SBH+Review
Page 1: Introduction
Title: SBH Review
Presented by: Erinne Kennedy
Institution: College of Dental Medicine, SAS City University, Kansas
Establishment Year: 1916
Page 2: Exam Topics Overview
Core Topics Covered:
Attitudes, Beliefs, Spirituality
Social Determinants of Health
Cultural Humility, Diversity
Motivational Interviewing
Communication Types
Health Behavior Models
Health Equity
Health Literacy
Mental Health Disorders (MDD, GAD, PD, SP)
Suicide Assessment Best Practices
Additional Mental Health Conditions (OCD, PTSD, BP I and II, Schizophrenia)
Page 3: Mood Disorders (DSM-5-TR)
Major Depressive Disorder:
Defined by five or more depressive symptoms, including sad mood or loss of pleasure for at least 2 weeks.
Persistent Depressive Disorder:
Low mood with two other symptoms of depression most days for at least 2 years.
Premenstrual Dysphoric Disorder:
Severe mood symptoms in the week before menstruation.
Disruptive Mood Dysregulation Disorder:
Severe temper outbursts with persistent negative mood for over 1 year before age 10.
Bipolar I Disorder:
At least one lifetime manic episode.
Bipolar II Disorder:
At least one lifetime hypomanic episode and one major depressive episode.
Cyclothymia:
Recurrent mood changes (high to low) for at least 2 years without manic or depressive episodes.
Page 4: Studying Conditions
Dentistry Focus:
Evidence-Based Practices
Psychological Focus:
Symptoms
Signs
Definitions (DSM-5)
Page 5: Managing Dental Anxiety
Key Concepts:
Definitions of dental fear, anxiety, and phobia.
Techniques for managing dental fear:
Cognitive Behavioral Therapy (CBT)
Pharmacologic Management
Importance of Collaboration and Referrals
Page 6: Impact of Dental Anxiety
Consequences of Dental Anxiety:
Patients may avoid or delay dental cleaning.
Difficulties in treatment lead to increased time and stress.
Overall poorer dental health outcomes for anxious patients.
Page 7: Understanding Anxiety, Fear, Phobia
Definitions:
Anxiety: Emotional state preceding a fearful encounter.
Fear: Actual response in a scary situation.
Phobia: Marked fear or avoidance that significantly interferes with functioning.
Page 8: Management Techniques
Essential Approach:
Manage both pain and anxiety/fear in dental settings.
Page 9: Nature of Dental Fear
Influencing Factors:
Direct negative dental experiences might occur, but perception of the dental environment is crucial.
Other contributors may include social evaluations and fear of germs, along with psychological conditions such as depression.
Page 10: Factors Contributing to Dental Fear
Elements of Fear:
Aversive Situations: Reclined seating, personal space invasion, and unpredictability can enhance fear response.
Page 11: Types of Dental Anxiety
The Seattle System:
Fearful of Specific Situations:
Identify aspects of dentistry they fear, like injections or drills.
Fearful of Medical Situations:
Worry about inducing medical emergency or allergic reactions.
Page 12: Generalized Anxiety and Distrust
Types of Patients:3. Generalized Anxiety:
Patient is unaware of why they are anxious in dental settings.
Distrustful Patients:
Show skepticism and can be combative regarding care.
Page 13: Treatment Techniques for Anxiety
Gradual Exposure & Relaxation:
Focus on present, give positive feedback.
Page 14: Building Trust in Treatment
Methods to Establish Trust:
Provide information, request permission for each step of treatment, engage patient with a mirror for control.
Page 15: Measuring Dental Anxiety
Assessment Tools:
Modified Dental Anxiety Scale (MDAS):
Five items on a 5-point Likert scale, higher score indicates more anxiety.
Index of Dental Anxiety and Fear (IDAF-4C+):
8 items evaluating physiological, cognitive, emotional, and behavioral components.
Page 16: Single Item Assessments
Single Questions for Assessment:
Dental Fear Survey (DFS)
Dental Anxiety Question (DAQ)
Page 17: Proposed Dental History Tab
Assessment Questions:
Evaluate patient's feelings about their visit, highlighting specifics for record in future treatments.
Page 18: Tailored Anxiety Management
Strategies for Different Anxiety Levels:
Provide supporting therapies and coping strategies based on identified anxiety levels.
Page 19: Rapport & Communication Techniques
Key Techniques:
Basic courtesy and warmth.
Show understanding and empathy.
Ensure efficiency and punctuality in practice.
Encourage patient involvement in treatment plans.
Inform patients about fees and services proactively.
Page 20: Treatment Management Strategies
Trust-Building Techniques:
Implement "Tell, Show, Do" method; incorporate breaks and signaling cues for patients.
Page 21: Psychological Techniques in Treatment
Relaxation Techniques:
Include refocusing, guided imagery, breathing exercises, and progressive muscle relaxation.
Behavioral Techniques:
Positive reinforcement, systematic desensitization, and cognitive restructuring.
Page 22: Clinical Practice Considerations
Environment and Scheduling:
Minimize anxiety triggers; customize scheduling and treatment planning to patient needs.
Page 23: Take Home Messages
Overall Strategies and Flexibility:
Acknowledge that anxiety management is core to improving dental care; adapt strategies based on anxiety levels.
Page 24: Referral Protocols
Indications for Referral:
Severe anxiety, resembling specific phobia, longstanding dysfunctional beliefs, and safety concerns.
Page 25: Interprofessional Practice
Collaboration Levels in Care:
Ranges from minimal to full integration in practice, emphasizing communication and co-location of teams.
Pages 26-56: INDBE Style Template and Case Studies
Case Templates:
Various patient information forms with specific complaints, histories, findings, and assessment questions.
Focus on symptoms (anxiety, fear etc.), examples of assessments, expected conditions and scenarios for treatment protocols.