Hand Over Mouth Exercise(HOME)

Hand Over Mouth Exercise(HOME)

Hand Over Mouth Exercise is the physical approach for behavior management for the uncooperative children of 3 to 7 years of the age during dental treatment. This was introduced by Dr Evangeline Jordan who wrote that “ If a normal child will not listen but continues to cry and struggle-hold a folded napkin over the child’s mouth shut”.

Objectives

1. To gain a child’s attention enabling communication with dentist.
2. To eliminate inappropriate avoidance behavior to dental treatment.
3. To increase child’s confidence in coping with anxiety provoking stimuli.

Indication

1. A healthy child who can understand but who exhibits defiant,obstinate and hysterical behavior during treatment.
2. 3 to 7 years of age child.
3. A child who can understand simple verbal command
4. Child displaying uncontrollable behavior.

Contraindications

1. Child under 3 years of age.
2. Handicapped child, immature child, frightened child.
3. Physical, mental or emotionally handicap child.
4. When dentist are emotionally attached with child.
5. When it prevents child from breathing.

Procedure

1. After determing the child’s behavior, the dentist gently placed his/ her hand over child’s mouth and behavioral expectations are calmly explained.
2. Child is told that the hand will be removed as soon as he cooperate with the dentist and appropriate behavior is shown.
3. When child responds, the hand is removed.
4. When child cooperates he should be complimented and praise for good behavior.
5. If child show negative behavior then, procedure is repeated.
6. It should be noted that child airway is isn’t restricted and procedure shouldn’t last for 20-30 second.

Different Variations of HOME

1. Hand over mouth with airway unrestricted.
2. Hand over mouth and the nose and the airway restricted.
3. Towel held over mouth only.
4. Dry towel held over the mouth and nose.
5. Wet towel held over the mouth and nose.