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Flashcards in Pinkham - Chap 23 - Patient Management Deck (36)
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1
Q

What are the 5 basic domains for securing the cooperation of children during dental tx?

A

Physical, pharmacologic, aversive(flooding), reward-oriented, and linguistic domain

2
Q

physical domain entails?

A

hand restraint by DA,mouth props, papoose board, reserved for unmangeable children, children unable to be reached by language or developmentally disabled children

3
Q

pharmacologic domain?

A

ranges from N20 to GA

4
Q

aversive domain(flooding)?

A

a technique, which when used on a child is objectionable enough that the child will cooperate in order to avoid the technique. includes parental spanking and HOM. Avoid using this domain as a punishment

5
Q

reward oriented domain

A

reward used to secure childs cooperation(from parent or dentist)

6
Q

what are some problems with the reward oriented domain?

A

Child may think parent is offering a reward bc they think the dental appointment will be difficult, frightening, or scary.

When unusual rewards are mentioned, child may conclude that the more anxiety he/she builds up before the appointment, the greater the reward.

7
Q

Linguistic domain?

A

conversation of the dentist with child and child w dentist

8
Q

what age do majority of normally developed and socialized children reach maturity in language

A

bw 2-4yo

9
Q

what roles does the linguistic domain require of the dentist?

A

teacher,coach,rewarder,psychologist,distractor, authority figure

10
Q

which speech act is most important in securing a childs cooperation?

A

requests and promises. dentist makes effective requests and child makes effective commitments

11
Q

what should be done if a child declines a dentists request?

A

dentist must reframe original request in order to get commitment and let the child know dentist is serious

12
Q

what type of coach must the dentist be?

A

Ontological coach(ontology=the way of being)

13
Q

the best way for a child to behave during a dental appt?

A

quiet, listening for requests, and cooperating with requests

14
Q

Pre appt experience entails doing what?

A

giving child tour of office, child made aware that nothing will be done that day, introducing to dentist and personnel so they’re not strangers at next appt

15
Q

Voice control?

A

dentist interjects more authority and an attitude of confidence into his communication. Facial expression must mirror attitude of confidence.

16
Q

when is voice control effective?

A

effective at intercepting inappropriate behaviors as they start to happen

17
Q

HOM?

A

dentist places hand over mouth of hysterically crying child

18
Q

when is HOM used? what other behav mangagement technique is it used with?

A

to intercept tantrums or other fits of rage, paired with voice control

19
Q

how should HOM be used and not used?

A

should not be used aversively. HOM intended to get childs attention and quiet child so they hear what the dentist is saying

20
Q

when is HOM contraindicated

A

disabled, immature or medicated children

21
Q

Physical restraint?

A

when paired with language, becomes part of the entire linguistic domain.

22
Q

Gentle physical restraint allows dentist to?

A

reframe a previous request

23
Q

Praise and communication?

A

language needs to be age appropriate, combine with TSD

24
Q

other methods of patient management?

A

pairing a frightened child with a brave child, play therapy, “time out” to listen to music, distraction, desensitization, gift giving, observation

25
Q

when is the nonverbal management of children measured as successful/effective?

A

When dentists make verbal requests to stop behavior but are able to re-request when needed with more verbal determination, appropriate facial exp, and form a bodily posture in which they know that they are competent(“the place”)

26
Q

where is “the place?”

A

looking at the child in a downward and forward position

27
Q

When returning children to parents after procedures, some children like to make their parents feel _ and portray themselves _

A

guilty for making them go to the dentist and portray themselves as victims

28
Q

it is important to be aware of what when a frightening child comes to the office

A

these children often come from broken homes, are abused, grieving the death of family, etc..

29
Q

what external influences might cause a child to be frightened in the dental setting

A

Child may be intellectually unable to comprehend the dental appt bc of age(36-40months) or mental retardation, child was sold a set of fears by siblings,parents,friends,child is emotionally ill or had a previous negative experience.

30
Q

how should the dentist respond if a child asks if INJ will hurt?

A

cannot lie to patient. Respond with “you will feel a little pinch”

31
Q

whats the best way to handle shy, introverted children? This requires what skill from the dentist?

A

Talk to them at their own level, use praise, and TSD, establish rapport, communication, trust, and become their friends. Requires patience from dentist

32
Q

the child who is averse to authority usually attempts to reach 4 misdirected goals, which are?

A

gardner undue attention, struggle for power(“they will pay attention to me or else”), retaliation and revenge, inadequacy

33
Q

Undue attention behavioral charactersitics

A

“to feel superior, i will through manipulative behavior get my parents to pay attention to me”. these kids are annoying, irritating, teasing, disruptive

34
Q

struggle for power behav chars?

A

“to feel superior, i am prepared to have a power struggle with my parents about getting attention, they will pay attention to me or else”. behav chars: argues and contradicts, does opposite of instructions, makes people angry, throws temper tantrums

35
Q

retaliation and revenge behav chars

A

“if i dont get what i want i will get even with my parents and punish them” behav chars: violent temper, says hurtful things, seeks revenge, gets even

36
Q

inadequacy behav chars

A

give up easily, rarely participate, acts if incapable to do anything, displays inadequacy