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
- Nitrous oxide
- Conscious sedation
- General anesthesia
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