Module 5 Key Points
- The goal of behavior guidance is to ease a child’s fear and anxiety about the dental office and oral health procedures while promoting an understanding in the family of the need for good oral health and the process by which good oral health is achieved.
- Among children with special health care needs, lack of cooperation can be a consequence of immature or impaired development or communication disorders. Lack of stability, muscle control, or impulse control can also result in behavior that can endanger the safety of the child or the oral health professional providing care.
- Behavior guidance decisions must involve a legal guardian and, if
appropriate, the child.
- Oral health professionals should understand the objectives, indications, and contraindications for all behavior guidance techniques and should use the least restrictive option.
- Communicative guidance is used universally in dentistry with both
cooperative and uncooperative children. It is the most fundamental
form
of behavior guidance.
- Nitrous oxide/oxygen-inhalation sedation is a safe and effective technique to reduce anxiety and safely accomplish oral health care.
- Advanced behavior guidance techniques include protective stabilization,
deep sedation, and general anesthesia. Use of these techniques
requires special training and, in some cases, certification.
- Protective stabilization should be used cautiously and only when necessary to protect the child and staff during oral health procedures. Examples of stabilization devices include mouth props, PediWraps®, Papoose Boards®, and supportive seatbelts. Oral health professionals, dental office staff, or a parent can also gently hold the child’s hands, arms, or legs. Protective stabilization should not be used solely for the convenience of the oral health professional.
- Deep sedation can be used safely and effectively with children unable to receive oral health care for reasons of age or cognitive, emotional, physical, or medical condition.
- General anesthesia is a controlled state of unconsciousness accompanied by a loss of protective reflexes, including the ability to maintain an airway independently and respond purposefully to physical stimulation or verbal command. Careful consideration of indications and contraindications is crucial in making the decision to administer general anesthesia, as it generally is the last choice for managing behavior.
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