BEHAVIOR PROBLEMS can complicate oral health care. Anxiety and fear about dental treatment can cause some patients to be uncooperative. Behaviors may range from fidgeting or temper tantrums to violent, self-injurious behavior such as head banging. This is challenging for everyone, but the following strategies can help reduce behavior problems:
Set the stage for a successful visit by involving the entire dental team--from the receptionist's friendly greeting to the caring attitude of the dental assistant in the operatory.
Arrange for a desensitizing appointment to help the patient become familiar with the office, staff, and equipment before treatment begins.
Try to gain cooperation in the least restrictive manner. Some patients' behavior may improve if they bring comfort items such as a stuffed animal or a blanket. Asking the caregiver to sit nearby or hold the patient's hand may be helpful as well.
Make appointments short whenever possible, providing only the treatment that the patient can tolerate. Praise and reinforce good behavior and try to end each appointment on a good note.
Use immobilization techniques only when absolutely necessary to protect the patient and staff during dental treatment--not as a convenience. There are no universal guidelines on immobilization that apply to all treatment settings. Before employing any kind of immobilization, it may help to consult available guidelines on federally funded care, your State department of mental health/disabilities, and your State Dental Practice Act. Guidelines on behavior management published by the American Academy of Pediatric Dentistry (http://www.aapd.org/) may also be useful. Obtain consent from your patient's legal guardian and choose the least restrictive technique that will allow you to provide care safely. Immobilization should not cause physical injury or undue discomfort.