“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