Authors: John Morgan, Bonnie F. Zimble
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Behavior Management: The Patient Care Experience for Patients with Disabilities:
Alternatives and the Patient Cooperation Scale
Special Care in Dentistry
John Morgan, DDS
Tufts University School of Dental Medicine, 2008
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Study
Questions
1. What
three alternative modalities may be needed?
2.
Describe the purpose of, use of, and behavioral
descriptors used in the Patient Cooperation
Scale.
Sometimes a flexible set of
alternatives is needed …
Many patients may require additional modalities
to prepare them for dental care. Behavior problems can prohibit safe,
effective dental treatment. Health related protection, conscious
sedation, and general anesthesia
may be indicated based on an assessment of the patient’s medical
profile, behavioral issues and dental needs. Using a
combination of techniques may improve the patient’s behavior over time
and result in a cooperative patient with minimal levels of
intervention. Some patients often require deep sedation for initial
visits, but as they gain confidence, require minimal sedative agents
for future visits. Also, some dental procedures are more stimulating
than others and may require varying levels of sedation depending on the
nature of the treatment being provided.
The Cooperation Scale to Evaluate
Patient Behavior Tracking patient behavior from visit to visit is
difficult. Decisions concerning the effectiveness of various
modalities of health related protection, behavior management and
sedation are usually based on the ability of the patient to cooperate
for the dental visit. In order to monitor the patient’s
behavior a cooperation scale is used. Recorded at every
visit, this simple measurement tool allows the dental practitioner to
assess the cooperation level of the patient and receive feedback
concerning the effectiveness of the comprehensive patient management
program in use.
Patient Cooperation
Scale |
|
Rating |
Behavior |
|
0 |
Did not enter clinic/dental
chair |
|
1 |
Sat in dental chair but did not allow
exam |
|
2 |
Allows only brushing of teeth and/ or visual
exam |
|
3 |
Allows instruments placed in mouth and exam with help from
staff and/or assistant |
|
4 |
Allows complex procedure with stabilization more than 50% of
the time |
|
5 |
Allows complex procedure with stabilization less than 50% of
the time |
|
6 |
Allow complex procedure with no
stabilization |
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