Child Management in Pediatric Dentistry PDF

“ Child management in pediatric dentistry ” Presented by dr: Mohira ezzeldin Child management The most important and professional role of pediatric dentistry is to promote positive dental attitudes of the child patient and improve the dental health of society. Behavior management  Definition : ar...

“ Child management in pediatric dentistry ” Presented by dr: Mohira ezzeldin Child management The most important and professional role of pediatric dentistry is to promote positive dental attitudes of the child patient and improve the dental health of society. Behavior management  Definition : are the means by which the dental health team effectively performs treatment for a child and at the same time instill a positive dental attitude.  It is a science which helps us to understand the development of fear, anxiety and anger as it applies to a child in dental operatory. Pediatric treatment triangle Child patient The triangle indicates that : 1-The child is the focus of attention for both the dentist and the parents. 2-The arrows shows that the relationship should be reciprocal. 3-The dentist has to communicate with the child as well as the parents whereas in case of adults a direct communication is possible. 4-Management methods acceptable to society have been identified as factors influencing treatment modalities. What is Child Psychology?  Child Psychology deals with behavioral development from the prenatal period to maturity in the areas of cognition, ethology, genetics, language, learning, perception, and social behaviour.  Children were often viewed simply as small versions of adults and little attention was paid to the many advances in cognitive abilities, language usage, and physical growth. Cognitive development The cognitive capability (thinking or using mental processes) of children changes radically from birth through to adulthood.  A Swiss psychologist called Jean Piaget (1952) formulated the 'stages view' of cognitive development on the basis of detailed observations of his own children, and suggested that children pass through four broad stages of cognitive development. Stages of cognitive development:  Sensorimotor 0 to 18–24 months:  During the sensorimotor stage, an infant’s knowledge of the world is limited to their sensory perceptions and motor activities. Reflex, habits, object permanence 2. Preoperational thought (2 to 7 years):  Language development, symbolic functioning, difficulty in seeing things from different points of view.  Thought patterns are not well developed, being egocentric. 3. Concrete operations (7-11 years):  Begins using logic to problem solve actual (concrete) events; can see other points of view; moral feelings and judgment; autonomy.  Thinking is rooted in concrete objects, abstract thought is not well developed. 4. Formal operations (11 years and more):  This is the last stage in the transition to adult thinking ability.  Hypotheses and reasoning Language development:  Newborn children show a remarkable ability to distinguish speech sounds and by the age of 5 years most children can use 2000 or more words. Language and thought are tied together and are important in cognitive development.  The key to successful communication is to give your advice and instructions at just the right level for different age groups of children. Social development:  Babies tend to form specific attachments to parents and are prone to separation anxiety.  At about 8 months infants show a definite fear of strangers.  This potential for anxiety separation remains high until about 5 years of age.  This is important as a successful transition from home to school depends on the ability to interact with other individuals apart from parents. Clinical classifications of behavior patterns  Numerous systems have been developed for classifying children’s behavior in the dental environment.  Wright's clinical classification places children in three categories: Cooperative Lacking in cooperative ability Potentially cooperative 1.Cooperative children are :  Reasonably relaxed.  They have minimal apprehension and may even be enthusiastic.  They can be treated by a straightforward, behavior-shaping approach.  When guidelines for behavior are established, these children perform within the framework provided. 2.child lacking in cooperative ability  This category includes very young children with whom communication cannot be established and of whom comprehension cannot be expected.  Because of their age, they lack cooperative abilities.  Another group of children who lack cooperative ability is those with specific debilitating or disabling conditions. The severity of the child’s condition prohibits cooperation in the usual manner.  Although their treatment can be carried out, immediate major positive behavioral changes cannot be expected. 3. Potentially cooperative :  These children have the capability to perform cooperatively. This is an important distinction. When a child is characterized as potentially cooperative, clinical judgment is that the child’s behavior can be modified, that is, the child can become cooperative.  Moreover, the adverse reactions have been given specific labels, such as uncontrolled, defiant, timid, tense-cooperative, and whining. Frankl Behavioral Rating Scale:  Another system that has been used in behavioral science research is the Frankl behavior rating scale. A description of the scale that divides observed behavior into four categories follows: Rating 1: Definitely Negative. Refusal of treatment, forceful crying, fearfulness, or any other overt evidence of extreme negativism. Rating 2: Negative. Reluctance to accept treatment. uncooperativeness, some evidence of negative attitude but not pronounced (sullen, withdrawn). Rating 3: Positive  Acceptance of treatment; cautious behavior at times; willingness to comply with the dentist, at times with reservation, but patient follows the dentist's directions cooperatively. Rating 4: Definitely Positive  Good rapport with the dentist, interest in the dental procedures, laughter and enjoyment.