GOOD AFTERNOON

BEHAVIORAL SCIENCESIN DENTISTRY

PRESENTED BY:NIDHI

B.D.S. FINAL YEAR

UNDER GUIDENCE OF:Dr. D.J. BHASKARDr. CHANDANDr. HIMANSHU PUNIADr. VIPUL GUPTADr. MANU BATRA

CONTENTS

•BEHAVIOR•BEHAVIOR SCIENCES•SOCIOLOGY

•SOCIAL PSYCHOLOGY•CULTURAL ANTROPOLOGY•ECONOMICS•POLITICAL SCIENCE

•HEALTH BEHAVIOR AND LIFESTYLE•BEHAVIOR OF CHILD•THEORIES OF CHILD PSYCHOLOGY

•PSYCHOANALYTICAL THEORY•PSYCHOSOCIAL THEORY•COGNITIVE THEORY•HIERARCHY OF NEEDS MASLOW•CLASSICAL CONDITIONING THEORY PAVLOV•FRANKL ET AL RATING SCALE

•BEHAVIOR MANAGEMENT

BEHAVIOR

Behavior is an observable act, which can be described in similar ways by more than one person. It is defined as any change in the functioning of an organism. Learning as related to behavior is a process in which past experience or practice results in relatively permanent change in an individual’s behavior. (SHOBHA TANDON)

BEHAVIORAL SCIENCES

Behavioral Science is the science of the study of human behavior at the level of their own self, other individuals, family and community members, and the resulting reaction on the dental health programme.(Hiremath)

SOCIAL SCIENCES

SOCIOLOGY

CULTURAL

ANTHROPOLOGY

SOCIAL PSYCHOL

OGY

ECONOMICS

POLITICAL

SCIENCE

SOCIOLOGY

CULTURAL ANTHROPOLOGY

SOCIAL PSYCOLOGY

Are together called as

‘BEHAVIORAL SCIENCE’

SOCIOLOGY

Sociology is defined as the study of groups of individuals which form a society and how they interact behave within themselves and the outcome of the interactions.

SOCIOLOGICAL FACTORS GOVERNING DENTAL HEALTH CARE SERVICES IN COMMUNITY:

Affordability of dental health services:In order to determine if community can pay directly or indirectly for the health care services, there is a need to measure socioeconomic status to which a particular community belongs.Recently devised method for the same is above poverty line (APL) or below poverty line(BPL).

Accessibility to dental health care services:Dental health care services are not easily available in villages. Therefore provision of dental care can be created only if there are roads and better communications for villagers to reach cities, and the like. This is called accessibility.

Acceptability of dental health care services:Even if community based dental health services are present, the sociological behavior of the people is important in accepting these services for their own use. This is called acceptability which is controlled by social taboos & beliefs which can be changed by promoting good social belief.

Community participation:For any community based dental health programme to remain successful, community members themselves must participate in the planning, publicity, provision of facilities for the programme, motivating others & helping to suggest methods of making programme more practical and useful.

Sustainability of programme:Funds are required for programme to sustain forever so local selfhelp groups in economic activities must be trained to generate funds for dental programme.

SOCIAL PSYCHOLOGY

PSYCHOLOGY is defined as the study of human behavior in terms of how, when, with whom, where and why they behave the way they do.

PSYCHOLOGICAL FACTORS AFFECTING BEHAVIOR:

Age and sexSkills and habitsIntelligence and emotionBeliefs and culturePast experienceBehavior during illnessBehavior when healthyIndependent or marriedPresent environmentLevel of interest and motivationCoping or managing problemsDecision making ability

Self esteem Expectation of othersAttitudeEmotional level

Scope and uses:

In any dental health programme, it is important to determine what is normal behavior related to health.

If a behavior is good for young programme, then promote it further.

If it is harmless then leave it alone

If it is harmful then we may need to change the behavior to suit a desired health behavior

Psychological behavior is different when an individual is alone as compared to when he/she is in a group.

CULTURAL ANTHROPOLOGY

Anthropology is the study of manand his works

It has two main divisions:1. Physical anthropology2. cultural anthropology

Physical anthropology is the study of man as a biological organism.

Cultural anthropology is the branch dealing with man’s behavior and product.

Branches of Cultural anthropology are:

1. ETHNOLOGY: The comparative study of cultures.

2. ARCHEOLOGY: The study of past cultures and civilizations using their remains as the principal source of informations.

3. LINGUISTICS: The study of patterns of man i.e. study of language and dialects.

4. SOCIAL ANTHROPOLOGY: A specific branch of cultural anthropology dealing with comparative dealing with comparative study of kinship and non kinship organization patterns in different societies.

Scopes of anthropology:

1. In terms of physical anthropology, the dimension of facial structure varies with racial features.

2. With increasing urbanization & its influence on changing lifestyles, facial appearance has an increased role to play in communication strategies.

3. Cultural anthropology would be a major challenge for any form of change in habits and customs, especially in rural areas and traditional families.

4. Decision making in the use of dental hygienic measures by the community, becomes an important component of cultural anthropology.

ECONOMICS

It studies the economic aspects of man i.e. production distribution and consumption of the three basic essentials for his living namely food, shelter and clothing. Scarcity or excess of these are found to affect human behavior.

POLITICAL SCIENCE

It deals with the constitution, the government and the laws of the state, which impose some sort of discipline on man’s movements or behavior.

HEALTH BEHAVIOR AND LIFE STYLE

Health behavior “Any activity undertaken by an individual, regardless of actual or perceived health status, for the purpose of promoting, protecting or maintaining health, whether or no such behavior is objectively effective towards that end.”-WHO Health Promotion Glossary, 1986

Illness behavior:It is the interpretation of symptoms or signs of illness, especially pain and the search for relief. It is a social process drawing on past experience and involving interaction with others in denfining a solution to an oral health problem. This process is called illness behavior.

Labeling behavior:In the case of conditions that are visible and that affect the social identity or acceptability of the person, more complex processes of decision making are involved. In such instances, both the pressures from others and the will to accede to such pressures are much greater. This process of influence and response is called labelling behavior.

BEHAVIOR OF CHILD IN THE DENTAL OFFICE

Pedodontic treatment triangle

THEORIES OF CHILD PSYCHOLOGY

Child psychology theories can be broadly classified into:

1. Psychodynamic theories • Psychosexual theory/ psychoanalytical theory by

Sigmund Freud (1905)• Psychosocial theory /model of personality

development by Erik Erikson (1963)• Cognitive theory by Jean Piaget (1952)

2. Theories of learning and development of behavior• Hierarchy of needs by Maslow (1954)• Social learning theory by Bandura (1963)• Classical conditioning by Pavlov (1927)• Operant conditioning by Skinner (1938)

3. Margaret S Mahler’s theory of development

PSYCHOANALYTICAL THEORY

Given by Sigmund Freud.He proposed a structure called as psychic triad that essentially has three parts that is:-

1. ID2. EGO3. SUPER EGO

ID:-it is the most primitive part of personality. It is the basic structure of personality, which serve as a reservoir of instincts. The ID is the source of all gratification and pleasure, it represent the unconscious, instructive urges that motivate behavior.It can be defined inherited reservoir of unorganized drive. It is governed by the pleasure- pain principle, aims of immediate satisfaction of libidinal urges, is immoral, is illogical and lacks unity of purpose.

EGO:- It is the ego that makes the necessary interaction with the social world possible and permits the needs of the ID to be satisfied. It can be defined as the integrating or mediating part of personality out of interaction of ID and environment.

SUPER EGO:- it is that part of personality that is internalized representation of values and morals of society as taught by the parents and others.

It act as a conscience, it is the internal part of the individual that make the value judgment.

Freud believed that many personality disorders come because a conflict between the EGO and SUPEREGO.

PHYCHOSOCIAL THEORYIt is given by Erikson

He gave 8 stages of emotional development

1. Basic trust vs. mistrust :- the infant forms the first trusting relationship with the caregiver and it occurs uptil one year of age

2. Autonomy vs. shame, doubt:- toddler begins to push for independence. It occurs between 2-3 years of age.

3. Initiative vs. guilt :- the child becomes more assertive, resulting conflict causes guilt. occurs between 4-5 years of age.

4. Industry versus inferiority:- the child learns basic cultural and academic skills, it occurs between 7-11 years of age.

5. Identity vs. role confusion:- the child as a teenager now must realize who he is and what he shall become characterize by development of personal identity. Occurs between 12 to 17 years.

6. Intimacy vs. isolation:- the adult realizes the need for one truly intimate relationship. Occurs in young adults

7. Generativity vs. stagnation:- the adult rears children or performs creative act failing which stagnation occurs. Occurs in adults.

8. Ego integrity vs. despair:- the adult integrates earlier stages and achieve sense of integrity. Occurs in late adults greater than 50 years of age.

COGNITIVE THEORY

Given by Jean Piaget(1962)

He formulated his theory on how children and adolescents think and acquire knowledge.

1. Sensorimotor :- every child is born with certain strategies for interacting with the environment. These strategies mark the beginning of thinking process. The child doesn't yet have the capacity to represent the object or people to himself mentally. As the maturation progresses the simple reflexes begin to be coordinated. Occurs up to 2 years of age.

4. Formal operational stage:- the child now a teenager is able to think still more abstractly. The child uses inductive or deductive logic to make decisions and solve problem.

3. Concrete operational stage:- the thinking process become logical. He develops ability to use complex mental operations. The child is able to understand others point of view.

2. Preoperational stage:- primitive strategies change as the child assimilates new experiences and accommodates original strategies. The child uses symbols in language and play. He solves problem as a result of intuitive thinking but cannot explain why. Occurs between 2-6 years of age

HIERARCHY OF NEEDS MASLOW

CLASSICAL CONDITIONING: PAVLOV

FRANKL et al RATING SCALE (1962)

RATING BEHAVIOUR1.Definitely Negative (--)

2.Negative (-)

3.Positive (+)

4.Definitely Positive (++)

Refuses treatment, cries forcefully,extremely negative behavior associated with fear.

Reluctant to accept treatment and displays evidence of slight negativism.

Accept treatment, but if the child has a bad experience during treatment, may become uncooperative.

Unique behavior, looks forward to and understands the importance of good preventive care.

BEHAVIOR MANAGEMENT

It is defined as the means by which the dental health team effectively and efficiently performs dental treatment and thereby instills a positive dental attitude. (WRIGHT,1975)

Behavior management can be classified as:

1. Non- Pharmacological

2. Pharmacological

NON-PHARMACOLOGICAL METHODS OF BEHAVIOR MANAGEMENT:

1. COMMUNICATION2. BEHAVIOR SHAPING (MODIFICATION)

• DESNSITIZATION• MODELLING• CONTINGENCY MANAGEMENT

3. BEHAVIOR MANAGEMENT• AUDIO ANALGESIA• BIOFEEDBACK• VOICE CONTROL• HYPNOSIS• HUMOR• COPING• RELAXATION• IMPOLSION THERAPY• ADVERSE CONDITIONING

PHARMACOLOGICAL METHODS OF BEHAVIOR MANAGEMENT

1. PREMEDICATION• SEDATIVES AND HYPNOTICS• ANTIANXIETY DRUGS• ANTIHISTAMINES

2. CONSCIOUS SEDATION

3. GENERAL ANESTHESIA

CONCLUSION

Behavioral science plays a major role in understanding the individual, his community and his environment. The desire to understand behavior and help maintain people at an almost perfect state of oral health rather than wait to treat them after they have developed oral or dental disease has been at the forefront of promoting a healthy lifestyle and modifying habits so as to reach optimal oral health status.

REFERENCES

•SOBEN PETER’S TEXTBOOK OF ‘‘ESSENTIALS OF PREVENTIVE & COMMUNITY DENTISTRY” 4TH

EDITION

•S.S. HIREMATH’S “TEXTBOOK OF PREVENTIVE & COMMUNITY DENTISTRY” 2ND EDITION

•SHOBHA TANDON’S “TEXTBOOK OF PEDODONTICS” 2ND EDITION