The use of rehearsal and positive reinforcement in the dental treatment of uncooperative patients with mental retardation

We evaluated the effectiveness of a multi-component behavioral intervention including the provision of information (e.g, tell-show-do procedure), monetary and social reinforcement, brief and frequent dental sessions, and increased patient control in managing disruptive and resistive behavior during routine intraoral examination and prophylaxis. A multiple baseline design across subjects was used. The four subjects were all adult males ages from 25 to 41, who ranged in cognitive functioning from severe to mildly mentally retarded. The systematic application of the intervention resulted in significant increases in cooperativeness in the first training session and throughout the study. Improvement in cooperation was maintained over a several month follow-up with as little as one booster treatment session per month. Results are discussed in terms of the ease of use and cost effectiveness of the intervention.