88
ILLUSTRATED PAEDIATRIC DENTISTRY
Figure 14.2
Management of a highly anxious child.
Multisensory
Communication
Features:
• Child is not relaxed on a
reclined dental chair
• Cries with breath-catching
sobs
• Keeps hands held together
• Keeps feet crossed and
toes flexed
• Observes the dentist keenly
• Eyes follow the dentist’s/
dental assistant’s hands in
the anxiety of ‘what’s next’
• If not attended well, the child
may display obstinate
behaviour
Establish a
relationship with
adequate reassurance
to develop a sense of
trust in the child
HIGHLY ANXIOUS CHILD
Behaviour Shaping
Tell-show-do, modelling and
contingency management have to
be strategically and precisely applied
to reassure and allay anxiety
The behaviour is reinforced
and maintained with
contingency management
Behaviour Retraining
Voice Control only
Aversive conditioning should
be avoided if the child is still
highly anxious
Treatment under
conscious sedation to
obtain mood alteration
Behaviour Shaping
is
attempted again
Positive
behaviour
Negative
behaviour
Positive
behaviour
Negative
behaviour
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