Psychological management of child in dentistry using Eric Erikson theory

PSYCHOSOCIAL THEORY Eric H. Erikson

Basic trust vs mistrust-birth to 18 m(Erik Erikson)

• Successful development of trust depends on a caring and consistent mother or mother substitute, who meets both the physiologic and emotional needs of the infant.

Clinical importance-• “Separation anxiety”• In children with lack of trust : uncooperative, frightened

Unstable mothering- lack of sense of trust

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• The child starts analysing the surrounding and any untoward treatment against the comforts which is perceived with long term impact on child developing mistrust.

• So clinical application is to bring the dental home into reality and bring the child in 1st year itself where a chid perceives and enhances its sensory motor development.

• As a child’s brain is absorbing all information around him and storing it.Its importance is to portray dentistry as a safe place and help him develop trust.

Autonomy v/s shame and doubt- Toddler (18 months to 3 yrs)

• By 2yrs the child is enjoying his motor skills and later pride in autonomous task and likes to do thing on his own.

• So the child brought to clinic along with mother and allows performing small tasks like switching on the lights and encouraging by appreciating the child for the good job which he did.

Preschooler -Initiative vs Guilt (3-5 yrs)

The child uses its own initiative in planning or carrying out plans or if they cannot live within parents’ limitations, they develop a sense of guilt over misbehaviour

• Child should be encouraged in tasks like maintaining his oral hygiene and brushing techniques are taught and later should be reinforced with reinforces to encourage the initiatives he made in the future.

Industry means, a willingness to remain busy with something and to finish a job. As children do things well, they develop a sense of industry, but if their work is insufficient to accomplish their goals, they acquire a sense of inferiority.

Industry vs. Inferiority

• Chair side procedure can carried out by child and made occupied in an industrious task to divert him from dental procedure.

• Example – filling the cup with water here way syringe helps in externalization of the child’s attention during drilling of cavity.

Identity vs. Role Confusion (11-18 yrs) Adolescence

• Adolescence, a period of intense physical development, is also the stage in which a unique personal identity is acquired.

• Members of the peer group become important role models, and the values and tastes of parents and other authority figures are likely to be rejected.

• Sense of identity develops.• Child has matured personality.• He can satisfy his genital potency and realizes his

goals for reproduction and survival.• Matures the personality of the individual

• The adolescent is trying to create his own identity in the society, so helping his esthetics to be socially acceptable by correcting malocclusion or composite restorations for correction of mid line diastema which will help him

With The Philosophy Of Treating The Patient Not The Tooth