behavioural management
TRANSCRIPT
-
8/3/2019 Behavioural Management
1/16
BEHAVIOURAL MANAGEMENT
IN PEDIATRIC DENTISTRY
BY :- MAHARISHI RATHORE
-
8/3/2019 Behavioural Management
2/16
BEHAVIOURAL MANAGEMENT
Should go hand in hand with the hand piece skill andknowledge of Dental materials for the successfultreatment of children.
Disruptive behaviour can interfere significantly withproviding quality dental care,resulting in increaseddelivery time and risk of injury to the child.
Surveys of clinicians have found thatDENTISTSconsider the uncooperative child to be among the mosttroulbesome problems in Clinical Practice.
-
8/3/2019 Behavioural Management
3/16
Behavioural management methods in pediatric
dentistry are directed towards the goal of
communication and education.
The relationship between the dentist and the
child is built through a dynamic process of
dialouge,facial expression and voice tone ; allmethods of delivering a message.
The Goals of behaviour management are to
achieve good dental health in the child and tohelp develop the childs positive attitude
towards dental health.
-
8/3/2019 Behavioural Management
4/16
Behavioural management is a thus not an
application of individual techniques created to
deal with the child,but rather a comprehensivemethodology means to develop a relationship
between the patient & the doctor which ultimately
builds trust and allays fears & anxieties.
-
8/3/2019 Behavioural Management
5/16
Child can be Managed by the
following methods:- 1. AUDIO ANALYSIS (or,White Noise):- is amethod of producing pain.This techniqueconsists of providing a sound stimulus to such
intensity that the patient finds it difficult toattend to anything else.Auditory stimulus suchas pleasant music has been used to reducestress and also reduce the reaction to pain.
2. BIO FEEDBACK:- Bio feedback involvesthe use of the certain instruments to detectcertain physiologic process associated with
fear.
-
8/3/2019 Behavioural Management
6/16
3. HUMOR :- Humor help to elevate the mood of
the child which help the child to relax.
Functions of humor are :- - Social
- Emotion
- Informative
- Motivation- Cognitive
4. COPING :- It is the mechanism by which the
child copes up with dental treatment .It is definedas the cognitive and behavioural efforts made by
an individual to master, tolerate or reduce
stressful situations.
-
8/3/2019 Behavioural Management
7/16
5. VOICE CONTROL :- It is the modification of
intensity and pitch of one own voice in an attempt
to dominate the interaction between the dentistand the child.
6. RELAXATION :- This technique is used
to reduce Stress & based onprinciples ofelimination of anxiety.
7. HYPNOSIS :- It is an altered state of
consciousness characterized by heightenedsuggestibility to produce desirable ,
behavioural &physiological changes .
-
8/3/2019 Behavioural Management
8/16
8. IMPLOSION THERAPY :- Sudden flooding
with a barrage of stimuli which have affectedhim adversely & the child has no other choice .
But to face the stimuli until negative response
disappears.
9. ADVERSIVE CONDITIONING :- Child who
displays a negative behaviour and does not
respond to moderate behaviour modifications
technique falls into the category of frankles ,
definitive negative behaviour .
-
8/3/2019 Behavioural Management
9/16
HOME
(Hand-Over-Mouth-Exersice) The behavioural modifications method of
aversive conditioning is also known as
HOME. It was 1st introduced by Evangeline
Jordan,1920.
The purpose of HOME is to gain theattention of a child so that communicationcan be achieved.
-
8/3/2019 Behavioural Management
10/16
INDICATIONS
A healthy child who can understandbut who exhibits defiance &hysterical behavior duringtreatment.
3-6 years old.
A child who can understand simple
verbal commands. Children displaying uncontrollable
behavior.
-
8/3/2019 Behavioural Management
11/16
CONTRAINDICATIONS
Child under 3 years of age.
Handicaped child/immature child,
frightened child.
Physical ,mental and Emotional
Handicap.
-
8/3/2019 Behavioural Management
12/16
Factors To Be Considered Before
Applying HOME Technique
HOME technique should not be used as a
routine procedure for the management of thechild.
Inform the parents about the procedure.
Consent of the Parents is very important. Pediatric Dentists should be aware of the
changing laws that govern informed consent.
-
8/3/2019 Behavioural Management
13/16
TECHNIQUE
After determining the childs behavior ,the dentistfirmly places his hand over the childs mouth andbehavioral expectations are calmly explained closeto the childs ear. When the childs verbal outburstis completely stopped and the child indicates hiswillingness to cooperate, he should becomplimented for being quiet and praised for good
behavior. It should be noted that the childs airwayis not restricted while performing the techniqueand the whole procedure should not last formore than 20-30 seconds.
-
8/3/2019 Behavioural Management
14/16
Several Variations of HOME
Hand over mouth with the airway
unrestricted.
Hand over mouth and the nose and the
airway restricted.
Towel held over the mouth only.
Dry towel held over the nose and mouth.
Wet towel held over the nose and mouth.
-
8/3/2019 Behavioural Management
15/16
HOMAR (Airway Restricted)
TheAdvantage behindAirway Restriction is that
the child will be quiet so as to breathe and the
screaming will decrease so that the Doctor canproceed.
Together with Hand Over Mouth,Nostrils are
pinched for 15 seconds.
Belanger,(1993) believed that Airway Restriction
was the critical element and it should be avoided.
-
8/3/2019 Behavioural Management
16/16