-Shield type II: Primary teeth similar to DI.

Permanent teeth have pulp stones, thistle tube shaped

chambers, no periapical radiolucencies
Part 2: Management of Child Behavior
Classification of Behavior
1) Cooperative: children w/ minimal apprehension, communicative, comprehending, and willing
-respond well to behavior shaping
2) Lacking cooperative ability: children are deficient in comprehension and communication skills
-includes very young children (under 3 yrs) and disabilities
3) Potentially cooperative: are capable of appropriate behavior but disruptive in dental setting
a) Uncontrolled: characterized by tantrums; 3-6 yrs old
b) Defiant: I dont want to attitude in children and passive resistance in adolescents
-can be all ages
c) Timid: char. by shielding behavior and hesitation
-usually preschool and young grade school kids
d) Tense-cooperative: want to cooperate and try to behave but are very nervous
-typically older children at least 7 yrs old
e) Whining: continuous, whining behavior but no crying
Frankl Behavioral Rating Scale
1) Rating 1: definitely negative refusal of txt
-forceful crying, fearful, extreme negativism
2) Rating 2: negative reluctance to accept txt
-uncooperative, negative attitude but not pronounced
3) Rating 3: positive acceptance of txt
-cautious behavior but willing to comply and cooperates w/ dentist
4) Rating 4: definitely positive w/ good rapport w/ dentist
-has active interest in dental procedure and laughs/enjoys visits
Variables Influencing Behavior in Dental Setting
1) Age
a) < 2yrs: typically lack cooperative ability
b) 2 yrs: wide variance in ability to communicate
-dentist should use tell-show-do technique
-may be helpful to have parent in room due to possible separation anxiety
c) 3-7 yrs: most often are cooperative and willing to comply w/ dental procedures
-familiarization techniques and behavior shaping strategies are helpful tools
d) 8+ yrs: children try to control apprehension as they get older but stressful situations may cause them to
revert to negative behaviors
-behavior shaping and familiarization techniques can still be helpful
2) Maternal anxiety
-high correlation btw maternal anxiety and childs negative behavior
-effect greatest on children under 4 yrs old
3) Past medical history
-children w/ positive past medical experiences are more likely to be better at dentist
-children who have experienced pain in past medical visits will have more negative behavior
-previous surgery correlated w/ negative behavior at first visit
4) Patient awareness of problems
-if child thinks they have a dental problem, they are more likely to exhibit negative behavior