Law Clarice S, Blain Stephen
University of California School of Dentistry, Los Angeles 90095-1668, USA.
J Calif Dent Assoc. 2003 Sep;31(9):703-13.
One of the difficulties of the practice of dentistry is being responsible for the highest quality of care for patients while often having to propose alternate solutions for a variety of reasons, which include financial concerns. Dental practitioners treating young children have the added responsibility of gaining their patient's cooperation to render the best treatment. Determinants that influence the development of a behavioral strategy for a young patient include disease status, the child's physical and mental development, parental characteristics, and provider personality and capabilities. Classic strategies--including a supportive office environment, "tell-show-do," successive approximation, distraction, behavior shaping, and retraining--must be matched to the characteristics of each child and family situation. Current cultural trends suggest that disciplinary forms of behavior management strategies--such as hand-over-mouth, physical restraint, and even voice control--are losing societal acceptance.
牙科实践的困难之一在于，要为患者提供最高质量的护理，同时又常常因包括经济问题在内的各种原因而不得不提出替代解决方案。治疗幼儿的牙科从业者还肩负着额外的责任，即要获得患者的配合以提供最佳治疗。影响为年轻患者制定行为策略的因素包括疾病状况、儿童的身心发育、父母的特点以及医护人员的个性和能力。经典策略——包括支持性的诊所环境、“讲解-示范-操作”、逐步接近、分散注意力、行为塑造和再训练——必须与每个孩子的特点以及家庭情况相匹配。当前的文化趋势表明，诸如捂嘴、身体约束甚至声音控制等行为管理策略的惩罚形式正逐渐失去社会的认可。
