| Abstrak/Abstract |
ABSTRACT Introduction: Self-mutilation is a disturbance of self-injurious behavior which is consciously done and causes tissue damages such as bite wounds, scratches, or wounds from blunt objects. The most affected areas are oral tissue, hands, and neck. Psychologically, patients feel the uncomfortable emotion but unable to cope the condition. Case: A 4 years old girl came to the academic dental hospital RSGM Prof. Soedomo with swollen gums in left mandible. She was diagnosed suffering from self mutilation by her pediatrician and she has been in psychological therapy with decreasing frequency. There were scars on the fingers and wrist area and teeth 51,61,72,71,82 are missing. Clinical examination showed bad oral hygiene with abscess in 74 and 75, dental caries and radices. She has came to another dentist before, but did not want to come back due to fear of the handpiece voice. Discussion: On the first visit, the main goal was to build trust and create a sense of security through verbal and non- verbal communication then the treatment could be established. Endodontic treatment, filling, SSC, extraction, and also protheses were completed in six visits and there is no self mutilation habit again. Conclusion: Behaviour management for child with self mutilation can be done with special technique are positive pre-visit imagery, direct observation, tell-show-do, ask-tell-ask, nonverbal communication and positive reinforcement. A good teamwork in building trust and creating a sense of security before dental care treatment is an important stage in the management of children's behavior with self-mutilation |
