L03 Behaviour Management

Question 1

What are the key strategies to manage children’s behavior during dental treatment?

Answer 1

• Communication
• Non-pharmacological methods
• Pharmacological methods

Question 2

Is it possible to manage a child’s behavior during dental treatment?

Answer 2

Yes, but it depends on the child and your behavior management approach. Effective behavior management ensures treatment is provided while instilling a positive dental attitude.

Question 3

What does behavior management in dentistry involve?

Answer 3

Behavior management involves the means by which the dental team effectively and efficiently undertakes treatment for the child while fostering a positive dental attitude. It includes considering the child’s behavior and cooperation in their treatment plan.

Question 4

What factors influence a child’s behavior and anxiety?

Answer 4

• Stage of child development (motor, cognitive, perceptual, language, emotional, and social)
• Age and developmental milestones
• History (dental, medical, social, and family)
• Internal factors (hunger, illness, pain)
• External factors (time of day, lights, sounds, clinical environment)
• Special care patients (e.g., autism, sensory sensitivities)

Question 5

What are key developmental milestones for a 2-year-old?

Answer 5

• Gross motor skills
• Adventurous (explores by touching and putting things in the mouth)
• Attached to parents
• Solitary play
• Short attention span (1-5 minutes)

Question 6

What are key developmental milestones for a 3-year-old?

Answer 6

• Less egocentric
• Likes to please others (especially parents)
• Active imagination, increased curiosity
• Short attention span (4-8 minutes)
• Remains attached to parents

Question 7

What are key developmental milestones for a 4-year-old?

Answer 7

• Participates in small groups
• Developing independence, can be bossy
• Grasp reasoning and explanations
• More accepting to change and explanations

Question 8

What are key developmental milestones for a 5-year-old?

Answer 8

• Takes pride in possessions (toys, clothes)
• Relinquishes comfort objects (e.g., security blanket, soft toy)
• Plays cooperatively with peers
• Starts becoming more independent and aware of what is ‘grown-up’ behavior

Question 9

How does a child’s previous dental history affect their behavior during treatment?

Answer 9

Previous negative experiences can increase anxiety, while positive experiences may result in better cooperation. Additionally, parents’ anxiety and stories from family/friends can influence behavior.

Question 10

What role does parental anxiety play in managing a child’s behavior?

Answer 10

Maternal anxiety can influence the child’s anxiety and behavior. If parents are anxious, it may be difficult to manage the child’s behavior during treatment. In such cases, excluding the parent tactfully or having an alternative adult accompany the child may help.

Question 11

How do parenting styles affect behavior management in dental treatment?

Answer 11

• Dominant parents may interfere or try to control the situation, which can be counterproductive.
• Laid-back parents may not intervene when needed, which could lead to misbehavior.
• The dentist should take the lead and manage the situation assertively.

Question 12

How does a child’s cooperation and compliance affect treatment?

Answer 12

Cooperation is assessed at the start of treatment and throughout. It should be documented to provide insights for future treatment. Cooperation can vary depending on the child’s age, behavior, and development.

Question 13

What are the main behavior scales used to monitor a child’s compliance in dental treatment?

Answer 13

• Frankl Behavior Scale
• FIS: Facial Image Scale (Venham)
• MCDAS: Modified Child Dental Anxiety Scale

Question 14

How can communication influence behavior management?

Answer 14

• 55% of communication is non-verbal (gestures, facial expressions, welcoming smiles)
• 38% is vocal tone (firm, soothing, or approving)
• 7% is words used (age-appropriate language, positive phrasing)

Question 15

What are some examples of non-pharmacological behavior management techniques?

Answer 15

• Tell, Show, Do
• Behavior shaping (positive reinforcement, ignoring inappropriate behavior)
• Modeling (using live models like siblings)
• Distraction (conversation, music, games, etc.)
• Systematic desensitization (step-by-step process to overcome fears)

Question 16

What is the role of negative reinforcement in behavior management?

Answer 16

Negative reinforcement involves strengthening a behavior by removing an unpleasant stimulus when the child behaves well. However, it should never be used as punishment.

Question 17

What other techniques can be used to manage children’s behavior in dental treatment?

Answer 17

• Cognitive Behavioral Therapy (CBT)
• Relaxation techniques
• Hypnosis (works better in younger children)

Question 18

What is conscious sedation in dentistry?

Answer 18

Conscious sedation involves using drugs to depress the central nervous system, enabling treatment while maintaining verbal contact with the patient. Nitrous oxide and benzodiazepines are common sedatives used.

Question 19

What is the difference between inhalation sedation and general anesthesia (GA)?

Answer 19

• Inhalation Sedation: Uses a mixture of nitrous oxide and oxygen, patient remains conscious.
• General Anesthesia (GA): Patient is fully unconscious and used for more extensive treatment, typically requiring hospital-based care.

Question 20

What is the main contraindication for inhalation sedation in children?

Answer 20

A blocked airway, which prevents the child from breathing in the sedative gases.