Behavioural Science for dentists

Question 1

What is the scientist practitioner model ?

Answer 1

integration of clinics and research so they can dictate each other
using methods to test out different interventions

Question 2

What is the medical model of care ?

Answer 2

dominant
diagnosis and treatment of the focus disease
signs and symptoms are resolved with treatment

Question 3

What is teh biopsychosocial model ?

Answer 3

patient recovery is due to a number of factors not just medical
social, biological and psychological factors

Question 4

What are social factors in the biopsychosocial model ?

Answer 4

family
cultural 
habits 
beliefs 
finance/social class

Question 5

What are psychological factors in the biopsychosocial model ?

Answer 5

thoughts
nehaviours
attitudes
beliefs

Question 6

What are biological factors in the biopsychosocial model ?

Answer 6

medication

infection etc

Question 7

What is the relevance of behavioural science ?

Answer 7

differences in communication style can dictate complaints, dentlal anxiety and behaviour

Question 8

What are the comp;ications with fearful people ?

Answer 8

likely to have poor oral health
no show
treatment with sedation which is expensive and rsiky and does not solve the problem

Question 9

What is self efficacy ?

Answer 9

a persons confidence in their ability to carry out a behaviour

Question 10

What is the implementation intention theory ?

Answer 10

likelihood of a person performing a behaviour is increased by making an implicit behaviour plan

Question 11

What is exhibited in burnout ?

Answer 11

exhaustion-emotional and physical
combination of environemtnal and internal stressors
negative attitude to job, low self esteem etc

Question 12

What are the 4 challenges leading to burnout ?

Answer 12

dealing with anxious patients
making complex decsions
difficult postures
time pressures

Question 13

What is fear ?

Answer 13

an emotion now
danger and urge to fight or escape
physical response is fight or flight

Question 14

What is anxiety ?

Answer 14

an emotion
associated with anticipation of danger
in the future
urge to avoid

Question 15

What is pain ?

Answer 15

unpleasant sensroy experience assocaited wit actual or potential tisseu damage
can be increased by distress

Question 16

What is behaviour learning theory ?

Answer 16

classic conditioning
2 things that always occur together become linked
pavlovs dogs
the dentist and unpleasant feelings are linked

Question 17

What is a stimulus ?

Answer 17

exerts a particular response

Question 18

What is a neutral stimulus ?

Answer 18

something that has no effect goes to becoming a conditioned stimulus

Question 19

What is generalisation ?

Answer 19

conditioned response can be triggered by other similar stimuli

Question 20

What are the dental implications of classic condtioning ?

Answer 20

patients may react with fear to the features of the dental environment
elements may resemble past abuse

Question 21

What is operant conditioning ?

Answer 21

behaviour and emotions are foten linked
are we reinforcing appraoch behaviour or avoidance behaviour
behaviour is shaped by what happens imemdiately after

Question 22

What is positive reinforcement ?

Answer 22

a behaviour is followed by a rewarding outcome

eg. getting canfy for getting an A

Question 23

What is negative reinforcement ?

Answer 23

behaviour is followed by cessation of an unwanted experience
eg. eat brocolli and i will stop shoutung at you

Question 24

What is punishment ?

Answer 24

a behaviour followed by an unwanted experience

Question 25

What is extinction ?

Answer 25

a behaviour is followed by no rewarding outcome and eventually stops

Question 26

What does stopping reinforcement lead to ?

Answer 26

fast exticntion

Question 27

What is the cognitive model ?

Answer 27

thinking thoughts more likely to feel it | thinking anxious thoughts you are more likely to feel it

Question 28

What are the implications of escape ?

Answer 28

if they escape then they have no idea if the worst would have happened or not

Question 29

What is vicarious leaning ?

Answer 29

learning through the experiences of someone else eg, observations, hearing, picking up eg. siblings in the room

Question 30

What does the 5 areas model do ?

Answer 30

splits up our experience into thoughts, behaviors, emotional feelings and physical - they are linked

Question 31

How can we apply the 5 areas model ?

Answer 31

by making 1 or 2 small changes over time | little changes over time make a big difference

Question 32

How does dental fear come about ?

Answer 32

traumatic dental experiences pain vicarious experience

Question 33

What is the cycle of dental fear ?

Answer 33

dental fear leads to delayed visiting dental problems symptom driven treatment

Question 34

What is the fight or flight response ?

Answer 34

``` triggered by potential danger cortisol and adrenaline release fast breathing and HR hot and sweaty fumbling and nausea ```

Question 35

How can we minimise fear ?

Answer 35

paying attention to factors that present as a conditioned stimulus

Question 36

What is systematic desensitisation ?

Answer 36

fear can be treated by exposure to factors that present as conditioned stimuli - patient sees nothing wrong and fear reduces

Question 37

What are cognitive principles ?

Answer 37

help patients understand what is happening in theri treatment ask and address concerns normalise reactions

Question 38

What are recommendations for mild forms of anxiety ?

Answer 38

general anxiety reducing style acknowledge anxiety assure patient nothing will happen against will distraction and relaxation

Question 39

What are recommendations for specific phobia ?

Answer 39

construct a hierarchy and work through each level with patient tolerance

Question 40

What are recommendations for high treatment needs ?

Answer 40

IV or General sedation | but the patient wont progress with ther fear

Question 41

How can we address psychosocial aspects ?

Answer 41

keep calm signalling let them know it is due to fight/flight response breathe 7 in 11 out

Question 42

How can we address social aspects ?

Answer 42

treat with respect and without judgement

Question 43

What can pain be influenced by ?

Answer 43

``` situation interpersonal factors previous experience temperament response ```

Question 44

How can we address pain ?

Answer 44

anxiety management principles

Question 45

What are behaviour changes that dental professonals are intersted in ?

Answer 45

cleaning teeth attending routine check up diet and smoking general health

Question 46

What is the assumed model of communication ?

Answer 46

we give accurate information about the risk and impact of current behaviour patient understands and this leads to appropriate behaviour change

Question 47

What is required for change ?

Answer 47

an intetntion

Question 48

What does intention depend on ?

Answer 48

whether we are confident

Question 49

What happens after intetnion ?

Answer 49

we need the ability to translate into new behaviours

Question 50

What does the self efficacy theory state ?

Answer 50

a change in behaviour is predicted by the ability of the person to carry out the behaviour

Question 51

How can we change confidence ?

Answer 51

experience observations persuasion feeling good after

Question 52

What can affect intention ?

Answer 52

attitude subjective norm normal beliefs

Question 53

What is the intention behaviour gap ?

Answer 53

we intend something doesnt always lead to behaviour

Question 54

What are 2 stages of changing ?

Answer 54

motivational phase- leads to intetnion and wanting to change volitional phase- going ahead and doing it

Question 55

What is volitional phase affected by ?

Answer 55

maintenance of self efficacy

Question 56

What are the stages of the change model ?

Answer 56

``` pre contemplation contemplation planning action maintenance ```

Question 57

What is motivational interviewing ?

Answer 57

to motivate someone develop a guiding style ask about pros and cons allow consultation to be patient led

Question 58

How to design an intervention phase ?

Answer 58

define problems target behaviours specify the behaviour identify what needs to change

Question 59

What are the factors of the behaviour change wheel ?

Answer 59

capability - physical motivation - do they think its important opportunity - provide opportunities

Question 60

What is behaviour learning theory ?

Answer 60

behaviour is affected by stimuli and reinforcement

Question 61

What is classical conditioning ?

Answer 61

a stimuli can become conditioned to produce a particular response

Question 62

What is the difference between operant and classical conditioning ?

Answer 62

operant conditioning states that behaviours are performed based on what happens after that behaviour classical conditioning states that behaviour is determiend by stimuli that have been conditioned to produce a certain response