Behavior guidance is a methodology utilized to create a comfortable and effective working environment for both the doctor and the patient. This includes the various means by which a dentist can appropriately achieve treatment goals as well as assist the patient to have a positive experience while in the dental chair. Another way of describing “behavior guidance” is cognitive and environmental molding to achieve age (and medical condition) appropriate responses to the dental experience. Our ultimate goal is to achieve individual treatment goals with minimal amount of struggle. The goal for behavior guidance is to adequately master the ability to read and assess a patient before they sit in the dental chair, to determine how the parent may influence the performance of their child, and to make sure to maintain an open line of communication with the patient and the parent with a patient centered and family centered approach to the child’s care.
Well of course, a little bit of magic! But also, paying very close attention to the child experience. Often, dentistry can be a stress inducing experience when we are dealing with more complicated treatment. We can help an emotional child identify what they are experiencing during a difficult appointment rather than try to fix it. Brene Brown in one of her many hugely popular parenting podcasts, “The Gifts of Imperfect Parenting” guides parents to manage their children through difficult experiences with compassion and empathy. Dentists, like parents, are encouraged to verbally label what a child may be experiencing in a difficult moment whether emotionally, physically, or mentally. By providing empathy children feel understood, supported, and are able to learn the value of this skill for their own use, rather than using shame or psychological control to achieve the behaviors we want. Rather than try to “fix it”, we as dentists in these challenging moments can help bridge the gap between the child’s emotional brain and logical brain while encouraging parents to model vulnerability with their children by sharing personal struggles that may mirror their experience.
Further, child attachment theory almost justifies parental involvement in a child’s difficult experiences, suggesting that that sensitive and responsive parenting provides the foundation for the child’s sense of knowing that he or she will be responded to when necessary – this again is a powerful to develop a means to guide a patient through a difficult dental procedure. This is a big reason why we don’t just suggest, but truly encourage parental presence in the dental operatory for dental procedures.