Treating Dual Diagnosis Patients: Challenges and Opportunities
The Psychology of Treating Child Patients
description
Transcript of The Psychology of Treating Child Patients
The Psychology of Treating Child Patients
Brandy A. Lopez
Project Design
Child patient and dental staff observation
Dental staff survey
College student survey
Introduction
In the United States it was found that 23% of 895 5-11 year olds showed dental anxiety.
Dental anxiety occurs via 3 pathways:Direct conditioningModeling
Maternal Dental AnxietyInformation/Instruction
Non-Physical Behavioral Management
American Academy of Pediatric Dentistry: voice control, distraction and social learning theory
Dental Terminology Word Substitutes
Rubber dam Rubber raincoat
Rubber dam clamp Tooth button
Rubber dam frame Coat rack
Sealant Tooth paint
Topical Fluoride Gel Cavity Fighter
Air syringe Wind gun
Water syringe Water gun
Suction Vacuum cleaner
Alginate Pudding
Study Models Statues
High Speed Whistle
Low Speed Motorcycle
Physical Behavior Management
American Academy of Pediatric Dentistry:
Papoose board
Sedation35%
Results:Dental Staff Survey
Majority consensusThe behavior of the parent/guardian that brings the child
affects the behavior of the child.
Social learning theory (tell-show-do technique) is a vital element in acquiring child cooperation.
It is possible to diagnose the level of dental anxiety of a patient within the first few minutes of meeting with dental caregiver.
Having the television on relaxes the patient.
Low D
enta
l Anxie
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Moder
ate D
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High Den
tal A
nxiety
Don't
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Norman Corah's Dental Anxiety Scale:
SLU College Students
NC Part 1
NC Part 2
NC Average
Surv
ey A
nsw
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ntag
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Results: College Student Survey
55.12% of college students have low dental anxiety
21.97% of college students have moderate dental anxiety
18.32% of college students have high dental anxiety
Greatest anxiety triggers: Waiting for the dentist to begin drilling on the patient’s
teethRoot canal treatmentNot being numb enough for the treatment procedure
References
1 Miligrom P, Mancl L, King B, Weinstein P. Origins of childhood fear. Behav Res Ther 1995; 33: 313-329.2 Klingberg G, Berggren U, Carlsson SG, Noren JG. Child dental fear: cause-related factors and clinical effects. Eur J Oral Sci 1995; 103: 405- 412. 3 Klingberg G, Berggren U. Dental problem behaviors in children of parents with severe dental fear. Swed Dent J 1992; 16: 27-32.4 American Academy of Pediatric Dentistry. Guidelines 2001-02. Chicago, IL: AAPD, 2002.5 Bandura A. Social Learning Theory. Morristown, NJ: General Learning Press, 1971.
Discussion: Are you afraid of the dentist?
1. If you had to go to the dentist tomorrow for a check-up, how would you feel about it? 16.3% a. I would look forward to it as a reasonably enjoyable experience. 41.9% b. I wouldn't care one way or the other. 32.6% c. I would be a little uneasy about it. 4.7% d. I would be afraid that it would be unpleasant and painful. 4.7% e. I would be very frightened of what the dentist would do. 2. When you are waiting in the dentist's office for your turn in the chair, how do you feel? 39.5% a. Relaxed. 25.6% b. A little uneasy. 16.3% c. Tense. 16.3% d. Anxious. 2.3% e. So anxious that I sometimes break out in a sweat or almost feel physically sick. 3. When you are in the dentist's chair waiting while the dentist gets the drill ready to begin working on your teeth, how do you feel? 23.3% a. Relaxed. 34.9% b. A little uneasy. 16.3% c. Tense. 20.9% d. Anxious. 4.7% e. So anxious that I sometimes break out in a sweat or almost feel physically sick. 4. Imagine you are in the dentist's chair to have your teeth cleaned. While you are waiting and the dentist or hygienist is getting out the instruments which will be used to scrape your teeth around the gums, how do you feel? 32.6% a. Relaxed. 34.9% b. A little uneasy. 14.0% c. Tense. 18.6% d. Anxious. 0% e. So anxious that I sometimes break out in a sweat or almost feel physically sick.
Key to Scoring the Dental Anxiety Scale:
a = 1, b = 2, c = 3, d = 4, e = 5 Total possible = 20
Anxiety rating: 9 - 12 = moderate anxiety but have specific
stressors that should be discussed and managed 13 - 14 = high anxiety 15 - 20 = severe anxiety (or phobia).