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Behaviour management in dental clinic Safe and effective treatment of dental diseases often requires modifying the child’s behavior. Behavior guidance is a continuum of interaction involving the dentist and dental team, the patient, and the parent directed toward communication and education.
Its goal is to ease fear and anxiety while promoting an understanding of the need for good oral health and the process by which that is achieved. For treating children a variety of behavior guidance approaches are used it is important to, assess accurately the child’s developmental level, dental attitudes, and temperament and to predict the child’s reaction to treatment. The child who presents with oral/dental pathology and noncompliance makes the management more challenging. The pediatric dental staff can play an important role in behavior guidance.
Communication may be accomplished by a number of means but, in the dental setting, it is affected primarily through dialogue, tone of voice, facial expression, and body language. One should communicate with the child patient briefly at the beginning of a dental appointment to establish rapport and trust.
However, once a procedure begins, the dentist’s ability to control and shape behavior becomes paramount, and information sharing becomes secondary.
Various behavior management techniques such as Tell-show-do is used by many pediatric professionals.
The technique involves verbal explanations of procedures in phrases appropriate to the developmental level of the patient (tell); demonstrations for the patient of the visual, auditory, olfactory, and tactile aspects of the procedure in a carefully defined, nonthreatening setting (show); and then, without deviating from the explanation and demonstration, completion of the procedure (do). The tell-show-do technique is used with communication skills (verbal and nonverbal) and positive reinforcement. Voice control is a controlled alteration of voice volume, tone, or pace to influence and direct the patient’s behavior.
Distraction is another technique involving diverting the patient’s attention from what may be perceived as an unpleasant procedure.
Giving the patient a short break during a stressful procedure can be an effective use of distraction prior to considering more advanced behavior guidance techniques. Some children may require a more advanced behavior management techniques using pharmacological agents such as conscious sedation, deep sedation or general anesthesia.
Nitrous oxide/oxygen inhalation is a safe and effective technique of giving conscious sedation to reduce anxiety and enhance effective communication. Its onset of action is rapid, the effects easily are titrated and reversible, and recovery is rapid and complete. Additionally, nitrous oxide/oxygen inhalation mediates a variable degree of analgesia, amnesia, and gag reflex reduction. Some children and developmentally disabled patients require general anesthesia to receive comprehensive dental care in a safe and humane fashion. Many pediatric dentists (and others who treat children) have sought to provide for the administration of general anesthesia by properly-trained individuals in their offices or other facilities (eg, outpatient care clinics) outside of the traditional hospital setting.
For information on this subject please contact Dr Eva A. Douvara DMD PhD, owner and principle of the Dental Clinic Dr Douvaras.
Tel: +30 210 7224224 - Mob: +30 6932 486648
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