Hand over mouth technique (HOME) is an aversive behavior modification technique used to modify a negative child’s behavior during his/her visit to a dental clinic.

• First described by Dr. Envangeline Jordan in 1920.
• Also known by name as Aversion – Crammer (1973)
• Emotional Surprise therapy – Lampshire
• Hand over mouth airway restricted (HOMAR) – Levitas (1947)
• Aversive conditioning – Lenchner & Wright (1975)

The hand-over-mouth exercise (HOM) and the handover-mouth with airway restricted technique (HOMAR) have historically been, to varying degrees, accepted techniques used in the management of children exhibiting negative or maladaptive behavior

Technique

• To perform this technique, a doctor or parent gently places their hand over the child's mouth and nose, allowing the child to feel their breath and focus on the sensation of breathing.
• The child is instructed to take deep breaths in and out, which can help them slow down their breathing and regulate their emotions.
• The child is informed that the hand would be removed only after required behavior begins.
• As the child responds, the hand is removed.
• If after removal of hand, negative behavior is shown, the process is repeated.
• Nowadays HOMAR is not done by dentist

Objective

• To redirect child’s attention enabling communication
• To extinguish excessive avoidance behavior
• To reduce the of GA

Indication of HOME

• Healthy child
• Child who understands simple verbal commands
• Child displaying uncontrollable behavior
• to 6 years old

Contraindication of HOME

• Physical, mental, emotionally handicap
• Immature and frightened child
• Less than 3 years old
• Respiratory issue patients

Objective

• To redirect child’s attention enabling communication
• To extinguish excessive avoidance behavior
• To reduce the of GA

Indication of HOME

• Healthy child
• Child who understands simple verbal commands
• Child displaying uncontrollable behavior
• 3 to 6 years old

Contraindication of HOME

• Physical, mental, emotionally handicap
• Immature and frightened child
• Less than 3 years old
• Respiratory issue patients

NOTE.

It should be done in the presence of parents

Modifications:

• HOM with airway unrestricted
• HOM with airway restricted (HOMAR)
• Towel held over nose & mouth
• Dry towel held over nose & mouth
• Wet towel held over nose & mouth