliminate untoward movement.
2. Protect patient, staff, dentist, or parent from injury.
3. Facilitate delivery of quality dental treatment.

Question 25

Should consider in using Restraints?

Answer 25

1. Alternate behavior guidance modalities
2. Dental needs of the patient
3. The effect on the quality of dental care
4. The patient’s emotional development
5. The patient’s physical considerations

Question 26

In using restraints, the patient’s record should include?

Answer 26

1. Informed consent for stabilization
2. Indication for stabilization
3. Type of stabilization
4. The duration of application of stabilization
5. Behavior evaluation/rating during stabilization

Question 27

4 contraindications of restraints

Answer 27

1) Cooperative non-sedated patients.
2) Patients who cannot be immobilized safely due to associated medical or physical conditions.
3) Patients who have experienced previous physical or psychological trauma from protective stabilization.
4) Non-sedated patients with non-emergent treatment requiring lengthy appointments.

Question 28

4 precautions for restraints

Answer 28

1) Medical conditions which may compromise respiratory function (e.g., asthma).
2) Tightness and duration of the stabilization must be monitored and reassessed at regular intervals.
3) Must not actively restrict circulation or respiration.
4) Should be terminated as soon as possible in a patient who is experiencing severe stress or hysterics to prevent possible physical or psychological trauma.