Behavior Guidance for the Pediatric Dental Patient
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This best practice provides health care personnel, parents, and others with information for predicting and guiding behavior in children during dental procedures. Successful treatment of pediatric dental patients depends on effective communication and developing customized behavior guidance plans dependent on the patient’s treatment needs and the skills of the dentist. Behavior guidance is a continual process from basic to advanced techniques, using non-pharmacological and pharmacological options. The following items should be addressed before, during, and after patient treatment: informed consent, pain assessment, behavior documentation, and preventive and deferred treatment considering all behavior guidance options. Basic behavior guidance includes communication guidance, positive pre-visit imagery, direct observation, tell-show-do, ask-tell-ask, voice control, non-verbal communication, positive reinforcement and descriptive praise, distraction, and desensitization. For anxious patients and those with special health care needs, additional behavior guidance options include sensoryadapted dental environments, animal assisted therapy, picture exchange communication systems, and nitrous oxide-oxygen inhalation. Advanced behavior guidance includes protective stabilization, sedation, and general anesthesia. Each option should be assessed for objectives, indications, contraindications, and precautions. Knowledge of these options will aid healthcare professionals in providing appropriate patientspecific and family-centered behavior guidance for infants, children, adolescents, and persons with special health care needs.
This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and recommendations to inform health care providers, parents and others about the behavior guidance techniques used and behavioral influences impacting contemporary pediatric dental care.
KEYWORDS: ANESTHESIA, GENERAL, BEHAVIOR THERAPY, CHILD, INFORMED CONSENT, NITROUS OXIDE, PAIN MEASUREMENT