Pretreatment Modeling: A Technique for Reducing Children’s Fear in the Dental Operatory

Joanne Lewis
Date: 9-12-08

Article title: Pretreatment Modeling: A Technique for Reducing Children’s Fear in the Dental Operatory
Author(s): Paul E. Greenbaum, Ph.D.; Barbara G. Melamed, Ph.D.
Journal: Dental Clinics of North America
Volume (number): 32
Month, Year: October 1988
Major topics: The use of modeling as a pretreatment preparation to reduce children’s fear and misbehavior during dental treatment.
Minor topics: N/A
Type of Article: Review of research
Main Purpose: Present and summarize the research regarding modeling as a behavior guidance technique; includes advice on implementation of modeling in a dental practice.
Overview of method of research: Review of research
Findings: This article seeks to answer several questions:
How well does modeling work?
Children who were exposed to modeling (watched an older sibling receive dental treatment) had more positive behavior during treatment, for both a cleaning and exam and for a restorative appointment. Yes, modeling can reduce patient fear associated with treatment.
Does the child’s age or gender affect the effectiveness of modeling?
According to the research, modeling has been shown to reduce fear behavior among male and female children and across a wide age range – 3 to 13 years of age.
Does the child’s fear level affect the effectiveness of modeling?
The research shows that modeling reduces patient fear in both high and mild to moderate fear level children.
Is modeling more effective on children with previous dental experience or on children with no previous dental experience?
Modeling preparation by itself is more effective on children with no previous dental experience. However, modeling in combination with other techniques (coping instructions, imagery, etc.) may be effective in children with previous dental experience.
What behavior should be modeled?
2 components – 1.) the child must vicariously receive rewards, either the model receives reinforcement or the model does not receive any adverse consequences and 2.) the child must be presented with information about the upcoming dental treatment and how to handle it.
Should the model be highly similar to the patient, or of high prestige?
Both similar and high status models can be effective.
Is a symbolic model as effective as a live model? – YES!
Should mothers (parents) be allowed in the operatory during dental treatment?
Mothers often act as a natural model for their children’s behavior. The parent is an important model in children’s ability to cope with stress.
Key points/Summary :
Modeling is an effective behavior management technique to reduce fears and decrease disruption, especially in patients with no prior dental exposure. Many practitioners do not currently use modeling; in the past, it was a difficult technique to implement. Now with videos and DVD’s, modeling could gain more widespread use, especially if a set of standardized modeling tapes was developed.
Assessment of article:
A good reminder of a behavior guidance technique that is familiar and intuitive – really, just an expansion on tell-show-do. Makes a good case to increase the use of modeling in the pediatric dental office.