For most Pediatric Dentists, physical restraint is a last-resort solution when all other possible solutions have been exhausted. If the well-being of your child depends on getting the dental work accomplished and he or she is not a candidate for sedation, it is often the only viable solution.

The restraints can be applied quickly to keep a child from struggling and resisting treatment, thus protecting the child from injury.

• For a patient who requires diagnosis/ treatment and cannot cooperative due to a lack of maturity or a handicapping condition.
• When the safety of the patient or staff would be at risk without restraint. As a part of treatment during conscious sedation procedures if GA is not readily available

Contraindications

• If there is no available informed parental consent and child is cooperative.
• Child with complicating physical or mental condition.
• Non sedated patient with non emergent treatment requiring lengthy appointments.
• Patient has experienced previous physical or psychological trauma from physical restraint.
• Child suffering from respiratory problems (asthma)

Types of protective stabilization

1) Physical Restraint (Active restraint)

Physical restraint also known as personal restraint refers to personal restriction that reduces the ability of the child to freely move his or her arms, legs or head.

Example: Head holds, hand guarding, therapeutic holds, hand-over-mouth exercise, and hand-over-mouth with airway restricted.

2) Mechanical Restraint (Passive restraint)

Refers to the use of mechanical devices which assist the patient in remaining properly positioned during the course of dental treatment.

Example: Papoose board, pedi-wrap, sheets, straps, towels, and mouth props.

3) Chemical Restraint (conscious sedation)

Also called pharmacological restraint and refers to the use of a sedative or other drug to manage patient's movements.

In addition, conscious sedation usually requires mechanical and/or physical restraints to effectively manage a patient's movements.

DETAILED VEIW ON Types of MECHANICAL restraint used

For body

Pedi wrap Papoose board Sheet Beanbag with straps Towel and tapes

 

PediWrap

Pediatric Arm Immobilizers are cute, comfortable arm immobilizers that quickly and safely control arm movements to prevent kids from pulling out feeding tubes or tracheostomies, putting objects in their mouths, or inflicting injuries to themselves.

Papoose board

A papoose board is a temporary medical stabilization board used to limit a patient's movement to decrease risk of injury while allowing safe completion of dental treatment. Protective stabilization also known as a papoose board is used only when necessary.

The child is placed on a flat board and wide fabric straps are wrapped around the upper body, middle body, and legs.

Beenbag with straps

An over-sized dental chair can feel insecure for patients under the age of two, and it can cause you to bend and twist in order to provide treatment.

Chair Cushion for Infants creates a safe, cozy lift for the patient, presents a professional image for parents, and helps you maintain better posture.

The chair cushion is like a bean bag, with soft foam inside. Air escapes through side vents as the child is placed upon it. This settles the cushion into the curves of the dental chair while securely nestling the baby.

For extremities

Velcro straps Posey straps Towel and tapes

Velcro straps

Velcro straps that can be adjusted to limit a patient’s ability to move.

The straps are adjusted to limit movement but not cause discomfort.

It is used by Doctors and Dentists to keep patients immobilized during necessary procedures when the safety of the patient or the medical staff is at risk.

Posey straps

Towel and Tape

Posey straps also known as posey vest is a type of physical restraint used to restrain child to dental chair.

The vest is placed on the patient, and meshy straps extending from each corner are tied either individually to each side or together to the back of a chair. They are fastened to the arms. They allow patients the freedom to move around their arms and legs if no limb restraints have been applied

Towels and tapes

A simple restraint device is to wrap the patient's arms in a towel, then wrap adhesive tape around the towel and finally tape the arms to the chair arm rests.

Thesame procedure may be used to restrain the patient's legs against the base of the dental chair. Care should be taken not to use adhesive tape that may remove the vinyl covering of some chairs.

For head

Head positioner Towel Forearm body support

Head positioner or stabilizer

Head Stabilizer is a comprehensive head control device that minimizes both upand-down  and side-to-side movement.

It attaches to the Board with screws for reliable stability.

Adjustable side panels tilt in at a slight angle and accommodate a wide range of patients. The thick cushions on the side panels allow for a snug fit while maintaining patient comfort.

Note that the Head Stabilizer does not function as a stand-alone device; it must be used in conjunction with the Board

Towel

A folded towel placed on a patient's forehead and held by a dental assistant standing behind the dental chair, can limit minor head movements. This is a good example of a combination of a physical (dental assistant) and mechanical (towel) restraint.

For mouth

Mouth blocks Tongue blades

Mouth block or prop

A mouth prop also known as ‘BITE BLOCK’ is a wedge shaped implement used in dentistry.

It has a rubber like texture and made typically from ‘thermoplastic vulcanizate’ (TPV) material.

Mouth props are often necessary for dental treatment of disabled patients who lack the ability to keep their mouths open

Tongue blades

It is flat, thin, wooden blade, smoothed and rounded at both ends. Made of balsa, pine, red wood woods.

Customerized for amount of bite opening that is desired.

Mouth can be opened wider by placing tongue blades posteriorly

Flavoured tongue blades are available