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

Hussain Alhasan1, Ahmad Samara2, Nada Bamashmous3, Heba Jafar Sabbagh3, *
1 Pediatric Dentistry Resident, Saudi Ministry of Health, King Faisal General Hospital, Hofuf, Saudi Arabia
2 Ministry of Health, The Specialty Dental Center, Taif, Saudi Arabia
3 Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 335
Abstract HTML Views: 125
PDF Downloads: 124
ePub Downloads: 49
Total Views/Downloads: 633
Unique Statistics:

Full-Text HTML Views: 236
Abstract HTML Views: 91
PDF Downloads: 114
ePub Downloads: 40
Total Views/Downloads: 481

Creative Commons License
© 2022 Alhasan et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Pediatric Dentistry Department, King Abdulaziz University, P.O. Box 80209 Jeddah 21589. Saudi Arabia; Tel: +0966505668481, E-mail address:



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.

Case Presentation:

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.

Keywords: Beta-thalassemia, Behavior modification, Dental anxiety, Dental management, General anesthesia, Hemoglobin.