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“To suffering, there is a limit; to fearing, none”
Sir Francis Bacon
THE FRIGHTENED CHILD
DEEPTHI P. R.PUSHPAGIRI COLLEGE OF DENTAL SCIENCES
CONTENTS
•Introduction•Misbehaving child dental patients•Definitions•Causes of fear of dentistry•Management•Conclusion•Bibliography
INTRODUCTION
•Pediatric dentist- avoidance behaviors
•Frustrates ; guilt & anxiety, discomfort
•Management skills refined with time & dedication
•Ways to manage-”embarrassment of riches” by Dr. David Chambers in 1977
MISBEHAVING CHILD DENTAL PATIENTS
Can’t or won’t cope with the stimuli & behavioral demands of the dental experience
Category I: The emotionally compromised child
Category II: The shy, introverted childCategory III: The frightened childCategory IV: The child who is aversive to
authority
THE FRIGHTENED CHILD
•Formidable challenge to everyone who encounters – dentist
•Intense, enormous cooperation •Problem of fear is contended more
THE FRIGHTENED CHILD
•Study in the US by Agras et al(1969): snakes>heights>storms>dental visit•Fear of needles, handpiece, rubber dam
placement•Fear of bodily harm•Fear of the uncertain & strangers- infants
& toddlers•Fear of separation- 3 year old
THE FRIGHTENED CHILD
•Misbehaviour is attributed to fear or other cause- difficult
•Information, experience & common sense
DEFINITION
•Fear is an unpleasant emotion or effect consisting of psychophysiological changes in response to realistic threat or danger to one’s own experience
•Fear & anxiety interchangeably used•Anxiety is a vague unpleasant feeling
accompanied by a premonition that something undesirable is going to happen
- Kent
CAUSES OF FEAR OF DENTISTRY
Intellectually unable Not relieved even when educatedChronologic age <36-40 monthsSlow development
CAUSES OF FEAR OF DENTISTRYEmotional upsets in lifeAcute chaos at homeAbused childrenGrieving close one’s death Other health problems
Self limitingResolve in timeRigorous procedures- difficult to endure
CAUSES OF FEAR OF DENTISTRY
Acquired fears‘sold’ to the child by peers, siblings or
parentsSubjective FearsBased on feelings & attitudes that have
been suggested by othersNot experienced personally
CAUSES OF FEAR OF DENTISTRY
Learned fearsPrevious painful or difficult experience at
physician’s or dentist’s officeObjective FearsDirect physical stimulation of the sense organsNot of parental origin
CAUSES OF FEAR OF DENTISTRY
Emotionally illUndiagnosed Not noticed by the parentsBroken homesDaily observing teacher may notice
MANAGEMENT
•Easily identified except the emotionally ill•Make certain-misbehavior is out of dread
of dentistry•Parent & dentist obliged to avoid
increasing the anxieties - postponing dental work - using drugs - perform under G/A
MANAGEMENT
•The most appropriate measures to be taken regardless of :
-cost -inconvenience -loss of efficiency
MANAGEMENT
•Emotional illness: -Refer to psychiatrist, psychologist, counselor -establish whether the child is emotionally healthy to go through dental appointment
CONCLUSION•Misbehaving children encountered in
pediatric dental practice on a day to day basis
•A careful and intelligent identification of the actual cause behind the behavior
•The management techniques to be adopted
•Reveal any unidentified psychological condition suffered by the child.
BIBLIOGRAPHY
•Pediatric Dentistry- Infancy through adolescence, Edition 4
-Pinkham, Casamassimo, Fields, McTigue,Nowak
•Clinical Pedodontics, Edition 4-Finn•Pediatric Dentistry, Edition 3 -Welbury, Duggal,Hosey•Textbook of Pedodontics, Edition 2 -Shobha Tandon
THANK
YOU