Behavior management of children in the dental office.

One of the first conclusions offered by this article was that behavior management has been a pertinent theme in literature addressing clinical pediatric dentistry. This has been true for much of the twentieth century. Another conclusion stated that this literature generally focuses on the preschool child after the child has acquired sufficient development and maturity that he or she can be communicated to in conversation. It was also pointed out that most general approaches to the subject of behavior management deal with the normal child, which for the purposes of this article can be construed as a cognitively, sociologically, and psychologically developed child with no unusual circumstances. The usual age of a child being approachable in language was determined to be approximately around the third birthday. An analysis of patient management in two previous issues of Dental Clinics of North America written almost 35 years apart revealed that there were many more similarities than differences. One conclusion derived from the present article was that all North American dental practitioners have lived in a culture that assumed that the behavior management of normal children 3 years of age and older can generally be regarded as achievable through linguistic techniques. This comparison of the two issues showed that the topics of informed consent and risk management in behavioral pediatric dentistry grew considerably in the last decades of the twentieth century, pharmacologic techniques became more sophisticated, and the linguistic domain remained important to most dentists who sought to treat preschool children. Regarding this last point, it was offered that a lot of the success of a clinician within the linguistic domain may be determined as much by the thoughts, feelings, and nonverbal acts of communication of the clinician as by any other factor. These include the many factors that describe a child's possibilities of success during the dental experience, such as fear status, allegiance to a misdirected goal of childhood, and learned helplessness. Because of the importance of the linguistic domain to most practitioners treating children, this domain was focused on, including how further mastery might be obtained for the clinician seeking more competence here. A method of the clinician examining his or her own effectiveness to refine a strategy for addressing the potential for more powerful linguistic interactions with children was briefly outlined. For the practitioner wishing more specific information, the reference list should provide a didactic base for further intellectual distinctions and assessments.