Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Mar;18(3):348-358.
doi: 10.5005/jp-journals-10005-3099. Epub 2025 Apr 19.

Behavior Puzzle: Nonpharmacological Behavior Management

Affiliations
Review

Behavior Puzzle: Nonpharmacological Behavior Management

Sharath Asokan et al. Int J Clin Pediatr Dent. 2025 Mar.

Abstract

A child's dental visit may often be associated with dental fear and anxiety (DFA). Children with DFA may exhibit dental behavior management problems (DBMPs), which mostly manifest as disruptive behavior. Children displaying disruptive behavior are often more challenging to treat, require more chairside time, and can result in a stressful appointment for the child, parent, and even the dentist. Factors that are specific triggers for DFA need to be identified, and their behavior assessed. This would help the dentist modify the child's behavior using appropriate behavior management techniques (BMTs) to facilitate the delivery of quality dental care. This article is not meant to be dogmatic or serve as a rulebook or a legal document. It sheds light on some practical methods of assessment of child behavior and communication, the key concepts in behavior guidance. The authors have also attempted to compile the nonpharmacological BMTs used in current clinical practice with evidence from the Indian scenario. They have also shared some of their personal experiences gained in the process of guiding children's behavior in the dental setting over the past two to three decades.

How to cite this article: Asokan S, Rodrigues SJL, Nuvvula S, et al. Behavior Puzzle: Nonpharmacological Behavior Management. Int J Clin Pediatr Dent 2025;18(3):348-358.

Keywords: Behavior guidance; Behavior management; Nonpharmacological behavior management techniques.

PubMed Disclaimer

Conflict of interest statement

Source of support: Nil Conflict of interest: Dr Nikhil Marwah is associated as Editor-in- Chief of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of the Editor-in-Chief and his research group.Conflict of interest: Dr Nikhil Marwah is associated as Editor-in- Chief of this journal and this manuscript was subjected to this journal's standard review procedures, with this peer review handled independently of the Editor-in-Chief and his research group.

References

    1. Milgrom P, Weinstein P, Heaton LJ. Treating Fearful Dental Patients: A Patient Management Handbook. 3rd ed. Seattle, WA: Dental Behavioral Resources; 2009.
    1. Armfield JM, Slade GD, Spencer AJ. Cognitive vulnerability and dental fear. BMC Oral Health. 2008;8:2. doi: 10.1186/1472-6831-8-2. - DOI - PMC - PubMed
    1. Armfield JM. The extent and nature of dental fear and phobia in Australia. Aust Dent J. 2010;55:368–377. doi: 10.1111/j.1834-7819.2010.01256.x. - DOI - PubMed
    1. Van Wijk AJ, Makkes PC. Highly anxious dental patients report more pain during dental injections. Br Dent J. 2008;205:E7. doi: 10.1038/sj.bdj.2008.583. - DOI - PubMed
    1. Van Wijk AJ, Hoogstraten J. Anxiety and pain during dental injections. J Dent. 2009;37:700–704. doi: 10.1016/j.jdent.2009.05.023. - DOI - PubMed

LinkOut - more resources