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Lecture 2: Research about human mind

In the video, we will describe what behavioral dentistry is.
Before I show you more examples about the behavioural issues in dental practice, we need to start with some definitions – I hope this is not too boring to you. First, according to American Psychological Association, behavioural science is a very broad term that refers to the disciplines of the study of human, and nonhuman animal actions and reactions. Of course in our class, we will mainly focus on human behaviour. And also we focus on not only the responses that are observable but also the inner experience associated with the responses. For example, we will discuss why patients avoid dental treatment and also focus on their fear, which is subjective, related to avoidance.
In fact, the inner experience and individual differences in personal traits is, traditionally, the field of psychology. However, our class is not to replacement for General Psychology, which I think every dental student needs to take. Our class will focus on a special field in psychology, i.e., Cognitive Psychology. Simply speaking, cognitive psychology focuses on the association between human behaviour and various mental functions, such as perception and memory. For example, when patients do not follow the oral healthcare instruction from dentists, there could be some reasons. The patients may suffer cognitive impairment so they cannot memorize what dentists said. Or they are just too anxious and cannot pay full attention to what dentists said.
If you agree that these mental functions are critical to patient behaviour, then we can hardly ignore the role of the nervous system, especially the brain, which mandates all the mental functions. This will be the focus of cognitive neuroscience. For example, age-related change in the prefrontal cortex is common in older people, and that’s something we need to know, because when patients prefrontal functions are compromised, their behaviour will be different, and we need to change our way of interaction with these patients.
Now before concluding this section, let me have a quiz for you. But this is not an ordinary quiz. The question that I propose to you is very similar to the question I have been asked, during the oral examination of my PhD at the University of Oxford.
The question is: Can a tree feel pain? I know the question looks a little bit silly but if you take it seriously, you will see that how you answer it depends on what perspective you take. For example, from behavioural science, we emphasize the tree’s response to painful stimuli. So our answer to the question depends on what it will do. In psychology, we want to ask if an association between the behaviour and the mind, if a tree has one, can be clarified. In cognitive psychology, we narrow down the concept of the mind into several mental functions. For example, people will react to painful stimuli by evaluating how threatening the stimuli are, according to their expectations and memory.
Can a tree do the same thing? Now finally, if we take a perspective from cognitive neuroscience, we believe that all the mental functions related to pain processing are supported by the nervous system. Then, the different systems of information processing between trees and humans would be the focus of the discussion.
Now we can more or less conclude what Behavioral Dentistry means here. The term behavioural dentistry can be considered as an analogue of behavioural medicine, which focuses on the integration of the biological, psychological and social aspects to understand the relationship between patients and disease. Such a focus on the biopsychosocial has been adopted by some dental researchers, such as Dr. Samuel Dworkin from the University of Washington. These researchers highlight that when we treat oral diseases, such as orofacial pain, we need to take care of not only the disease itself but also the psychosocial issues of patients. For example, their emotional experience of pain, their eating habits, their quality of life and interpersonal relationship with others, are all related to oral health.
Moreover, because we focus on the biopsychosocial interaction in Behavioral Dentistry, that means we focus on individual differences of a patient. In a class in Oral Pathology, you need to learn a typical condition of disease and learn the common mechanisms underlying the disease. However, in Behavioral Dentistry, we assume that every patient has a different condition – especially their psychosocial conditions. From Oral Pathology, two patients who have the same apical lesions need the same root canal treatment.
But in Behavioral Dentistry, we will learn more about the patients: a 40 years old single father occupied with work and a 70 years old granny living in the country may respond differently to the same treatment, and in Behavioral Dentistry, we need to learn how to respond differently to them, according to their psychosocial conditions. I want to highlight this quote from Dr. Dworkin again. What we learn from the textbooks and lectures are mainly knowledge regarding the biological and pathological mechanisms of oral diseases, which are, of course, the foundation of dental treatment. However, when it comes to healthcare and health promotion, we need to further emphasize the individual difference between patients.
Patients have different ways of reasoning, attitudes and motivation towards treatment – that’s what we need to emphasize in behavioural dentistry.

What is behavioral dentistry?

In this learning step, we will start with the definitions of behavioral science. Later, we will focus on behavioral dentistry, which is a special field in psychology, cognitive psychology. The association between human behaviour and various mental functions is highlighted in this field.

Patients have different ways of reasoning, attitudes and motivation towards treatment.

What we learn from the textbooks and lectures are mainly knowledge regarding the biological and pathological mechanisms of oral diseases, which is the foundation of dental treatment. However when it comes to healthcare and health promotion, we need to further emphasize the individual difference between patients. – Dr. Dworkin
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Brain, Behaviour, and Dentistry

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