Modifications of behavior management strategies pre- and post-covid-19 scenario A survey among pediatric dentists

Background: COVID-19 presented a unique scenario among children, specifically all over the world. The children had decrease outdoors activities and learning times, increased use of electronic gadgets and changes in sleep patterns. These altered behavior patterns of children directly influenced their behavior in the dental operatory. This coupled with the stringent protocols of COVID-19, made the behavior management of children a tedious task. However, as they say that necessity is the mother of all inventions, the pediatric dentist took this time to evaluate newer methods of behavior management and modified old strategies with newer modifications. Aim: The main aim of this study was to observe the modifications in behavior management strategies among pediatric dentists in the post-COVID-19 era while managing the child in dental operatory. Materials and Methods: Four hundred pediatric dentists were mailed a questionnaire consisting of 24 open and closed-ended questions consisting of personal data, professional information, and questions regarding various behavior management techniques used by them in pre- and post-COVID-19 era. Data obtained were subjected to statistical analysis using SPSS version 26.0, IBM, and a comparison of frequencies of categories of variables with groups was made using Chi-Square test and McNemar test. Results: The results showed that there were statistically highly significant changes in behavior management strategies pre- and post-COVID-19 scenario with P < 0.01. Conclusion: Conventional techniques like Tell-Show-Do were popular in both pre- and post-COVID-19 times with minor modifications in approach, but conscious sedation and distraction techniques were evaluated to have gained more popularity in the post-COVID-19 times along with exploration of new novel techniques.

Strategies for the treatment of circadian dysrhythmic sleep and wakefulness disorder / 中国临床药理学与治疗学

Circadian rhythm sleep-wake disorders (CRSWDs ) is a group of sleep-wake disorders caused by circadian rhythm disorder. Patients complain of difficulty in falling asleep, early waking, daytime drowsiness, which are often misdiagnosed and delayed for treatment. The American Academy of Sleep Medicine (AASM) updated the diagnostic criteria in 2014, and issued relevant treatment guidelines in 2015. In recent years, many countries have issued relevant clinical practice guidelines or consensus. The treatment of circadian rhythm sleep-wake disorder is different from the common sleep-wake disorder, with the focus on non-pharmacologic circadian rhythm regulation to reset the normal 24-hour sleep-wake rhythm. This article mainly introduces its treatment strategy and method.

Implementing a community-based parent training behavioral intervention for autism spectrum disorder / Capacitação parental para manejo de comportamentos disruptivos para tea em intervenção comportamental / Tea: capacitación de padres para manejo de conductas problemáticas

The autism spectrum disorder (ASD) affects developmental areas early in life and on families exert significant burden both emotionally and economically. This paper is a non-controlled, multicenter study to train caregivers of ASD individuals displaying disruptive behavior and deficit of communication, based on Applied Behavior Analysis. Results showed a reduction in the disruptive behavior measured by the Aberrant Behavior Checklist (ABC) and also the caregivers' depression and anxiety symptoms assessed by the Hamilton Scale. Group interventions may be an alternative for reaching a higher share of the population.

O transtorno do espectro do autismo (TEA) afeta precocemente áreas de desenvolvimento e resulta em uma sobrecarga significativa para as famílias, tanto emocional quanto economicamente. Este é um estudo não controlado, multicêntrico, com o objetivo de capacitar, com base na Análise Aplicada do Comportamento, cuidadores de indivíduos com TEA que apresentam comportamento disruptivo e deficit de comunicação. Os resultados mostraram redução nos comportamentos disruptivos, medidos pelo Aberrant Behavior Checklist (ABC), e também nos sintomas de depressão e ansiedade dos cuidadores, avaliados pela Escala de Hamilton. As intervenções em grupo podem ser uma alternativa viável para atingir uma parcela maior da população.

O transtorno do espectro do autismo (TEA) afeta precocemente áreas de desenvolvimento e resulta em uma sobrecarga significativa para as famílias, tanto emocional quanto economicamente. Este é um estudo não controlado, multicêntrico, com o objetivo de capacitar, com base na Análise Aplicada do Comportamento, cuidadores de indivíduos com TEA que apresentam comportamento disruptivo e deficit de comunicação. Os resultados mostraram redução nos comportamentos disruptivos, medidos pelo Aberrant Behavior Checklist (ABC), e também nos sintomas de depressão e ansiedade dos cuidadores, avaliados pela Escala de Hamilton. As intervenções em grupo podem ser uma alternativa viável para atingir uma parcela maior da população.

Analysis of Pediatric Dentistry Patients Treated Under General Anesthesia

This study was to determine the characteristics of children treated under general anaesthesia according to age, gender and medical condition, to investigate different indications for the dental treatment in children, and to assess the mean number of different dental procedures performed under general anaesthesia, in a single dental care unit in one year, according to age groups, indications and medical conditions. Methods: A retrospective study was designed. Data were collected from patients rehabilitation under general anaesthesia over a one year period (February-2018 to January-2019). The information collected from the records included age, gender, general health status, indications for general anaesthesia, type of procedure, attendance for review appointment and treatment provided including the number of primary and permanent teeth extracted and restored. Results: A total of 107 patients, 64 male and 43 female received dental treatment under general anaesthesia at private dental clinic in Istanbul, Turkey. The main indications for general anaesthesia were behaviour management problem (44.6%). It was determined that the number of dental fillings in primary teeth was higher (60.16%) in the 2-5 year age group. Conclusion: It has been observed that application of general anesthesia is an effective and efficient way in providing dental treatment to disabled individuals with special healthcare needs, young children with poor cooperation and children requiring comprehensive dental treatment as the dental treatment can be completed in a single session.

The management of dental fear symptoms in children in a coparticipation model / 口腔疾病防治

Objective@#To explore the impact of procedural behavior management on children with dental fear (DF) using the interactive mode of coparticipative doctor-patient interactions.@*Methods@#Ninety-eight children with dental fear and aged 3-6 years were randomly divided into an observation group and a control group. Dental treatment was performed on the observation group under the coparticipation model, while the control group adopted the traditional tell-show-do (TSD) operation. The entire process of diagnosing and treating each child was recorded, and the degree of dental fear was assessed using a behavioral grading method as the standard.@*Results@#The degrees of fear in the children in the observation group and the control group were 3.571 ± 0.913 and 3.857 ± 1.000. The two groups showed no significant difference in the degree of fear (t=1.477, P > 0.05). During the treatment, the fear scores of the children in the observation group and the control group were 1.428 ± 1.061 and 3.286 ± 0.707. The two groups showed statistically significant differences in fear scores (t=10.198, P < 0.001).@*Conclusion @#In the coparticipative model, the fear level of DF children was significantly reduced by process-based behavior management, which helped to improve the dental fear of the children.

Behavior management of children with autism spectrum disorder / 中国实用儿科杂志

Autism spectrum disorder(ASD)is a neurodevelopmental disability that occurs in childhood,characterized by two core disabilities in social interaction and communication,and the presence of repetitive behavior and restricted interest.Thus,the intervention of ASD focuses on improving behavioral disturbances by effective behavior management. Applied behavior analysis(ABA)is a science,which has been applied to the intervention of ASD and has been proved to be evidencebased. In the behavior management of ASD,instructors should master the basic principle of behavior,and apply the evidencebased strategies and treatments to carry out the work under guidelines of theory.

Student Satisfaction and Achievement after Role-playing in a Pediatric Dentistry Class / 대한소아치과학회지

This study aimed to investigate the effects of learning with role-playing on student satisfaction and achievement regarding behavior management teaching in pediatric dentistry.93 students were divided into 19 groups and randomly assigned to role-play as a doctor, patient, parent, assistant, or narrator. Their performances were evaluated by the instructor and the satisfaction survey was conducted. All participants took the written test and were asked to compare lecture and role-playing with regard to the effectiveness of learning. Statistical analysis was performed with Mann-Whitney U test, Independent T-test, and Kruskal-Wallis test.68 students (73.1%) who believed that the role-playing was more helpful than lecture showed higher level of satisfaction than students who believed lecture was more helpful. But there were no differences in the tutor evaluation score and the written test scores.Participants in the patient management scenario showed higher level of descriptive question scores of the written test and tutor evaluation score than those who participate in the parent management scenario. There were no differences between the role groups.Role-playing may help students to become more interested and participatory in learning behavior management. The level of satisfaction may differ by the design and content of the scenario.

Manejo de la salud bucal en discapacitados. Artículo de revisión / Oral health management in people with disabilities

Resumen En el mundo existen más de 1 000 millones de personas con alguna discapacidad y aunque estas condiciones no son sinónimos de alteraciones bucales severas, si se ha logrado detectar en los pacientes que las padecen, señales de mala higiene bucal y enfermedades bucales producto de la poca o nula atención odontológica, relacionadas en gran medida al temor que los profesionales del área enfrentan al momento de la atención. La comunicación con pacientes en condición de discapacidad como autismo, síndrome de Down, parálisis cerebral, deficiencia auditiva, presenta un componente adicional de difultad, por lo cual es necesario apoyarse en un sistema de estrategias comunicativas, protocolos de atención y otros medios que pueden variar entre las distintas discapacidades. Estos permiten que personas con dificultades de comunicación puedan relacionarse e interactuar con su entorno. La capacitación para el odontólogo en este campo no es fácil, dado que no se cuenta con suficientes programas que cubran de manera completa la formación del profesional en este ámbito. El propósito de este artículo fue realizar una revisión de tema sobre algunos tipos de discapacidades, las manifestaciones bucales más comunes, el manejo odontológico y estrategias de comunicación alternativa apropiada, para brindar una atención de calidad.

Abstract In the world there are more than one billion people with disabilities and although these terms are not synonymous with severe oral changes, it has been detected that people with disabilities have more risk to suffer oral pathologies due to poor dental service related to the reluctance dentist have to take care of these patients. Communication with patients with conditions such as autism, Down syndrome, cerebral palsy, hearing impairment; presents an additional component of difficulty, so it is necessary to rely on a system of communicative strategies, care protocols and means of support that may vary among different disabilities. These enable people with communication difficulties to interact with their environment. Training for dentists on this field is not easy, since there are not sufficient programs covering completely professional training in dentistry in this area. The purpose of this article was to review some types of disabilities, their most common oral manifestations, dental management and appropriate alternative communication strategies to provide good dental services.

Research progress in child behavior management technology / 口腔疾病防治

@#In the process of children’s dental treatment, children’s non-cooperation has always troubled dentists in clinical work. Using behavior management techniques properly can help us manage children’s behavior more effectively, improve the treatment efficiency, and greatly relieve the work stress. This paper reviewed the research progress on the basic and advanced behavior techniques for children’s oral behavior management techniques.

Estrategias para la modificación conductual en niños / Strategies for behavior modification in children

Los trastornos de conducta en niños son motivo de consulta frecuente. Sus causas son variadas incluyendo desde factores biológicos hasta condiciones psicosociales particulares. La intervención psicológica debe considerar características individuales del niño y su familia, previo a suimplementación. Así se entregan orientaciones generales para el manejo conductual de niños y adolescentes, siendo la base de estas estrategias: las prácticas de buen trato, vinculación positiva con los niños, la congruencia y la constancia en el tiempo.

Conduct disorder in children are frequent consultation. Its causes are varied including from biological factors to specific psychosocial conditions. Psychological intervention should consider individual characteristics of the child and his / her family, prior to implementation. So general guidelines for behavior management of children and adolescents are given, being the basis of these strategies: good treatment practices, positive relationship with children, consistency and constancy in time.

Parental acceptance of pharmacologicand non-pharmacologic behaviormanagement techniquesin pediatric dentistry / Aceptación de las técnicas de manejo farmacológicas y no farmacológicas en padres de pacientes pediátricos en odontología

Introduction and Objective:The constant changes in the socio-cultural and ethical-legal conditions required to continually evaluatethe techniques of behavior management of pediatric patients in dental treatment. Identify the acceptanceof parents towards behavior management techniques used routinely in pediatric dentistry in a Colombianpopulation.Materials and Methods:A cross-sectional descriptive study was carried out in which 129 parents of children between ages 3and 15 evaluated a video which presented different behavior management techniques and completeda Questionnaire specifically designed for this study. Techniques evaluated include tell-show-do, positivereinforcement, contingent distraction, active inmobilization, passive inmobilization (papoose board),nitrous oxide sedation and general anesthesia.Results:Communicative techniques such as tell-show-do, positive reinforcement, modeling and contingentdistraction were significantly more accepted when compared with pharmacological techniques andrestrictive techniques were the least accepted.Conclusions:There is great rejection of parents to the traditional use of restrictive techniques and social trends requirethe dentist to use more communication techniques to manage the behavior of patients.

Introducción y Objetivo:Los constantes cambios en el entorno socio-cultural y en las condiciones ético-legales exigen que seevalúen continuamente las técnicas de manejo de la conducta del paciente pediátrico. Identificar el nivelde aceptación que tienen los padres frente a las técnicas farmacológicas y no farmacológicas para elmanejo de la conducta en el tratamiento del paciente pediátrico en odontología.Materiales y métodos:Se hizo un estudio descriptivo transversal prospectivo en 129 padres de niños entre los 3 y 15 añosde edad, que evaluaron por medio de un cuestionario y un video las diferentes técnicas de manejode la conducta del paciente pediátrico: decir mostrar hacer, refuerzo positivo, modelado, distraccióncontingente, inmovilización activa y inmovilización pasiva (papoose board), sedación inhalada (oxidonitroso) y anestesia general.Resultados:Las técnicas comunicativas (Decir Mostrar Hacer, Refuerzo Positivo, Modelado, Distracción Contingente)fueron las más aceptadas al compararlas con las técnicas farmacológicas y las técnicas restrictivas fueronlas de menor aceptación.Conclusiones:Hay un gran rechazo de los padres hacia el uso tradicional de las técnicas restrictivas y las tendenciassociales actuales requieren que el odontólogo utilice más las técnicas comunicativas para el manejo delcomportamiento de los pacientes.