Contraindications: None.
- Parental presence/absence involves either allowing or removing the parent(s) from
the dental surgery in order to gain cooperation.
Objectives:
(i) To gain the patient's attention and compliance.
(ii) To avert negative or avoidance behaviours.
(iii) To establish appropriate adult-child roles.
(iv) To enhance the communication environment.
Indications: May be used with any patient.
Contraindications: None.
- Hand over mouth exercise is a technique for managing unsuitable behaviour that
cannot be modified by the more straightforward techniques. It is often used with
inhalation sedation (conscious sedation).
Objectives:
(i) To redirect the child's attention, enable communication with the dentist so that
appropriate behavioural expectations can be explained.
(ii) To extinguish excessive avoidance behaviour and help the child regain self-
control.
(iii) To ensure the child's safety in the delivery of quality dental treatment.
(iv) To reduce the need for sedation or general anaesthesia.
Indications:
(i) A healthy child who is able to understand and co-operate, but who exhibits
obstreperous or hysterical avoidance behaviours.
Contraindications:
(i) In children who, due to age, disability, medication, or emotional immaturity are
unable to verbally communicate, understand, and co-operate.
(ii) Any child with an airway obstruction.
Other techniques such as sedation in all its forms and general anaesthesia are
described elsewhere.
2.8 SUMMARY
- To prevent the development of anxiety it is more important to maintain trust than
concentrate on finishing a clinical task. - The reduction in dental caries means that children with special psychological,