Commonly seen expressions on the face of a paediatric dental patient

BEHAVIOURAL SCIENCE AS APPLIED TO PEDIATRIC DENTISTRY

Learning Objectives: Define Behaviour, Behavioural science and Behavioural Pedodontics. Classify child’ behaviour in a dental office under different classifications. A salient objective to identify and correlate different types of child behaviour in real time situations .

BEHAVIOUR Definition : The term behaviour is broadly used to include the entire complex of observable and potentially measurable activities including motor, cognitive and physiological classes of response, which can be described in similar ways by one or more person.

BEHAVIOURAL SCIENCE Definition: It is the science which deals with observation of behavioral habits of man and lower animals in various physical and social environments.

BEHAVIOUR OF A CHILD It can be defined as “the pattern in which a child responds to any social and environmental stimulus”

BEHAVIORAL PEDODONTICS Definition : It is the study of science which helps to understand development of fear, anxiety and anger as it applies to child in dental situation.

‘Behaviour’ of child cannot be dictated ‘Behaviour’ of child cannot be dictated...... .......the clinician can however, understand, analyze and manipulate it to his own advantage. Such skills of the clinician aid to determine the success of treatment provided.

CLASSIFICATION OF CHILD BEHAVIOUR AS OBSERVED IN DENTAL CLINIC

I. WILSON’S CLASSIFICATION (1933) It is the earliest established classification. Not primarily given for Pediatric Dentistry, was later adapted.

I. WILSON’S CLASSIFICATION (1933) a). Normal or bold DESCRIPTION : The child is brave enough to face new situations. ATTITUDE : co-operative, and friendly with the dentist.

I. WILSON’S CLASSIFICATION (1933) b). Tasteful or timid DESCRIPTION : The child is shy. ATTITUDE : but does not interfere with the dental procedures.

c). Hysterical or rebellious DESCRIPTION : Child is influenced by home and is rebellious. ATTITUDE: Exhibhits outwardly unacceptable behaviour like temper tantrums. D). Nervous or fearful DESCRIPTION : The child is tense and anxious, fears dentistry. ATTITUDE : Interupts dental treatment

III. WRIGHT’S CLASSIFICATION A) CO-OPERATIVE BEHAVIOUR 1.Co-operative behaviour 2.Lacking in Cooperative Ability 3. Potentially Cooperative B). UN- COOPERATIVE BEHAVIOUR 1. Uncontrolled /Hysterical/ Incorrigible 2. Defiant/Obstinate behaviour 3. Tense cooperative 4. Timid/shy 5. Whining type 6. Stoic

I. WRIGHT’S CLASSIFICATION A) Co-operative (Positive behaviour) 1.Co-operative behaviour Child is cooperative, relaxed with minimal apprehension.

2. Lacking in Cooperative Ability Includes very young children with whom communication cannot be established. Another group of children who lack in cooperative ability is of those with specific debilitating or disabling conditions. Physical and mental handicap children are also included under this.

3. Potentially Cooperative Has the potential to cooperate, but because of the inherent fears (subjective/ objective) the child does not cooperate.

1. Uncontrolled /Hysterical/ Incorrigible B). UN- COOPERATIVE BEHAVIOUR 1. Uncontrolled /Hysterical/ Incorrigible Usually seen in the preschool children at their first dental visit. Temper tantrums i.e the physical lashing out of legs and arms , loud crying and refuses to cooperate with the dentist.

2. Defiant/Obstinate behaviour Can be seen in any age group. Usually in spoilt or stubborn children. These children can be made cooperative.

3. Tense cooperative These children are the border line between the positive and negative behaviour. Does not resist treatment but the child is tensed at mind.

4. Timid Behviour/Shy Usually seen in a overprotective child at the first visit. Is shy but cooperative. Usually seen in overprotected children

5. Whining type Complaining type of behaviour Allows for treatment but complains throughout the procedure.

6. Stoic type Seen in physically abused children . They are cooperative and passively accept all the treatment without any facial expression. They are co-operative, but do not communicate.

II. LAMPSHIRE CLASSIFICATION(1970) 1. COOPERATIVE The child is physically and emotionally relaxed . Is cooperative throughout the procedure.

2. Tense cooperative The child is tensed and cooperative at the same time. Allows treatment

3. Outwardly apprehensive Avoids treatment initially, usually hides behind the mother, avoids looking or talking to the dentist. Eventually accepts dental treatment.

4. Fearful: Requires considerable support so as to overcome the fears of dental treatment.

5. Stubborn/Defiant Passively resists treatment by using techniques that have been successful in other situations.

6. Hypermotive 7. Handicapped The child is acutely agitated and resorts to screaming kicking etc. 7. Handicapped Physically/mentally, emotionally handicapped.

8. Emotionally immature Very ypung children, not able to follow instructions.

(Frankel’s behaviour rating scale) IV. FRANKEL’S CLASSIFICATION (1962) (Frankel’s behaviour rating scale) Rating Behaviour Definitely Refuses treatment, crises negative (- -) forcefully extremely negative behaviour associated with fear.

2. Negative (-). Reluctant to accept. treatment and displays 2. Negative (-) Reluctant to accept treatment and displays evidence of slight negativism.

3. Positive (+). Accepts treatment,. but if the child has a bad 3. Positive (+) Accepts treatment, but if the child has a bad experience during treatment, may become uncooperative.

4. Definitely Unique behaviour, looks positive (++) forward to and understands the importance of good preventive care.

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