Podcast
Questions and Answers
Which of the following interventions involves gradually exposing a patient to anxiety-provoking stimuli while they practice relaxation techniques?
Which of the following interventions involves gradually exposing a patient to anxiety-provoking stimuli while they practice relaxation techniques?
- Systematic desensitization (correct)
- Clinical holding
- Cognitive Behavioral Therapy (CBT)
- Hypnosis
A dentist is preparing to treat a young child with dental anxiety. Considering the principles of non-pharmacological interventions (NPIs), what is the MOST important initial step?
A dentist is preparing to treat a young child with dental anxiety. Considering the principles of non-pharmacological interventions (NPIs), what is the MOST important initial step?
- Immediately starting the dental procedure to minimize distress.
- Administering a mild sedative to reduce anxiety.
- Creating a child-friendly environment in the waiting area.
- Assessing the child's anxiety level and understanding their specific fears. (correct)
Which of the following techniques involves physical restraint to ensure safety?
Which of the following techniques involves physical restraint to ensure safety?
- Systematic Desensitisation
- Clinical Holding (correct)
- Hypnosis
- Cognitive Behavioural Therapy
A dentist notices several patients displaying signs of anxiety in the reception area. What modification to the environment might MOST effectively reduce their anxiety?
A dentist notices several patients displaying signs of anxiety in the reception area. What modification to the environment might MOST effectively reduce their anxiety?
In which of the following scenarios would Cognitive Behavioral Therapy (CBT) be MOST applicable as a non-pharmacological intervention?
In which of the following scenarios would Cognitive Behavioral Therapy (CBT) be MOST applicable as a non-pharmacological intervention?
Which resource provides updated guidelines specifically for non-pharmacological behavior management in pediatric dentistry?
Which resource provides updated guidelines specifically for non-pharmacological behavior management in pediatric dentistry?
Which of the following components is the MOST essential when documenting the use of non-pharmacological interventions?
Which of the following components is the MOST essential when documenting the use of non-pharmacological interventions?
Why is it important to include language appropriate terms in a glossary of Non-Pharmacological Intervention (NPI) terms?
Why is it important to include language appropriate terms in a glossary of Non-Pharmacological Intervention (NPI) terms?
What is the MOST appropriate way to apply non-pharmacological interventions in dental practice?
What is the MOST appropriate way to apply non-pharmacological interventions in dental practice?
When considering the environment of a dental practice, what is an important factor that can reduce patient anxiety?
When considering the environment of a dental practice, what is an important factor that can reduce patient anxiety?
Which communication technique involves using open questions, affirmations, reflections, and summaries?
Which communication technique involves using open questions, affirmations, reflections, and summaries?
What is the primary goal of using distraction techniques during a dental procedure?
What is the primary goal of using distraction techniques during a dental procedure?
In the 'Tell-Show-Do' technique, what is the purpose of the 'Show' step?
In the 'Tell-Show-Do' technique, what is the purpose of the 'Show' step?
What is the key emphasis when using language to communicate with patients, especially children?
What is the key emphasis when using language to communicate with patients, especially children?
Which of the following is the MOST effective way to guide a patient through a relaxation technique?
Which of the following is the MOST effective way to guide a patient through a relaxation technique?
A dentist is treating a 7-year-old patient. Applying the tell-show-do technique, after telling and showing, what would be the next step?
A dentist is treating a 7-year-old patient. Applying the tell-show-do technique, after telling and showing, what would be the next step?
What does 'positive reinforcement' primarily aim to achieve in a dental setting?
What does 'positive reinforcement' primarily aim to achieve in a dental setting?
What is the MOST important consideration when selecting a distraction technique for a patient?
What is the MOST important consideration when selecting a distraction technique for a patient?
During root surface debridement on a patient, if the patient appears anxious despite relaxation techniques, what would be the MOST appropriate next step?
During root surface debridement on a patient, if the patient appears anxious despite relaxation techniques, what would be the MOST appropriate next step?
A 30-year-old patient with autism spectrum disorder requires a BPE (Basic Periodontal Examination). Which modification to the standard communication approach would be MOST beneficial?
A 30-year-old patient with autism spectrum disorder requires a BPE (Basic Periodontal Examination). Which modification to the standard communication approach would be MOST beneficial?
A dentist is preparing a 7-year-old patient for a sealant placement. Besides the 'tell-show-do' technique, which strategy would best enhance the patient's sense of control?
A dentist is preparing a 7-year-old patient for a sealant placement. Besides the 'tell-show-do' technique, which strategy would best enhance the patient's sense of control?
A young patient is particularly anxious about their upcoming dental appointment, during which they will receive a fluoride treatment. Drawing from the concept of modeling, what is the MOST effective preparatory method?
A young patient is particularly anxious about their upcoming dental appointment, during which they will receive a fluoride treatment. Drawing from the concept of modeling, what is the MOST effective preparatory method?
When treating a child, a dentist uses 'structured time' by informing them that the procedure will only take 'just a bit more'. What critical consideration must the dentist keep in mind while doing so?
When treating a child, a dentist uses 'structured time' by informing them that the procedure will only take 'just a bit more'. What critical consideration must the dentist keep in mind while doing so?
A dentist is preparing to administer local anesthesia to a 16-year-old patient. Aside from the 'tell-show-do' approach, what additional strategy can help manage anxiety?
A dentist is preparing to administer local anesthesia to a 16-year-old patient. Aside from the 'tell-show-do' approach, what additional strategy can help manage anxiety?
In applying non-pharmacological interventions (NPIs) during dental treatment, which approach is generally MOST effective?
In applying non-pharmacological interventions (NPIs) during dental treatment, which approach is generally MOST effective?
A dentist notices a child patient becoming increasingly anxious during a routine check-up. Which initial action is MOST appropriate according to the principles of enhancing control?
A dentist notices a child patient becoming increasingly anxious during a routine check-up. Which initial action is MOST appropriate according to the principles of enhancing control?
What is the primary goal of using modeling as a behavioral technique in pediatric dentistry?
What is the primary goal of using modeling as a behavioral technique in pediatric dentistry?
For a patient undergoing a lengthy dental procedure, how does the concept of 'structured time' MOST directly improve their experience?
For a patient undergoing a lengthy dental procedure, how does the concept of 'structured time' MOST directly improve their experience?
A dentist is performing root surface debridement on a 55-year-old patient. Building on the 'tell-show-do' approach, what additional technique/step could be implemented to help manage patient discomfort or anxiety during the same procedure?
A dentist is performing root surface debridement on a 55-year-old patient. Building on the 'tell-show-do' approach, what additional technique/step could be implemented to help manage patient discomfort or anxiety during the same procedure?
Which of the following scenarios exemplifies an inappropriate application of Non-Pharmacological Interventions (NPIs)?
Which of the following scenarios exemplifies an inappropriate application of Non-Pharmacological Interventions (NPIs)?
Which of the following best describes the primary aim of using non-pharmacological interventions (NPIs) in oral health care?
Which of the following best describes the primary aim of using non-pharmacological interventions (NPIs) in oral health care?
A dental practitioner notices a patient exhibiting signs of dental anxiety. According to the context provided, what is the MOST appropriate initial step the practitioner should consider?
A dental practitioner notices a patient exhibiting signs of dental anxiety. According to the context provided, what is the MOST appropriate initial step the practitioner should consider?
In the context of clinical care, what is the MOST direct purpose of non-pharmacological interventions (NPIs)?
In the context of clinical care, what is the MOST direct purpose of non-pharmacological interventions (NPIs)?
Which of the following is NOT a typical component of formative assessment related to non-pharmacological interventions?
Which of the following is NOT a typical component of formative assessment related to non-pharmacological interventions?
What key area is assessed via OSCE (Objective Structured Clinical Examination) in the context from the text?
What key area is assessed via OSCE (Objective Structured Clinical Examination) in the context from the text?
A clinician is treating a young patient with a history of dental anxiety. Which approach aligns BEST with the principles of non-pharmacological interventions?
A clinician is treating a young patient with a history of dental anxiety. Which approach aligns BEST with the principles of non-pharmacological interventions?
According to the information provided, which organization's guidelines were updated to inform the evidence-base and guidance on non-pharmacological interventions in dentistry?
According to the information provided, which organization's guidelines were updated to inform the evidence-base and guidance on non-pharmacological interventions in dentistry?
What did systematic review evidence demonstrate regarding NPIs and their effectiveness in adults?
What did systematic review evidence demonstrate regarding NPIs and their effectiveness in adults?
Which of the following scenarios BEST illustrates the application of non-pharmacological interventions (NPIs) in a dental setting?
Which of the following scenarios BEST illustrates the application of non-pharmacological interventions (NPIs) in a dental setting?
A patient expresses concern that dental treatment will cause them significant pain, influencing their willingness to undergo the procedure. What BEST represents an appropriate NPI strategy in this scenario prior to commencement of treatment?
A patient expresses concern that dental treatment will cause them significant pain, influencing their willingness to undergo the procedure. What BEST represents an appropriate NPI strategy in this scenario prior to commencement of treatment?
Flashcards
Non-Pharmacological Interventions (NPIs)
Non-Pharmacological Interventions (NPIs)
Techniques to manage patient behavior, instill positive attitudes towards oral health care, and ultimately improve oral health.
Purpose of NPIs
Purpose of NPIs
To manage behaviour and instill positive attitudes towards oral health care.
Guidance for NPIs
Guidance for NPIs
British Society of Paediatric Dentistry guidelines and systematic reviews.
Effectiveness of NPIs
Effectiveness of NPIs
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Reasons for NPI use
Reasons for NPI use
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OSCEs
OSCEs
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Benefits of understanding NPIs
Benefits of understanding NPIs
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Formative Assessment examples
Formative Assessment examples
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Aim of Session
Aim of Session
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Future
Future
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OARS
OARS
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Non-verbal communication
Non-verbal communication
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Patient-appropriate language
Patient-appropriate language
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Tone of voice
Tone of voice
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Tell-Show-Do Technique
Tell-Show-Do Technique
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Distraction
Distraction
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Guided Imagery
Guided Imagery
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Relaxation techniques
Relaxation techniques
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Positive Reinforcement
Positive Reinforcement
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Ignore inappropriate behavior
Ignore inappropriate behavior
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Enhancing Control
Enhancing Control
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Modelling
Modelling
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Structured Time
Structured Time
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NPI Application
NPI Application
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Individualized Approach
Individualized Approach
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Building Trust
Building Trust
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Preparatory Information Through Modelling
Preparatory Information Through Modelling
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Time perception
Time perception
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Combined strategies
Combined strategies
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When to apply NPI?
When to apply NPI?
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Advanced NPIs
Advanced NPIs
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Environmental Impact
Environmental Impact
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NPI Workbook Task
NPI Workbook Task
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Glossary of Terms
Glossary of Terms
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BSPD Guidelines
BSPD Guidelines
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SCDEP Guidance
SCDEP Guidance
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Systematic Review Role
Systematic Review Role
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Context
Context
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NPI Types
NPI Types
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Study Notes
- Introduction to Non-Pharmacological Interventions in Clinical Skills Practice.
- Intended learning outcome: non-pharmacological interventions are introduced for behavior management.
- Learners will be able to describe common non-pharmacological interventions used for behaviour management, and reflect on how and when to use these techniques in the clinical setting.
Assessment
- Formative assessment include group discussions during lecture sessions, workbook activities, and the glossary of terms.
- Summative assessment includes OSCE to assess communication skills, and clinical care assessment.
- Future learning include dental therapy, and effective and quality oral healthcare provision.
Context for Non-Pharmacological Interventions in Clinical Care
- Non-pharmacological interventions (NPIs) are techniques use to manage behavior, instilling positive attitudes towards oral health care and behaviors, and ultimately improve oral health.
- NPIs relate to Psychology in Clinical Practice, Pain management, and communication lectures.
- The purpose behind NPIs is to reduce anxiety, manage pain, manage behaviour to create a positive experience.
Intervention Types
- Pharmacological interventions include anaesthesia, conscious sedation, and medication.
- Non-pharmacological interventions include communication skills, behavior modification, and psychotherapeutics.
Evidence-base and guidance
- British Society of Paediatric Dentistry (Campbell et al 2011) updated Royal College of Surgeons Guidelines (2002).
- Systematic review protocol on NPIs are available for managing dental anxiety (Anthonappa et al 2017)
- Systematic review evidence demonstrated NPIs is effective at reducing mental distress in adults (Burghardt et al 2018).
Communication skills
- Use OARS (open questions, affirmations, reflections and summaries).
- Use non-verbal skills.
- Language should be age and patient-appropraite.
- Tone of voice is important.
- Communication is important with children and special need patients, including patients' carers and support staff
Tell-Show-Do Technique
- The steps include explanation, demonstration, and action.
- Apply the tell-show-do technique for the placement of a fissure sealant for a 6-year-old patient.
- Apply the tell-show-do technique for injections of local anaesthetic for a 16 year old patient.
- Apply the tell-show-do technique root surface debridement for a 55 year old patient.
- Apply the tell-show-do technique BPE for an adult patient with austism aged 30 years.
Distraction
- Distraction helps shift a patient's focus from a procedure/environment that may be unpleasant, to something that is more pleasant.
Guided imagery
- Use visual imagery to distract a patient by making them think of a happy place.
Relaxation
- Reduce anxiety with guided breathing techniques.
- Instead of telling patients to "just relax," guide patients to take 5 deep breaths.
- Listen to music, and have a conversation to find out about ways that the patient uses to relax.
Positive reinforcement
- Acknowledge appropriate behavior to increase its repetition.
- Ignore inappropriate behavior so as not to draw attention to it while discouraging its repetition.
Enhancing control
- Patients can fell out of control, therefore control can be given back, and rehearse to gain patients' trust.
Modelling
- Learning can occur by observation of someone important ie sibling, parent, favourite toy, tv chracter etc.
- This can form part of preparatory information like video of dental visit.
Structured time
- Patients' tolerance of a procedure can increase knowing how long it will take.
- 'Just a bit more' vs 5 seconds count down.
- Needs to be appropriate to patients' development.
Activity 2
- Apply to the previous activity Scenarios, and discuss what other techniques you could use in conjunction to the Tell-Show-Do Approach:
- Placement of a fissure sealant for a 6 year old patient
- Injection of local anaesthetic for a 16 year old patient
- Root surface debridement for a 55 year old patient
- BPE for an adult patient with austism aged 30 years
When to apply NPI
- Apply for first time clinical encounters for children, special needs, those who are dentally anxious, explain procedures.
How to apply
- No single intervention works effectively in isolation; the combination of interventions is usually appropriate.
- Every patient is different, therefore it is not appropriate for every situation.
- Some will be applied without thinking is natural, however others need some more thought and conversation.
Other advanced techniques:
- Systematic desensitization
- CBT
- Hypnosis
- Clinical holding
- More will be covered in Year 2 Psychology
Environment
- NPIs noticed throughout the clip.
- Reflect on the impact of the patients in the reception area.
Summary
- Non-pharmacological interventions context, evidence-based guidelines, types and how & when to apply.
Future Learning.
- Dental Psychology in Year 2
- Paediatric oral health care in Year 2 and 3
- Clincial care
Workbook + glossary of terms
- Complete table in workbook that includes definitions, examples and situations for when to use non-pharmocological interventions.
- Terms to including language appropriate terms in the glossary.
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