Treatment of Non-cooperating Patients

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At children’s dentistry we may encounter patients who do not cooperate well. There may be lots of reasons for this non-cooperative behavior, the most frequent one being a pathologically exaggerated fear. Some of children who have normal intellect can be treated with use of proper medication and well planned psychological approach. High doses of Oxazepam have been used successfully at our clinic. If a painful treatment has to be performed, a child prepared by medication should be treated under a local anesthesia. Oxazepam has an advantage of a good antianxiety effect and low sedative effect. If this approach does not allow for a child’s treatment, general anesthesia should be chosen in collaboration with specialists - anesthesiologists. Treatment under general anesthesia is also indicated in cases of illnesses accompanied with twitches or uncoordinated movements, or in case of low intellect of a child. This kind of treatment should be more radical: not only all carious teeth should be repaired, but extractions and other surgical interventions should be performed as well. If prosthetic treatment is to be used, prepared teeth should be abutted and impressions should be taken. Keep in mind that treatment under general anesthesia is not a common method of therapy. We should select it only after all other attempts failed.