Paeds-behaviour Flashcards
Compare dental fear/ anxiety and phobia?
Anxiety- a reaction due to a previous negative experience.
Fear- Emotional response to a specific threat
Phobia- Persistent and extreme fear of objects or situations which interfere with daily life.
Discuss the physiological changes common in a child experiencing anxiety?
Breathlessness
Perspiration
Palpitations
Fealing of unease.
Discuss the cognitive changes in a child experiencing anxiety.
Interference in concentration
Hypervigilance
Inability to remember certain events
Imaging the worst that could happen.
Discuss the behavioural reactions of a child experiencing anxiety.
Avoidance- Postponing appointments/ constantly speaking/ closing thir mouth/ asking lots of quesitions/ asking to go to the toliet frequently. Older children may complain of headaches/dizziness/ or can’t be bothered.
Running away
Aggresive behaviour( will need to discuss these feelings)
The patient’s eyes are screwed up and their eyebrows are lowered.
What is this a sign of?
Pain.
The patient’s eyes are wide and their eyebrows are raised.
What is this a sign of?
Fear
What is the letter to dentist?
This collects the worry and pain expectations of the child’s dental treatment.
It also decides on the stop signal that is vital for patient control .
How do we assess dental fear and anxiety (DFA)
- Assess the patient’s desire to influence the course of treatment (give back control e.g. rest breaks/ stop signals)
- Find out the relevant health history questions.
- Use the MCDAS- modified child dental anxiety scale.
Why do we restore upper teeth before lowers?
Because it is easier to anaesthetise upper teeth & it is more comfortable.
What do we start with for child patients.
We start with the painless treatment to get the child used to the dental environment.
Compare social and non-social re-inforcers
Social reinforcers are facial expressions/ verbal praise/ appropriate physical contact.
Non social reinforcers are stickers or certificates.
e.g. a brave certificate or a clever certificate.
What is acclimitisation?
Gradually introducing children to the dental environment such as:
- showing the child on a stuffed animal
- introducing suction by letting the child suck water from a cup.
What is systematic desensitisation?
The idea that repeated non distressing exposure to a stimulus will reduce anxiety
e.g. systematic needle desensitisation (when the patient is calm show them a needle)
How does role modelling work to manage behaviour?
If a patient sees someone else doing a similar proedure and mastering it, they will imitate them
How does hypnosis work for behaviour management?
The patient is relaxed and asked to concetrate on ideas and images. The hypnotist communicates with the patient to get their subconcious brain more open to the ideas.
Describe the fight or flight response for a child
We have calm (p/s) and panic (S) mode.
Panic mode would be switched on if someone steps infront of you while you are riding a bike.
Your imagination can also switch panic mode on. (i.e. worrying about the dentist)
What is the applied tension relaxation technique?
You raise blood pressure to prevent fainting by:
- Tensing the muscles of the arms/ chest and keeping them tense until they feel the heat rising in their face.
- Releasing the tension (goes back to normal)
- Repeat 5 times.
When do we use the applied tension technique and why?
Used for patients with a fainting tendency and blood injury related phobia.
As fainting is caused by a rapid drop in blood pressure and blood injury injection related phobia is characteristic of causing fainting.
Discuss the relaxation technique of matching and pacing
You match your breathing with your patients so that you can begin to lead the pace yourself.
This ensures the pace is as slow as you want it to be.
Discuss progressive muscle relaxation.
You relax the body starting from the top and working down.
Through tensing the area, holding the tension and then releasing to relax.
How do you relax the child using controlled breathing?
- breathe in for 3
- hold
- Breathe out for 5.
This gets the child to focus on their breathing.
How do you relax a child using the space exercise?
Breathe in for 3, hold and breathe out for 5.
Then ask the patient to repeat each phrase that you say in their head while they are breathing out.
