Pedodontics: The Psychologic Management of Behavior
Two primary objectives of pediatric dentistry include providing for patients' immediate dental needs and initiating good attitudes towards dental health. The practice of pedodontics is currently undergoing significant change. Much greater emphasis is being placed on the psychological techniques of behavior management. With the decline in dental caries, children and dentists are no longer engaged in a crisis confrontation. Pediatric dentistry now involves more patient education and the establishment of trusting relationships.
The American Academy of Pediatric Dentistry (1990) has recently promulgated specific guidelines for behavior management. These "Standards of Care for Behavior Management" make the following point: "Behavior management is as much an art form as it is a science. It is not an application of individual techniques created to 'deal' with children but rather a comprehensive methodology meant to build a relationship between patient and doctor which ultimately builds trust and allays fear and anxiety (Musselman, 1991, p. 1309)." For a child, the dental visit is an intense, rapidly evolving situation. It typically consists of interaction with two different adults: the parent and the dentist. These various social interrelations form the pedodontic treatment triangle. The child's position is at the apex, with the family and dental team forming the triangle's base. In this model, the child becomes the primary focus of attention during dental treatment (Wright, p. 32).
Psychological issues are very important in pedodontics. The oral cavity represents a significant component of a child's psychological development. Perhaps, for this reason, unreasonable fears tend to become associated with the teeth and oral structures. Dentists must, therefore, always consider the psychologic implications of their actions (Frankl et al., 1962, pp. 159-160).
Fort...