Non pharmacological

1. Tell show do

• Tell – Explain procedure with age appropriate language
• Show – Demonstrate procedure
• Do – Perform procedure

Communication should be gentle, addressing the child. Use euphemism (eg. call LA “sleeping juice”, rubber dam “umbrella”) and smile. Have positive reinforcement.

2. Behavior modelling – Show other children getting procedures and how they behave

3. Distraction – Music, videos, virtual reality

4. Relaxation therapy – Relaxation exercises to do at home

5. Systemic desensitization – Present the procedure in a graduated fashion to reduce anxiety

6. Hypnosis – Altered state of consciousness to produce desirable behavior

7. Aversive techniques: Must obtain parent consent, informed consent, document indication and duration. Should be legal in country of practice and be used with extreme caution.

• Hand over mouth – and explain in child’s ear. Contraindicated in children below 3 and special health care needs
• Protective stabilization – can cause physical and psychological harm. Active is by dental team, passive is by protective devices
• Voice control – Changing volume, speed or tone of voice to get child’s attention

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Pharmacological

• Nitrous oxide
• Conscious sedation
• General anesthesia