Personalized behavior management as a replacement for medications for pain control and mood regulation

A lack of personalized approaches in non-medication pain management has prevented these alternative forms of treatment from achieving the desired efficacy. One hundred and ten female patients with fibromyalgia syndrome (FMS) and 60 healthy women without chronic pain were assessed for severity of chronic or retrospective occasional pain, respectively, along with alexithymia, depression, anxiety, coping strategies, and personality traits. All analyses were conducted following a ‘resource matching’ hypothesis predicting that to be effective, a behavioral coping mechanism diverting or producing cognitive resources should correspond to particular mechanisms regulating pain severity in the patient. Moderated mediation analysis found that extraverts could effectively cope with chronic pain and avoid the use of medications for pain and mood management by lowering depressive symptoms through the use of distraction mechanism as a habitual (‘out-of-touch-with-reality’) behavior. However, introverts could effectively cope with chronic pain and avoid the use of medications by lowering catastrophizing through the use of distraction mechanism as a situational (‘in-touch-with-reality’) behavior. Thus, personalized behavior management techniques applied according to a mechanism of capturing or diverting the main individual ‘resource’ of the pain experience from its ‘feeding’ to supporting another activity may increase efficacy in the reduction of pain severity along with decreasing the need for pain relief and mood-stabilizing medications.

Spanish and Portuguese Parental Acceptance of Behavior Management Techniques in Pediatric Dentistry

Aim. To compare acceptance of behavior management techniques used in pediatric dentistry by Spanish and Portuguese parents. Study design. cross-sectional study. A survey of 8 behavior management techniques used in pediatric dentistry was administered to parents whose children were being treated at the Universitat Internacional de Cataluña (Barcelona, Spain) or at the Universidade de Coimbra (Portugal). The techniques evaluated were: tell–show–do (TSD), nitrous oxide sedation, passive restraint using a papoose board, voice control, hand-over-mouth, oral premedication, active restraint and general anaesthesia. The questionnaire also included information on parents’ sex, number and sex of children receiving treatment, parents’ previous dental experience (positive or negative), children’s previous dental experience (positive or negative), and the socioeconomic status of the families. Results. TSD and voice control were rated the most acceptable techniques in both Spain and Portugal, whereas the least accepted techniques in both countries were active and passive restraint. There were no significant differences in the acceptance of each of the techniques, in relation to parents’ sex or their previous dental experience, children’s sex or age, children’s previous dental experience, or families’ socioeconomic status. Conclusion. TSD was the most widely accepted behavior-management technique by Spanish and Portuguese parents, even with the passage of time. Both groups of parents had a low opinion of active and passive restraint techniques.

MANAGING CHILD IN DENTAL OFFICE BY NON-PHARMACOLOGICAL BEHAVIOR MANAGEMENT TECHNIQUES

Behaviour management of a child in the dental office refers to methods of obtaining a childs approval of treatment in the dental chair which is based on proper communication, patient/ parent education with empathy, coaching and listening. The concept behind guiding a childs behaviour is treating them rather than just operating the tooth alone. The outcome of these techniques could maintain a proper communication or extinguish disruptive behaviour related to dental treatment.

EFFECTIVENESS OF PARENTAL PRESENCE/ABSENCE TECHNIQUE AS A BEHAVIOR MANAGEMENT TECHNIQUE IN PAEDIATRIC DENTSTRY

Objective: To assess the deliberate use of a parental presence/absence (PPA) intervention as a behaviormanagement technique to manage uncooperative children as well as its association with age. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at department of Paediatric dentistry, Rehman College ofDentistry, Peshawar, from Jan to Apr 2019. Methodology: Practice patient records were examined over a period of 3 months, during which Frankel behavior ratings were made for each patient. About 2 to 14 years olds were included in the study who had no previous dental treatment, accompanying by their parents. Sixty one children were selected out of 200 who showed uncooperative behavior Frankl 1 and Frankel 2. Their parents were asked to step out of the operatory until the patient become cooperative. Result: The study included 61 children out of 200 who showed uncooperative behavior according to Frankel‟sbehavior rating scale. The result showed significance in age group 4-6year, kinder garden (p=0.035). Conclusion: The Parental Presence/Absence technique (PPA) can be successfully used in gaining the cooperation of children displaying negative behavior aged 4-6, thus minimizing the need for other more aversive Behavior management techniques (BMT‟s).

Behavior management in Pediatric Dentistry during and after Corona pandemic

Children are not miniature adults. They should be treated as different entity and not just as adults who are shortened. Children have their own apprehensions and fear. The most commonly encountered is the fear of the unknown. Fear is something which is innate and inborn. Fear of dentistry is there in every individual, whether young or old. This is mostly subjective in nature. Children show exaggerated fear for dentistry as this is something new to them. The pediatric dentists are trained in behavior management for reducing fear. There have been many methods, both pharmacological and non-pharmacological for behavior management in children. The pediatric dentists were able to apply one or the other behavior management techniques till now. Sudden appearance of a pandemic caused by nCOV-2 (coronavirus) changed everything. The change in practice pattern is bound to effect all the dental patients, more so the children. Here we will discuss how the behavior management techniques will change for children and how we can get some newer methods to reduce the fear.

PREFERENCE OF USE OF RESTRAINTS BY POSTGRADUATE STUDENTS IN PEDIATRIC DENTISTRY IN BENGALURU.

Introduction: Dental treatment of uncooperative children is a challenge to Paediatric dentists. If psychological behaviour management techniques are inadequate then restraints may be considered. Aim: To assess the preference of use of restraints by post graduate students in Pediatric Dentistry in Bengaluru. Method: A self administered questionnaire was designed, which contained 12 questions that assessed the demographic data and information on the use of physical, mechanical, and positioning devices in clinical practice. Information was also obtained on consent. Results: A total of 80 postgraduate students participated in the survey. Our study revealed that 72.5% postgraduate students treat patients with some form of restraints. Only 26 % received training on the use of restraints. It was also observed that 70% have used HOME technique and 92.3% obtain only verbal consent before the use of restraints. Conclusion: Majority of the postgraduate students used restraints to treat patients even though they have not received any formal training. CDE programs and workshops presented by specialists or faculty may be used to update the postgraduate students on the use of restraints. Keywords: behavior management techniques, restraints, postgraduate students