When the assessment visit is used effectively, children with all levels of dental fear and anxiety (DFA) are better understood and treated by the dental team. A standardised assessment process gives us the ability to ensure that routinely a child-centred collaborative approach is taken.
In this chapter the importance of understanding treatment allocation options and explaining these to children and adolescents based on their needs are explored. A basic understanding of the characteristics of the individual requiring dental treatment can positively influence the success rates of different anxiety management techniques.
Intravenous (IV) conscious sedation is an effective technique for managing anxious or phobic patients. Historically a variety of drugs have been used, either singly or in combination. The principles of managing IV sedation safely are applicable to all techniques and agents. Several definitions of conscious sedation have been published in standard documents.
Anticipatory anxiety is often defined as a concern occurring in the absence of the feared stimulus. In adults, anticipatory anxiety is likely to lead to avoidance of dental treatment. Children may not be able to avoid dental treatment as they are usually made to attend by their parents, but their anxiety may then be manifest in poor behaviour for treatment.
Relaxation can be taught to patients who are not dentally anxious to ensure they cope well with dental care and avoid having any unpleasant experiences. This cop- ing technique has been shown to help reduce both dental and medical anxiety and provides a mechanism to help patients remain calm and feel in control.
Over the past 30 years, the rights of children have been increasingly recognised. The United Nations Convention on the Rights of the Child (UNCRC) was adopted in 1990 to recognise children’s rights to express their views. As more weight has been given to the rights and views of children, the ‘voices’ of children have become increasingly recognised and taken seriously. In healthcare, there have been many international and national policies recognising these rights.
We have all experienced anxiety and fear at some point in our lives; however, we sometimes still find it difficult to understand other people’s fears if these are different to our own. This can be a challenge for dental professionals who treat anxious children and who may struggle to understand their patient’s fear reactions.
Cognitive behavioural therapy (CBT) is a widely used and evidence-based form of talking therapy/psychotherapy. It aims to help people address unhelpful thinking patterns and ways of responding (behaviours) that can worsen how they feel.
Communication has both verbal (35 %) and non-verbal (65 %) elements. Non- verbal communications or cues are more readily believed than those of the spoken word. It is the case, for people in general, that “actions speak louder than words”. However, the benefits of understanding both non-verbal and verbal cues are essential in understanding and communicating with your child and adolescent patients.
It has been established in Chapter 1 that despite great advances in local anaesthetic and treatment techniques, many children find a trip to the dentist anxiety provoking. However, unlike adults, they have little control over whether they attend the dentist, and so identifying and facilitating effective coping in the dental setting is important if dentally anxious children are to have positive experiences in the dental clinic and are not to develop into dentally anxious adults.
Dental fear and anxiety (DFA) is common in children and is associated with important clinical and psychosocial impacts. Assessment of DFA is an important step in its management. The aim of this chapter is to discuss why dental professionals should prioritise DFA assessment; describe the different assessment options that are available, particularly the use of self-report measures for children; and consider when DFA is being assessed and what is actually being measured.
Perhaps it was just me, but as an undergraduate, the ‘art and science’ of non- pharmacological behaviour management techniques (NPBMT) seemed akin to that of a ‘dark art’ and a ‘non-evidence-based science’. This chapter aims to shed more light on both the ‘art’ and the ‘science’ of NPBMT.
Providing local anaesthesia (LA) is essential whilst undertaking dental treatment for children to ensure it is pain-free and as comfortable as possible. Giving LA injections to children is not always an easy task and can be stressful for the dentist, the child and parent(s). The aim of this chapter is to provide practitioners with knowledge of a range of techniques which complement the actual act of giving an injection to children and adolescents whether they have already acquired dental fear and anxiety (DFA) or are used preventively.