Behavioural Management Flashcards

Question

health history items to get from pt to assess DFA

Answer 1

ask about previous dental treatment Ask about past experience Items relating to trust include attention to the dentist/patient relationship, and perception of vulnerability good use of precious time

Answer 2

Validated age 8+ Likert scale 1-5 Can be given out in waiting room to be done with medical history - quick & easy to use different aspects dental experience rated base line levels of anxiety are established (Humphries, Morrison & Lindsay 1995)

Answer 3

Improves the information obtained from the patient - More you know about them the better the Tx as more adapted to them Enable the dentist to communicate information to the patient Increases the likelihood of patient compliance – feel safe, listened to Decreases patient anxiety

Answer 4

Verbal Communication (5%) Paralinguistic (30%) Non-verbal communication (65%)

Answer 5

Preventing pain Being friendly & establish trust Working quickly Having a calm manner Giving moral support Being re-assuring about pain Empathy

Answer 6

Main fear is pain Tell them to expect something and it varies from person to person – can they tell you what they feel after So don’t anticipate pain

Answer 7

Ignoring or denying feelings Inappropriate reassurance Coercing/Coaxing Humiliating Losing your patience with the patient - If cannot complete Tx, place a dressing and stop so child doesn’t get distressed

Answer 8

If cannot complete Tx, place a dressing and stop so child doesn’t get distressed

Answer 9

Screwing up the eyes and lowering the eyebrows with the mouth open in a squarish appearance Can be seen in drilling with LA failure

Answer 10

Opening eyes widely and raising eyebrows with mouth open and tense

Answer 11

Precipitator to conversion Focuses on why they are worried or fearful of dentist Parents experience too Can give information for prior to Tx Qs - How worried are they? - How painful do they think treatment will be? - What do they want to happen? - How will they cope? - What is their stop signal?

Answer 12

Research suggests that the child's behaviour is unaffected by parental presence or absence - exception would appear to be children less than 4 years of age who have been shown to behave better with a parent present. esp when young (knee to knee exam)

Answer 13

Patient is incapable or unwilling to sit for examination (positioning the child in the lap of the dentist and parent permits the child to be in direct visual and physical contact with the parent – need to knee to knee examination ) Opportunity exists for the parent to witness the behaviour the clinician must contend with - Can see how child behaves and why may need referred for behaviour

Answer 14

positive reinforcement tell show do Acclimatisation desensitisation voice control Distraction role modelling relaxation / hypnosis

Answer 15

The presentation of a stimulus that will increase the likelihood of a behaviour being repeated Social reinforcers- facial expression, verbal praise & appropriate physical contact Nonsocial reinforcers- stickers, colouring poster and clever certificates - Not brave – expected of them but also to do them

Answer 16

facial expression, verbal praise & appropriate physical contact

Answer 17

stickers, colouring poster and clever certificates | - Not brave – expected of them but also to do them

Answer 18

Used to familiarise a patient with a new procedure. The tell involves an age appropriate explanation of the technique. The show is demonstrating for the patient aspects of the procedure in a non-threatening setting. The do phase is initiated with minimal delay E.g. slow speed on fingernail

Answer 19

e.g., inhalation sedation, new instrument The planned, sequential introduction of environment, people, instruments and procedures. - An integral part of the treatment plan Introduce the 3:1, suction & cotton rolls on the visit before you plan a fissure sealant Use the slow speed first with a prophy cup, later with a bur and later introduce the high-speed Introduce topical one visit before using LA for the first time Give rubber dam home on the visit before you plan to use it

Answer 20

always making sure child is calm and in control This is based on the assumption that repeated non-distressing exposure to an anxiety-provoking stimulus will eventually reduce anxiety The child must be reassured that they are in control - This is done in an ordered manner from what they perceive as the least anxiety provoking to the most anxiety provoking, in imagination of in real-life until no anxiety is produced - Relaxation techniques taught or strategies like mental maths in head, So child knows able to cope with that so willing to try next stage e.g. Systematic Needle Desensitisation

Answer 21

A controlled alteration of voice volume, toneor pace to influence and direct the patient’s behaviour. - To gain the patients attention & compliance - To avert negative or avoidance behaviour

Answer 22

The technique of diverting the patient from what may be perceived as an unpleasant procedure - pulling the upper lip - telling a story while giving local anaesthetic - letting an older child bring in music to listen to

Answer 23

sometimes similar age same/similar treatment presence of an older sibling is best for children aged 3-5 yrs see other can cope therefore nothing to be anxious of

Answer 24

- Progressive muscle relaxation - Space exercise - breathing techniques Practice yourself so can teach well

Answer 25

An interaction between one person, the “hypnotist” and another person or people, the “subject” The hypnotist attempts to influence the subjects’ perception, feelings, thinking and behaviour by asking them to concentrate on ideas and images. The verbal communications that the hypnotist uses to achieve these effects are termed “suggestions” The response is experienced by the subject as having a quality of involuntariness or effortlessness.

Answer 26

HAND OVER MOUTH - unacceptable problems - adverse psychological effects - parental consent - professional acceptance - litigation

Answer 27

Care should be taken not to hurt any child. Restorative care is usually carried out under local anaesthesia. A painless technique of administering LA is of vital importance with topical an integral part of treatment. Upper carious teeth are normally restored with L.A. before lower.

Answer 28

upper before lower with LA

Answer 29

topical anaesthetic first

Answer 30

gradual introduction of dental equipment and procedures - E.g. suction from cup first This is done in a predetermined manner Some aspects can be completed while other instruments and procedures are being introduced Tell-Show-Do is an effective way to introduce instruments, in this way the child is acclimatised as treatment progresses Simple first then complex - OHI - Fissure sealants - Upper before lower teeth restorations

Answer 31

1. Simple exam, fluoride varnish application, give diet sheet, ask child to bring toothbrush next visit. Take radiographs or explain for next visit. 2. Brush teeth using child’s brush, invite to sit on chair. Check diet. Take radiographs. Polish teeth and dry teeth, and so introduce slow speed and air syringe. Explain F/S process. THIS MAY TAKE 1 OR 2 VISITS TO COMPLETE DEPENDS ON THE CHILD 3, Fissure sealants or dressings. Introduce the saliva injector 4. Remove carious tissue with hand excavator if immediate temporisation is required. Use slow speed drill, for small buccal and cervical cavities. Introduce topical & give rubber dam home to play with. (e.g. pulpotomy needed, do before extractions) THIS MAY TAKE 1 OR 2 VISITS TO COMPLETE DEPENDS ON THE CHILD 5. Restore upper teeth with local anaesthesia, using topical prior to injection 6. Restore lower teeth with local anaesthesia, again using topical prior to this 7. Pulp treatments and then extractions last if patient is pain free

Answer 32

The patient, dentist and parent all working as a team are key to ensuring that children are treated at their level in an empathic and caring manner.

Answer 33

honest & explain what is happening, using a combination of behaviour management techniques. Be positive

Answer 34

allows for acclimatization at the CHILD’S pace