BEHAVIOR MANAGEMENT OF SPECIAL CHILD IN DENTAL OFFICE

 BEHAVIOR MANAGEMENT OF SPECIAL CHILD IN DENTAL OFFICE

There is no greater disability in society, than the inability to see a person as more – ROBERT M.HENSEL    

 Children with special needs may have been born with a syndrome, terminal illness, profound cognitive impairment or serious psychiatric problems .Other children may have special needs that involve struggling with panic attacks, various phobias , developmental delays, etc. The extent of the child’s condition may call for far reaching medical attention and assistance to allow the child to live and thrive. Special need dentistry is that part of the dentistry which is concerned with the oral health of people adversely affected by intellectual disability, medical, physical or psychiatric issues. There are many ways of behavior management - pharmacological as well as non- pharmacological methodology. And that is what is going to be discussed here about the various behavior management techniques to be used for a special child in dental office so as to provide a comfortable environment for the dental team to work on and gain the child’s confidence and acceptance of dental treatment.

Now what are the techniques that we can use for behavior management :-

• Non- pharmacological 

• Pharmacological

Let’s discuss about the non- pharmacological method first. In non- pharmacological method there’s behavior shaping, effective communication, audio analgesia , hypnosis ,humor , progressive relaxation, aversion therapies ,distraction, empathy and support. Communication can be  both- verbal as well as non- verbal, non- verbal can include appropriate contact, posture and facial expressions .We must use regular tone of voice with children of special needs. We must be calm and patients with these children because it may take some time for them to communicate. Allow the child to complete their sentences and voice out their ailments.

WHAT IS BEHAVIOUR MODIFICATION ?

        Behavior Modification is an alteration of behavioral patterns by the use of various techniques. It has both positive and negative reinforcements i.e. we can modify the child’s behavior with both positive and negative consequences.

 Behavior Modification consist of the following techniques :-

• DESENSITIZATION :-

This is one of the best technique which can be used for children with specific phobias or dental fears. It can also be used for adults with autism or Asperger’s syndrome to overcome dental phobias and other anxiety disorders. To begin the process of systematic desensitization in a clinical setting, the child is first taught relaxation skills in order to control his/ her fear and anxiety responses to specific phobias. These are then used to react towards and overcome situations in an established hierarchy of fears.

• PROGRESSIVE RELAXATION :-

    This method can also be helpful in an abbreviated form. This method mainly involves helping patients to relax their entire body by first tensing specific muscle groups and then suddenly relaxing them.

• TELL SHOW DO :-

      This method can be used for children with autism. In this approach, dentist must explain the procedure before it occurs and show the instrument to the child which they will be using. Invite the child to sit alone on the dental chair and become familiar with the treatment settings. Always praise and reinforce good behavior.

• MODELING :-

     Modeling is a technique in which children observe and learn. It goes by the phrase “ monkey see, monkey do “. Parents should model the importance of cleaning teeth and visiting the dental office on regular intervals. At home, parents should continue to reinforce good behavior by brushing their teeth along with their children. This will make them feel grown up and important rather than a child being punished with a bedtime routine. 

• CONTINGENCY MANAGEMENT :-

         In this technique, the behavior is modified by presentation or withdrawal of reinforcements.

There are 2 types of reinforcements :-

1. Positive Reinforcement

2. Negative Reinforcement

        Positive Reinforcement includes giving praises, patting, gifting, letting him/her know that they can watch their favorite cartoon program on television while the treatment goes on, only if he/she follows the instructions of the doctor and remains obedient.

        Negative Reinforcements include depriving the child of a certain privilege ( such as watching TV during the treatment ), if he/she is not obedient enough.

   CONCLUSION :-

         We must always value the unique quality of each person and need to ensure he/she gets the maximum benefit, regardless of any developmental disability or other special healthcare needs.

   REFERENCES :-

         Text Book of Pediatric Dentistry – Nikhil Marwha.

- By

Karolyn Jose &  Sarojini Nair .

BDS.

M.A.Rangoonwala Dental College.

Students at Clinosol.