Non Farmakologi behaviour

Management

Drg SANDY CHRISTIONO Sp.KGA

Pediatric Dentistry
Universitas Islam Sultan Agung
OverView
 Dental practitioners are expected to recognize and
effectively treat childhood dental diseases that are
within the knowledge and skills acquired during dental
education.
 Behavior guidance is a continuum of interaction in-volving
the dentist and dental team, the patient, and the
parent directed toward communication and
education. Its goal is to decrease fear and anxiety while
promoting an understanding of the need for good oral health
and the process by which that is achieved.
 A dentist who treats children should have a variety of
behavior guidance approaches and, in most
situations, should be able to assess accurately the
child’s developmental level, dental attitudes, and
temperament and to predict the child’s reaction to
treatment.
Nonfarmakologi behaviour
techniques
 1. tell-Show-Do
 2. Voice control
 3. Nonverbal communication
 4. Positive reinforcement
 5. Distraction
 6. Desentitation
 7. HOME
Tell-Show-Do
 The technique involves verbal explanations of procedures in
phrases appropriate to the developmental level of the patient
(tell);demonstrations for the patient of the visual, auditory,
olfactory, and tactile aspects of the procedure in a carefully
defined, nonthreatening setting (show); and then, without
deviating from the explanation and demonstration,
completion of the procedure (do).
 Objectives: The objectives of tell-show-do are to:
- teach the patient important aspects of the dental visit and familiarize the
patient with the dental setting; and
- shape the patient’s response to procedures through de- sensitization and
well-described expectations.
Voice Control
 Voice control is a controlled alteration of voice volume, tone,
or pace to influence and direct the patient’s behavior.
 Objectives: The objectives of voice control are to:
 gain the patient’s attention and compliance;
 avert negative or avoidance behavior; and
 establish appropriate adult-child roles.
Nonverbal Comunication
 Nonverbal communication is the reinforcement and guidance
of behavior through appropriate contact, pos- ture, facial
expression, and body language
 Objectives: The objectives of nonverbal communication are
to:
 enhance the effectiveness of other communicative man-
agement techniques; and
 gain or maintain the patient’s attention and compliance.
Positive reinforcement
 Positive reinforcement is an effective technique to reward
desired behaviors and, thus, strengthen the recurrence of
those behaviors. Social reinforcers include positive voice
modulation, facial expression, verbal praise, and appropriate
physical demonstrations of affection by all members of the
dental team.
Distraction
 Distraction is the technique of diverting the patient’s
attention from what may be perceived as an unpleasant
procedure. Giving the patient a short break during a stressful
procedure can be an effective use of distraction prior to con-
sidering more advanced behavior guidance techniques.
 Objectives: The objectives of distraction are to:
 decrease the perception of unpleasantness; and
 avert negative or avoidance behavior.
PAIN MANAGEMENT
 Pain management during dental procedures is crucial for
suc-cessful behavior guidance. Prevention of pain can nurture
the relationship between the dentist and the patient, build
trust, allay fear and anxiety, and enhance positive dental
attitudes for future visits.
 Children perceive and react to painful stimuli differently
from each other. Children under age four are more
sensitive to painful stimuli and are not able to communicate
as well as older children and teens.
DENTAL TEAM BEHAVIOR
 The pediatric dental staff can play an important role in
behavior guidance. The scheduling coordinator or
receptionist will have the first contact with a
prospective parent, usually through a telephone conversation.
 the receptionist is usually the first staff member the child
meets. The manner in which the child is welcomed into the
practice may in-fluence future patient behavior
DENTIST BEHAVIOR
 The dentist’s communication skills play an important
role in behavior guidance.
 Dentist behaviors of vocalizing, directing,
empathizing, persuading, giving the patient a
feeling of control, and operant conditioning have
been reported as efficacious responses to uncooperative
patient behaviors.
 the dentist should become a teacher. The dentist’s
methods should include active listening and ob-servation of
the child’s body language.
Treatment
 When a child’s behavior prevents routine delivery of oral
health care using communicative guidance techniques, the
dentist must consider the urgency of dental need when
determining a plan of treatment.
Rapidly advancing disease, trauma, pain, or
infection usually dictates prompt treatment.
 The dentist must explain the risks and bene-fits of deferred
or alternative treatments clearly, and informed consent
must be obtained from the parent
 TERIMA KASIH
SEMOGA BERMANFAAT