Most children can be managed effectively using the tech-
niques outlined in basic behavior guidance. These basic behavior guidance techniques should form the foundation for all of
the management activities provided by the dentist. Children, however, occasionally present with behavioral considerations
that require more advanced techniques. These children often cannot cooperate due to lack of psychological or emotional maturity and/or mental, physical, or medical disability. The advanced behavior guidance techniques commonly used and taught in advanced pediatric dental training programs in-
clude protective stabilization, sedation, and general anesthesia.8 They are extensions of the overall behavior guidance contin-
uum with the intent to facilitate the goals of communication, cooperation, and delivery of quality oral health care in the
difficult patient.Skillful diagnosis of behavior and safe and effective implementation of these techniques necessitate knowledge and experience that are generally beyond the coreknowledge students receive during predoctoral dental education.While most predoctoral programs provide didactic expo-sure to treatment of very young children (ie, aged birth
through two years), patients with special health care needs, and
advanced behavior guidance techniques, hands-on experienceis lacking.84 A minority of programs provides educational
experiences with these patient populations, while few provide hands-on exposure to advanced behavior guidance
techniques.84 “On average, predoctoral pediatric dentistry
programs teach students to treat children four years of age and older, who are generally well behaved and have low levels of caries.”84 Dentists considering the use of these advanced behavior guidance techniques should seek additional
training through a residency program, a graduate program,
and/or an extensive continuing education course that involves
both didactic and experiential mentored training.