Child psychology

CONTENTS
• INTRODUCTION
• CLASSIFICATION OF PSHYCOLOGICAL DEVELOPMENT THEORIES
• THE PSHYCOSEXUAL THEORY
• PSYCHOSOCIAL THEORY
• COGNITIVE THEORY
• SOCIAL LEARNING THEORY
• CLASSICAL CONDITIONING THEORY
• PSYCOLOGICAL MANAGMENT OF ORTHODONTIC PATIENTS
• CONCLUSION
• REFERENCES

INTRODUCTION
• Dentistry for children can be demanding, tumultuous, and frustrating; at
the same time, it can be enriching, satisfying, and memorable.
• Dentistry for children who display disruptive behaviors places unique
demands on a dentist, requiring him or her to incorporate additional skills
and knowledge.

“The child is father of the man”, and “As the twig is bent so
grows the tree”

DEFINITIONS
PSYCHOLOGY:
• Study of human mind and its functions. It can be defined as ‘Science dealing with
human nature, function and phenomenon of his soul in the main’.
CHILD PSYCHOLOGY:
• Science that deals with the mental power or an interaction between the conscious
and subconscious element in a child.
EMOTION:
• Instinctive feeling as contrasted with reasoning - A feeling or mood manifesting into
motor and glandular activity.
BEHAVIOR:
• Is any change observed in the functioning of the organism

IMPORTANCE OF STUDYING CHILD PSYCHOLOGY
• provides a rich background of information about children’s behaviour and
psychological growth under a variety of environmental conditions.
• Provides understanding of basic psychological processes like learning, motivation,
maturation, and socialization.
• Stage wise understanding of a child helps to understand the characteristics of the
adult.
• To teach and motivate them about
importance of primary and preventive care
and the importance of oral health.
McDonald. Dentistry for the child and adolescent :eighth edition

IMPORTANCE OF KNOWING CHILD PSYCHOLOGY IN
DENTISTRY
• To understand the child as he comes to dental office
& know his problem in the way he explains.
• To establish effective communication with child and
parents, the basic skill is required.
• Child and most importantly parents should develop
confidence on our treatment and dentistry.
• To teach and motivate them about importance of
primary and preventive care and the importance of
oral health.
• The child and parent should be comfortable and
treatment satisfactory to child, parent and the
dentist.
• To plan out effective treatment

Psychologists have found it convenient to identify the
following chronological age groupings
GERMINAL : First two weeks after conception.
EMBRYO : Two to six weeks after conception
FETUS :Six weeks after conception until birth
NEONATE : First two weeks after birth
INFANT : First two years of life
PRESCHOOL CHILD : Two to six years of age.
PRIMARY-SCHOOL CHILD : Six to nine years of age.
INTERMEDIATE –SCHOOL CHILD : Nine to twelve years of age.
JUNIOR HIGH SCHOOL CHILD : Twelve to fifteen years of age (the onset of
adolescence occurs during this period).

Shakespeare found it poetically convenient to divide man’s life
span into the following seven periods :
1. The infant
2. The school boy
3. Adolescent lover
4. The soldier or mature man,
5. The justice or middle aged man,
6. Old age and decline. Shakespeare’s monologue:
7. finally senility and second childhood.

Classification of psychological developmental
theories
PSYCHODYNAMIC THEORIES:
• PSYCHOSEXUAL THEORY –SIGMUND FREUD
• PSYCHOSOCIAL THEORY-ERIC ERICKSON
• COGNITIVE THEORY- JEAN PIAGET
BEHAVIORAL LEARNING THEORIES:
• Social Learning Theory-Albert Bandura
• Classical Conditioning Theory-Ivan Pavlov
• Operant Conditioning Theory-Skinner

OTHER THEORIES
• SEPARATION AND INDIVIDUALIZATION – MARGARET MAHLER.
• ATTACHMENT THEORY – JOHN BOWLBY.
• THEORY OF MORAL DEVELOPMENT – KOHLBERG L.
• CHILDRENESE – HAIM GINOTT.

PSYCHOSEXUAL THEORY-DR. SIGMUND
FREUD(1905)

• According to Freud, personality is mostly established by the age of five.
• Early experiences play a large role in personality development and
continue to influence behavior later in life.
• Freud believed that personality develops through a series of childhood
stages during which the pleasure seeking energies of the id become
focused on certain erogenous areas.
• These psychosexual energies, or libido, were described as the driving
force behind behavior.

THE STRUCTURAL MODEL OF
PERSONALITY
• According to Freud’s psychoanalytic theory of
personality, personality is composed of three
elements.
• These three elements of personality are known as
the
• ID
• EGO
• SUPEREGO
• which work together to create complex human
behaviors.

The Id
• The id is the only component of personality that is present from birth
• This aspect of personality is entirely unconscious and includes of the
instinctive and primitive behaviors.
• Id is the source of all psychic energy, making it the primary component of
personality.
• The id is driven by the pleasure principle, which strives for immediate
gratification of all desires, and needs.
• If these needs are not satisfied immediately, the result is a state anxiety
or tension.

EGO:
• The ego derives from the id and tends to maximize instinctual gratification while
minimizing punishment and guile.
• Famous quote: "Where the id ("it") was, there shall become ego ("I").
• SUPEREGO:
• It is differentiated from the ego, and is partially unconscious.
• Freud viewed the superego as the heir to the Oedipus complex:
Children internalize parental values and standards around the age of 5
or 6 years

STAGES OF PSYCHOSEXUAL
DEVELOPMENT
• The Oral Stage (0 to 1 yr )
• The infant’s primary source of interaction
occurs through the mouth, so the rooting and
sucking reflex is especially important.
• The mouth is vital for eating, and the infant
derives pleasure from oral stimulation through
gratifying activities such as tasting and sucking.

• Because the infant is entirely dependent
upon caretakers, the infant also develops a
sense of trust and comfort through this oral
stimulation.
• The primary conflict at this stage is the
weaning process the child must become less
dependent upon caretakers.

 The Anal Stage (2 to 3 yr)
• The primary focus of the libido is on controlling
bladder and bowel movements.
• The major conflict at this stage is toilet training,
the child has to learn to control his or her
bodily needs.
• Developing this control leads to a sense of
accomplishment and independence.
• Success at this stage is dependent upon the
parents approach to toilet training.

• If parents take an approach that is too lenient, an anal-
expulsive personality can develop in which the individual
has a messy, wasteful, or destructive personality.
• If parents are too strict or begin toilet training too early, an
anal retentive personality develops in which the individual
is stringent, orderly, rigid, and obsessive.

The Phallic Stage (3 to 7 yr)
• The primary focus of the libido is on the genitals.
• Children discover the differences between males
and females.
• Boys begin to view their fathers as a rival for the
mother’s affections.
• The Oedipus complex describes these feelings of
wanting to possess the mother and the desire to
replace the father.

• However, the child also fears that he will be punished
by the father for these feelings, a fear Freud termed
CASTRATION ANXIETY.
• The term Electra complex has been used to described a
similar set of feelings experienced by young girls.

The Latency stage (8 to 11 yr)
• During the latent period, the libido interests are
suppressed.
• The development of the ego and superego contribute
to this period of calm.
• The stage begins around the time that children enter
into school and become more concerned with peer
relationships, hobbies, and other interests.
• The latent period is a time of exploration in which the
sexual energy is still present, but it is directed into
other areas such as intellectual pursuits and social
interactions.
• This stage is important in the development of social
and communication skills and self-confidence.

The Genital Stage (12 yrs to adult)
• During the final stage of psychosexual
development, the individual develops a strong
sexual interest in the opposite sex.
• Where in earlier stages the focus was solely on
individual needs and, interest in the welfare of
others grow during this stage.
• If the other stages have been completed
successfully, the individual should now be well
balanced, warm, and caring.
• The goal of this stage is to establish a balance
between the various life areas.

Psychosocial Theory-Eric Erickson(1963)
• Erikson is a Freudian ego-psychologist.
• He accepts Freud's ideas as basically
correct, including the more debatable ideas
such as the Oedipal complex, and the ideas
about the ego.
• However, Erikson is much more society and
culture-oriented than Freud

THE EPIGENETIC PRINCIPLE
• This principle says that we develop through a predetermined unfolding of our
personalities in eight stages.
• Our progress through each stage is in part determined by our success, or lack
of success, in all the previous stages.
• Each stage involves certain developmental tasks.
• The various tasks are referred to by two terms .
• Each stage has a certain optimal time as well.

1. Trust vs Mistrust
2. Autonomy vs. Shame and
Doubt
The child is developing physically and becoming more mobile
The aim has to be “self control without a loss of self-esteem” (Gross, 1992.)
Success in this stage will lead to the virtue of will.
Erickson, E. (1958).Young man Luther:A study in psychoanalysis and history. NewYork: Norton

Erickson, E. (1958).Young man Luther:A study in psychoanalysis and history. NewYork: Norton

Occurring in young adulthood (ages 18 to 40 yrs).we begin to share
ourselves more intimately with others. Success in this stage will lead to the
virtue of love.
6.Intimacy vs.
Isolation
Bee, H. L. (1992).The developing child. London: HarperCollins

Involved in community activities and organization.this stage will
lead to the virtue of care
7.GENERATIVEVS
STAGNATION
8.Integrity vs.
Despair
Bee, H. L. (1992).The developing child. London: HarperCollins

Cognitive Theory-Jean Piaget (1952)
• Piaget believed that every individual is born with the
capacity to adjust and adapt to both physical and
socio-cultaral environment in which he or she live in.
• He described two processes used by the individual in
its attempt to adapt: assimilation and accomodation.
• Assimilation is the process of incorporation of events
within environment into mental categories called
cognitive structures or schemas.
• Accomodation is the process of changing cognitive
structures to better represent the environment.

• Both processes are used simultaneously and
alternately throughout life.
• As schemes become increasingly more
complex (i.e., responsible for more complex
behaviors) they are termed structures.
• As one's structures become more complex,
they are organized in a hierarchical manner
(i.e., from general to specific).
ProffitW R: ContemporaryOrthodontics. Mosby 2013.5th Edition

• Assimilation and accommodation work like a pendulum, swings at advancing our
understanding of the world and our competency in it.
• They both are directed to attain a balance between the structure of the mind and
the environment, and that ideal state is called as equilibrium.
• As Piaget continued his investigation of children, he noted that there were periods
where assimilation dominated, periods where accommodation dominated, and
periods of relative equilibrium, and that these periods were similar among all the
children he looked at in their nature and their timing.
• And so he developed the idea of stages of cognitive development.
Proffit W R: Contemporary Orthodontics. Mosby 2013.5th Edition

The sensorimotor stage ( from birth to two years)
• As the name implies, the infant uses senses and
motor abilities to understand the world, beginning with
reflexes and ending with complex combinations of
sensorimotor skills
• Between one and four months, the child works on
primary circular reactions -- just an action of his own
which serves as a stimulus to which it responds with
the same action, and around and around.
• Between four and 12 months, the infant turns to
secondary circular reactions, which involve an act that
extends out to the environment: She may squeeze a
rubber duckie. It goes quack.
• That is great, so do it again, and again. She is
learning procedures that make interesting things last.

• Between 12 months and 24 months, the child
works on tertiary circular reactions.
• They consist of the same making interesting
things last cycle, except with constant variation.
• Around one and a half, the child is clearly
developing mental representation, that is, the
ability to hold an image in their mind for a period
beyond the immediate experience

Preoperational stage (two to about seven years).
• Children begin to think symbolically and learn to
use words and pictures to represent objects.
• They also tend to be very egocentric, and see
things only from their point of view.
• Children at this stage tend to be egocentric and
struggle to see things from the perspective of
others.
• Piaget did a study to investigate this
phenomenon called the mountains study.
• He would put children in front of a simple plaster mountain range and seat
himself to the side, then ask them to pick from four pictures the view that he,
Piaget, would see. Younger children would pick the picture of the view they
themselves saw; older kids picked correctly.

• He is much more likely to understand: "Brushing
makes your teeth feel clean and smooth” and,
"Toothpaste makes your mouth taste good”
because these statements rely on things the child
can taste or feel immediately.
• Another characteristic of thought process in this
stage is Animism-investing inanimate objects with
life.
• For example while talking to a 4-year-old about
how desirable it would be to stop thumb sucking .

• The orthodontist might have only little problem in
getting the child to accept the idea that "Mr.
Thumb" was the problem and that the dentist and
the child should form a partnership to control Mr.
Thumb who wishes to get into the child's mouth.
• Animism, in other words, can be applied even to
parts of the child's own body, which seem to take
on a life of their own in this view.

Concrete operations stage ( 7 to11 yrs).
• The word operations refers to logical principles we
use when solving problems.
• In this stage, the child not only uses symbols
representationally, but can manipulate those
symbols logically.
• But, at this point, they still perform these operations
within the context of concrete situations.
• The stage begins with progressive decentering.
• By six or seven, most children develop the ability
to conserve number, length, and liquid volume.

• Conservation refers to the idea that a quantity remains the same despite changes in
appearance.
• And he will know that you have to look at more than just the height of the milk in the
glass: If we pour the milk from the short, fat glass into the tall, skinny glass, he will
tell us that there is the same amount of milk as before, despite the dramatic increase
in milk-level! .

• If we take a ball of clay and roll it into a long thin rod, or even split it into
ten little pieces, the child knows that there is still the same amount of
clay.
• And he will know that, if we rolled it all back into a single ball, it would
look quite the same as it did -- a feature known as reversibility.
• By nine or ten, the last of the conservation tests is mastered-
conservation of area.

• In addition, a child learns classification and
seriation during this stage. Now the child begins to
get the idea that one set can include another.
• Seriation is putting things in order. The younger
child may start putting things in order by, say size,
but will quickly lose track.
• Now the child has no problem with such a
task. Since arithmetic is essentially nothing more
than classification and seriation, the child is now
ready for some formal education!

Formal operations stage (12 yrs to adult)
• Around 12 yrs of age, child enter the formal
operations stage.
• Here he become increasingly competent at
adult-style thinking.
• This involves using logical operations, and
using them in the abstract, rather than the
concrete. We call this as hypothetical
thinking.
• Child is capable of understanding concepts
like health ,disease ,preventive treatment etc.
At this child should be treated like an adult.

CRITICISMS OF PSYCHODYNAMIC APPROACHES
• Freud’s theories overemphasized the
unconscious mind, aggression, and childhood
experiences.
• Many of the concepts proposed by
psychodynamic theorists are difficult to
measure and quantify.

• STRENGTHS OF PSYCHODYNAMIC
APPROACHES
• While most psychodynamic theories did not
rely on experimental research, the methods
and theories of psychodynamic thinking
contributed to experimental psychology.
• Many of the theories of personality
developed by psychodynamic thinkers are
still influential today, including Erikson’s
theory of psychosocial stages and Freud’s
psychosexual stage theory.

SOCIAL LEARNING THEORY-ALBERT BANDURA
(1963)
• He suggested that environment causes behavior,
but behavior causes environment also.
• He called this concept as reciprocal
determinism.
• The world and a persons behavior cause each
other.
• Development of personality takes place as an
interaction among three things: the environment,
behavior, and the persons psychological
processes.
• These psychological processes consist of our
ability to entertain images in our minds, and
language.

• According to Bandura the steps involved in the
modeling are:
• 1. ATTENTION:
• If we are going to learn anything, we have to be
pay attention. Likewise, anything that puts a
damper on our attention is going to decrease
learning, including observational learning.
• Main thing that influence attention involves
characteristics of the model. If the model is
colorful and dramatic, we pay more attention.
• If the model is attractive, or prestigious, or
appears to be particularly competent, we will pay
more attention. And if the model seems more like
our self, we will pay more attention.

2. RETENTION:
• we must be able to retain what we have paid
attention to.
• This is where imagination and language come in.
• We store what we have seen the model doing in the
form of mental images or verbal descriptions.
• When so stored, we can later bring up the image or
description, so that we can reproduce it with our own
behavior.
3.REPRODUCTION:
• We have to translate the images or descriptions into
actual behavior.
• So we have to have the ability to reproduce the
behavior in the first place.
ProffitW R: ContemporaryOrthodontics. Mosby 2013.5th Edition

4. MOTIVATION.
• And yet, with all this, we are still not going
to do anything unless we are not motivated
to imitate, i.e. until we have some reason
for doing it. Bandura mentioned following
motives:
a. past reinforcement.
b. promised reinforcements - incentives.
• Of course, the negative motivations are
there as well, giving us reasons not to
imitate someone:
a. past punishment.
b. promised punishment (threats).

• Research has demonstrated that one
of the best predictors of how anxious a
child will be during dental treatment is
how anxious the mother is.
• A mother who is calm and relaxed
about the prospect of dental treatment
teaches the child by observation that
this is the appropriate approach of
being treated, whereas an anxious
and alarmed mother tends to elicit the
same set of responses in her child.

CLASSICAL CONDITIONING THEORY-IVAN PAVLOV
(1927)
• Described by the Russian physiologist Ivan Pavlov.
• Who discovered during his studies of reflexes that
apparently unassociated stimuli could produce reflexive
behavior.
• Pavlov's classic experiments involved the presentation of
food to a hungry animal, along with ringing of a bell.
• The sight and sound of food normally elicit salivation by a
reflex mechanism.
• If a bell is rung each time food is presented, the auditory
stimulus of the ringing bell will become associated with the
food presentation stimulus, and in a relatively short time,
the ringing of a bell by itself will elicit salivation.
• Classical conditioning, operates by the simple process of
association of one stimulus with another, and some times
also referred as learning by association.

• Classical conditioning can have a considerable impact
on a young child's behavior on the first visit to a dental
office.
• By the time a child is brought for the first visit to a
dentist, it is highly likely that he or she will have had
many experiences with pediatricians and medical
personnel.
• When a child experiences pain, the reflex reaction is
crying and withdrawal

• In Pavlovian terms, the infliction of pain is
an unconditioned stimulus, but a number of
aspects of the setting in which the pain
occurs can come to be associated with this
unconditioned stimulus.
• If the unconditioned stimulus of painful
treatment comes to be associated with the
conditioned stimulus of white coats, a child
may cry and withdraw immediately at the
first sight of a white coated dentist or
dental assistant.
• In this case, the child has learned to
associate the unconditioned stimulus of
pain and the conditioned stimulus of a
white coated adult, and the mere sight of
the white coat is enough to produce the
reflex behavior initially associated with
pain.

Operant Conditioning Theory-Skinner (1938)
• The basic principle of operant conditioning is
that the consequence of a behavior is in itself a
stimulus that can affect future behavior.
• In classical conditioning, a stimulus leads to a
response; in operant conditioning, a response
becomes a further stimuli.
• The general rule is that if the consequence of a
certain response is pleasant, that response is
more like to be used again in the future; but if a
particular respond produces an unpleasant
consequence, the probability that response
being used in the future is diminished.

• Skinner described four basic types of operant
conditioning distinguished by the nature of the
consequence .
A) POSITIVE REINFORCEMENT:
 If pleasant consequence follows a response, the
response has been positively reinforced, and the
behavior that led to the pleasant consequence
becomes more likely in the future .
B) NEGATIVE REINFORCEMENT:
 involves the withdrawal of an unpleasant
stimulus after a response. Like positive
reinforcement, negative reinforcement also
increases the likelihood of a response in the
future. The word negative merely refers to the
fact that the response that is reinforced is a
response that leads to the removal of an
undesirable stimulus.

C) OMISSION :
 Involves removal of a pleasant stimulus after a
particular response.
For example, if a child who throws a temper tantrum,
has his favorite toy taken away for a short time as a
consequence of this behavior, the probability of similar
misbehavior is decreased.
D) PUNISHMENT:
 Occurs when an unpleasant stimulus is presented
after a response.
This also decreases the probability of similar kind of
behavior that prompted punishment in the future.
Punishment is effective at all ages, not just with
children.

• In general, positive and negative
reinforcement are the most suitable
types of operant conditioning for use in
the dental office, particularly for
motivating orthodontic patients.
• Both types of reinforcement increase
the likelihood of a particular behavior
recurring, rather than attempting to
suppress a behavior as punishment and
omission do. Simply praising a child for
desirable behavior produces positive
reinforcement, and additional positive
reinforcement can be achieved by
presenting some tangible reward.

Psychological timing of orthodontic
treatment-by-Jay Weiss:AJO-1977
• A questionnaire type of study was undertaken to test the hypothesis that
prepubescent patients are more cooperative than adolescents.
• Older children were found to be psychologically resistant to the demands of
orthodontic treatment because of their involvement in Oedipal conflicts, a
normal but distracting aspect of "growing up.“

• Study found that patients under 12 were more cooperative than other age groups in
the wearing of headgear and other removable devices but they were less
cooperative in keeping appointments or in protecting appliances from breakage.
• The study suggests that, from a psychological standpoint, activator and headgear
treatment should be begun sometime after age 6 and soon enough to be
completed before the onset of puberty.

• Children at this stage still are not likely to be motivated by abstract concepts such
as "If you wear this appliance your bite will be better." They can be motivated,
however, by improved acceptance or status from the peer group.
• This means that emphasizing how the teeth will look better as the child cooperates
is more likely to be a motivating factor than emphasizing a better dental occlusion,
which the peer group is not likely to notice.

• Most orthodontic treatment is carried out during the adolescent years, and
behavioral management of adolescents can be extremely challenging.
• Since parental authority is being rejected, a poor psychological situation is
created by orthodontic treatment if it is being carried out primarily because the
parents want it, not the child.
• At this stage, orthodontic treatment should be instituted only if the patient wants
it, not just to please the parents.

Psychological Management of Orthodontic Patient :
Louis Norton- AO July 1971
YOUNG CHILD (6 TO 9 YRS):
• Easiest to work with.
• Same approach for both boys and girls.
• Natural curiosity of school days makes their attention readily available.
• The best method for obtaining cooperation is to actively teach the child the purpose of
your treatment.
• Careful explain about what you intend to do and a brief why, using language that the
child can understand.
• This may be supplemented with charts, simple stories which the child can read
himself or short single concept films.

• Children of this age are natural imitators.
• They tend to do almost anything they are told to do, particularly if it is with precise
directions.
• This is why most children of this age respond well to tooth brushing charts and
tables which allow them to see how well they are progressing. This, in effect, is a
simplified teaching machine.
• Praise should be given freely as a means of re-enforcement.
• The bribe of a toy for good behavior from the dentist decreases their desire to know
what is happening to them. Bribery should therefore not be used.
Psychological Management of Orthodontic Patient : Louis Norton- AO July 1971

• It is difficult to use removable appliances in children from six to nine.
• In the early mixed dentition when undercut areas for appliance retention are hard
to find.
• They are learning to articulate adult speech patterns.
• They are attempting to break their infantile habits of digital sucking and tongue
thrusting.

Early Adolescent (ten to thirteen yrs)
• BOYS:
• Retains his curiosity about the "why" of treatment during this period, but the
"how" begins to capture his imagination.
• He is fascinated by scientific instruments and mechanical gadgets.
• He is also looking for a hero, to emulate.
• It is not unusual for a personable dentist to fill this hero's role for the child.
• To gain cooperation from a boy of this age group, one must show interest in his
interests.

• One must again be careful to explain each
procedure to the child and why.
• "Show and tell" explanations will lead him to
ask "how do you do that, or how does this
machine work?".
• Let him observe operative procedures
through a hand mirror.
• Allow him to hold some materials such as
periphery wax, alginate or blunt hand
instruments.
• If he seemed quite excited by this, the
reward of a trip to the laboratory will turn the
young patient into a fast friend.

 FEMALE :
• Quite different from the boy but an equal challenge.
• She is passionately interested in her developing body.
• Any dental procedure that might affect her looks is either accepted with exuberance
or dread.
• She is very susceptible to flattery which can lead to the ''crush syndrome" which
can be a management problem.
• Efforts to establish rapport through conversation can end up as a talked away
appointment.

• Friendliness may be demonstrated by a smile and a
compliment on behavior or an achievement.
• References to her body, may invite problems. For
example if you say she has gotten quite tall.
• The conversation should be brief, pleasant,
impersonal and thoughtful.

The Teenage (14 to 18 yrs)
MALE:
• Express the adult image which is usually overtly
uncomfortable for him.
• He wishes to be treated as an adult but often
express himself as an irrational child.
• His interests have now narrowed to normal
development of his body, acceptance by his peers.
• He spends hours primping himself in the mirror.
• He is desperately fighting anything that makes him
look different from the group with whom he identifies.
• Management of the teenage male is a matter of
sympathy and understanding.

• One must be direct and forthright. Being devious or overly complex will lead to
suspicion.
• Trust is the most valuable asset to be sought from this age group.
• It is important that treatment plans be discussed with the same logic, responsibility
and firmness, as with an adult patient.
• This allows the boy to assume the adult role which will soon be reality.
• If discipline becomes a problem the dentist has an advantage.
• He is an authority figure outside the family.
• The chances are good that a boy will readily discuss why he is not following your
instructions.

 Female
• She is conscious about her appearance and peers.
• She wants to be as proportional as her peers.
• Orthodontic appliances offer a threat to her immediate
body image or, if she has an unaesthetic malocclusion,
they offer a promise.
• The thrust in management must be toward the
cosmetic and status value.

• Once trust is established, she will usually be cooperative , probably due to her
earlier maturity.
• Discipline should again be handled by discussing the root of the problem and its
various solutions rather than making “parent like” demands for cooperation.
• Latent crush syndromes can occur in this age group, particularly in girl with the
unaesthetic malocclusion.
• The orthodontist is freeing her of her problem. He takes on the proportions of a
hero.

• They are trying to assume the role of an adult and they do not believe their
parents have an understanding of any of their problems.
• Therefore detailed consultations and progress reports should be given to the
parent and child, but separately.
• The patient will take comfort in knowing that his parents are concerned about his
treatment, but the patient will take offense if she feels they are directing it.
• The primary relationship is with the child and not with the parents.

PRACTICAL PSYCHOLOGY TO THE
CLINICAL PRACTICE OF ORTHODONTICS
 DIVIDED INTO TWO BROAD CATEGORIES:
1.SOCIAL PSYCHOLOGY OF ORTHODONTICS.
2.ORTHODONTIC MOTIVATIONAL PSYCHOLOGY.
• A RELATIVELY NEW AREA OF APPLICATION
3. EDUCATIONAL PSYCHOLOGY.
Methods of improving patient compliance • JCO 1996 Sep MELVIN MAYERSON, R.G “WICK” ALEXANDER

SOCIAL PSYCHOLOGY
• Why patient’s seek orthodontic treatment ?
• Adolescents : my mom thinks I need braces, to
look better
• Adults : own initiative; to improve facial
appearance.
• Clearly a person’s dentofacial appearance can
have a significant effect at their overall quality of
life.
Methods of improving patient compliance • JCO 1996 Sep MELVIN MAYERSON, R.G “WICK”ALEXANDER

Methods of improving patient compliance
A.O. 1998 No. 2, T. Mehra, R.S. Nanda, P.K Sinha.
(1) verbally praising the patient,
(2) educating the patient about the consequences of poor compliance,
(3) discussing treatment goals with the patient,
(4) educating the patient about the proper use of elastics,
(5) educating the parent about the consequence of poor compliance,
(6) discussing poor patient cooperation with the patient,
(7) educating the patient about the proper use of headgear,
(8) discussing poor patient cooperation with the parent,
(9) discussing treatment goals with the parent, and
(10) educating the parent about the use of orthodontic appliances.

CONCLUSION
• One golden thread that runs through out the literature of orthodontic psychology is
the importance of the doctor-patient relationship. Once the orthodontist has earned
the trust and respect of the patient by establishing a good rapport , the task of
achieving a good treatment result is made remarkably easier

REFERENCES
• Proffit W R: Contemporary Orthodontics. Mosby 2013.5th Edition
• McDonald. Dentistry for the child and adolescent
• Moyers Robert E.: Hand book of Orthodontics
• Angle Orthod. 1998 Apr;68(2):115-22. Orthodontists' assessment and management of patient
compliance.Mehra , Nanda RS, Sinha PK.
• Methods of improving patient compliance • JCO 1996 Sep MELVIN MAYERSON, R.G “WICK” ALEXANDER
•
• Erickson, E. (1958). Young man Luther: A study in psychoanalysis and history. New York: Norton.
• Gross, R. D., & Humphreys, P. (1992). Psychology: The science of mind and behaviour. London: Hodder &
Stoughton. Freud, S. (1923). The ego and the id. SE, 19: 1-66.
• Piaget's Stages of Cognitive Development Kay C. Wood, Harlan Smith, Daurice Grossniklaus Department of
Educational Psychology and Instructional Technology, University of Georgia

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