Lec 1.5 Nonpharmacological BMT Flashcards
- 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.
Tell Show Do
__________ → 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.
Tell
Show
Do
Euphemism for:
1. Amalgam
2. Local anesthesia
3. Rubber dam
4. Dental caries
5. Mouth mirror
6. Explorer
7. Dental chair
- Silver star/ filling
- Magic / sleepy juice
- Raincoat / blanket
- Tooth worm
- Baby mirror
- Tooth counter / pointer
- Airplane / spaceship
- 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.
Distraction
2 objectives of distraction?
(1) Decrease the perception of unpleasantness.
(2) Avert negative or avoidance behavior.
- Is an effective technique to reward desired behaviors and strengthen the recurrence of those behaviors.
- Objective: To reinforce desired behavior.
Positive reinforcement
What are the two kinds of reinforcement?
- Nonsocial reinforcers
- Social reinforcers
Example of nonsocial reinforcers
Tokens and toys
Example of social reinforcers
- Very good, good job, thank you, etc.
- include positive voice modulation, facial expression, verbal praise, and appropriate physical demonstrations of affection.
Another term for “reassuring touch”
Nonverbal Communication
Is the reinforcement and guidance of behavior through appropriate contact, posture, facial expression and body language.
Reassuring Touch
2 objectives of reassuring touch
- Enhance the effectiveness of other communicative management techniques.
- Gain or maintain the patient’s attention and compliance.
- 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.
Modeling / Imitation
- 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.
Flexible authority / Enhancing control
- 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.
Voice control
3 objectives of voice control
1) Gain the patient’s attention and compliance.
2) Avert negative or avoidance behavior.
3) Establish appropriate adult-child roles.
Other terms for “Restraints”
- Physical Intervention
- Protective Stabilization
Is the restriction of patient’s freedom of movement, with or without the patient’s permission.
Restraints
2 types of restraints?
- Active
- Passive
Examples of active restraints
Dentist, Dental Assistant, Parents or Guardian
Example of passive restraints
Mouth props/gag, papoose board, strap
- 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.
Restraints
A contraindication of voice control?
Patients who are hearing impaired
3 objectives of Restraints
- Reduce or eliminate untoward movement.
- Protect patient, staff, dentist, or parent from injury.
- Facilitate delivery of quality dental treatment.
Should consider in using Restraints?
- Alternate behavior guidance modalities
- Dental needs of the patient
- The effect on the quality of dental care
- The patient’s emotional development
- The patient’s physical considerations
In using restraints, the patient’s record should include?
- Informed consent for stabilization
- Indication for stabilization
- Type of stabilization
- The duration of application of stabilization
- Behavior evaluation/rating during stabilization
4 contraindications of restraints
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.
4 precautions for restraints
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.
