Use of Protective Stabilization for Pediatric Dental Patients

Abstract

This best practice is presented to assist dentists and other health professionals regarding the need for and appropriate use of protective stabilization/medical immobilization when treating pediatric patients and individuals with special health care needs. Immobilization of a person for delivery of safe, quality dental/medical care can be passive (using equipment or mechanical devices) or active (being held by other persons). Details to consider before using protective stabilization include the patient’s particular needs, dental and medical histories, and cognitive and emotional development as well as the desires of the parent. Recommendations for using protective stabilization focus on the following areas: education of the health care providers, discussion of consent/assent with parent and patient, parental presence in the operatory or treatment area, specific immobilization techniques and equipment, method of monitoring the patient, and individualized considerations for patients with special health care needs. Indications, contraindications, risks, and required documentation are addressed. In the spirit of patient safety, the decision to utilize protective stabilization and chosen techniques should be customized for each patient, depending on his medications and physical and psychological health. Protective stabilization is considered within an overall behavior guidance plan that promotes a positive dental attitude and quality of care.

This document was developed through a collaborative effort of the American Academy of Pediatric Dentistry Councils on Clinical Affairs and Scientific Affairs to offer updated information and recommendations regarding assessment of caries risk and risk-based management protocols.

^{KEYWORDS: BEHAVIOR THERAPY, CHILD, DELIVERY OF HEALTH CARE, INFORMED CONSENT; RESTRAINT, PHYSICAL}