1、Hospital Based Dentistry,Behavioral Growth and Development Anne S. Aiello, D.M.D. April 7, 1999,Hospital Based Dentistry for Children,What you should know !,To understand the concept of hospital based dentistry for children. To be able to discuss the indications for the use of general anesthetic for
2、 normal and special child dental patients. To be able to discuss the psychological effects of a surgical procedure on a child and their family. To be able to discuss what is involved in admitting, performing, and dismissing patients.,Review of Management Techniques,Desensitization tell-show-do model
3、ing distraction Flooding Techniques voice control restraints HOME,Management Techniques,Pharmacologic inhalation analgesia premedicationGeneral Anesthesia,Option of Last Resort,“Drugs do nothing to help child become a good patient.” Dr. Kramer,Behavioral Themes in Pediatric Dentistry: 1968-1994,“All
4、 is flux, nothing is stationary. There is nothing permanent except change.” -Heraclitius, Greek philosopher, 470 B.C.,Paradigm Shift,Postfigurative rear their children the way that they have been raised Configurative Looks at immediate past and and present to devise a strategy Prefigurative parents
5、solve dilemmas of child rearing in a day to day basis,Candidates for Hospital Dentistry,Children with handicapping conditions,Emotional or behavioral problems of any age The very young child needing a lot of work,Candidates for Hospital Dentistry,Very invasive procedures Patients who have sustained
6、extensive orofacial and dental trauma,Psychological Effects of Hospitalization on Children,75% of all children receiving a GA exhibited some behavioral change 42% positive less fuss about eating, fewer tantrums, better appetite 42% negative easily upset when left alone, avoidance of new things, need
7、ing more attention, fear of the dark,Ways to Minimize Negative Changes,Involve child on operating room tour Allow child to bring favorite doll or toy Utilize preinduction sedation Allow parents to rejoin child ASAP Thoroughly explain procedure to parent mothers of children receiving GA were more str
8、essed Fully describe post op course,Outpatient Care,More expeditious Better tolerated by family and hospital team Dentist becomes coordinator,Decrease in health care costs for consumers and third-party providers Children must be free of any significant medical disorders,Inpatient Care,Required if pa
9、tient has medical condition that requires close follow-up It family lives outside general area,If parents or caretaker demonstrate questionable ability to comply with pre-op or post-op instructions,Steps needed to hospitalize a child patient and complete care,1 - Initial Exam2 - Parental Consultatio
10、n3 - Consultations4 - Preadmission5 - One Week Before Appointment 6 - Patient Admittance,Steps needed to hospitalize a child patient and complete care,7- Preoperative Procedures8 - Equipment Preparation9 - Anesthesia Induction10 - Restorative Procedure 11- Postoperative Procedures 12 - Discharge and
11、 Follow-up Care,Advantages of Hospital Dentistry,Child is not a behavior problem No need for multiple visits,All treatment is accomplished in 1 to 1.5 hours Dentistry is done under ideal circumstances,Disadvantages,Doesnt help with behavior management Doesnt teach child about dentistry Element of ri
12、sk Need to bring own staff and supplies Need to close office Expensive,Obtaining Staff Privileges,Must be graduate from an accredited dental school Hold license to practice in state where facility is located Membership in ADA,Obtaining Staff Privileges,References regarding high ethical and moral standards Professional liability insurance Signed delineation on privileges form,Slides Please,
