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MANAGING THE PATIENT, PRACTICE, AND PARENT I

MANAGING THE PATIENT, PRACTICE, AND PARENT I. “The Behavior of Children in the Dental Environment”. CLASSIFYING BEHAVIOR. Cooperative Lacking Cooperative Ability Potentially Cooperative Uncontrolled Behavior Defiant Behavior Timid Behavior Tense-Cooperative Behavior Whining Behavior.

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MANAGING THE PATIENT, PRACTICE, AND PARENT I

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  1. MANAGING THE PATIENT, PRACTICE, AND PARENT I “The Behavior of Children in the Dental Environment”

  2. CLASSIFYING BEHAVIOR • Cooperative • Lacking Cooperative Ability • Potentially Cooperative • Uncontrolled Behavior • Defiant Behavior • Timid Behavior • Tense-Cooperative Behavior • Whining Behavior

  3. CRYING TYPES • Compensatory cry • Fearful cry • Obstinate cry • Painful cry

  4. FEAR AND ANXIETY

  5. ANXIETY “…apprehension, tension or uneasiness which stems from the anticipation of danger, the source of which is largely unknown or unrecognized. Primarily of intrapsychic origin, in distinction to fear, which is the emotional response to a consciously recognized and usually external threat or danger.Anxiety and fear are accompanied by similar physiologic changes. May be regarded as pathologic when present to such an extent as to interfere with effectiveness in living, achievement of desired goals or satisfactions or reasonable emotional control.”

  6. FEAR • Objective Fears • Direct stimulation of the sense organs; personal experience based • Subjective Fears • Based on feeling and attitudes suggested to the child by others, without the child having had an experience personally.

  7. PRINCIPLE FEARS BY AGE • THREE YEARS - Visual fears (masks, policeman) • FOUR YEARS - Auditory fears (sirens) • FIVE YEARS - Bodily harm (falling, dogs, dentist) • SIX YEARS - Many fears; especially auditory and spatial • SEVEN YEARS - Deeper fears (not being liked/loved) • EIGHT YEARS - Fears reduced; continuation of failure, being liked • NINE YEARS - Few fears; but ability to compete successfully exists • TEN YEARS - School • ELEVEN YEARS - Major fears re-emerge; health and animals • TWELVE YEARS - Fears dissipate; fear is “silly.”

  8. RELATING EMOTIONAL MATURATION TO THE DENTAL SITUATION • Two Year Old • Three Year Old • Four Year Old • Five Year Old • Six to Twelve Year Olds

  9. VARIABLES AFFECTING CHILDREN’S BEHAVIORS • Parental Behavior • Overprotection (extreme domination or indulgence) • Rejection • Over anxiety • Over-Identification • Past Medical History • Other Variables: socioeconomic, cultural, sex, ordinal position, sibling relationships, number of children in the family

  10. ASSESSING AND RECORDING CHILDREN’S BEHAVIOR IN THE DENTAL SITUATION • Definitely Negative (F1) • Refusal of treatment, crying forcefully, fearful, or any overt evidence of extreme negativism • Negative (F2) • Reluctant to accept treatment; uncooperative; some evidence of negative attitude, such as sullen or withdrawn, but not pronounced. • Positive (F3) • Acceptance of treatment; at times cautious; willingness to comply, at times with reservation, but follows directions • Definitely Positive (F4) • Good rapport with dentist; interested in procedures; enjoys the situation.

  11. DYNAMICS OF BEHAVIOR • These codes should be entered in the patient’s record, and will provide a cue for anticipated behavior at a subsequent visit. • Children’s behavior will vary through an appointment and the codes should be used to indicate such: “F1 initially and during anesthesia; F4 after rubber dam placement and during treatment.”

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