Behavioral Modification of an Uncooperative Preschool Child with Sickle Beta Thalassemia Disease in a Dental Clinic: A Case Report

Treating medically compromised pediatric patients with dental anxiety can be challenging, especially when general anesthesia and sedation are not an option. This paper reported a case of an uncooperative preschool child who was medically compromised and presented in the dental clinic with Severe-Early-Childhood-Caries (S-ECC). The dental behavior management of such a case was not previously discussed in the literature.

This paper explains the dental management and behavior modification carried out for a 5-year-old male child who was diagnosed with sickle beta thalassemia disease (Sβ-thalassemia), S-ECC, had a negative dental behavior, and was successfully and efficiently treated under a dental setting. The patient presented with his mother, who was concerned about her child’s decayed teeth and sought dental treatment as soon as possible to avoid any risk of infection. Dental examination revealed multiple dental caries and high caries risk. The patient’s behavior can be classified as definitely negative with high level of anxiety. The mother showed permissive parenting and the father exerted an authoritative parenting style. Dental management focused mainly on child behavioral modification via utilizing the difference between the parenting styles. Middle way of treatment, the child showed behavioral improvement, which was progressing toward the end of the treatment. Teeth were successfully restored with composite and metal crowns.

With several behavior management techniques and understanding the parenting styles, the patient's behavior improved, and the treatment plan was successfully used on a dental chair without the need for more advanced management under general anesthesia.