<![CDATA[Managing dental treatment in preschool children with multiple carious lesions can be challenging, particularly when behavioral difficulties and physiological responses, such as an exaggerated gag reflex, interfere with clinical procedures. Effective behavior guidance strategies are essential to achieve successful treatment outcomes while maintaining the child’s comfort, cooperation, and psychological well-being. This case report aimed to describe the considerations and application of behavior guidance approaches in managing a preschool child with multiple carious lesions and a hyperactive gag reflex during dental treatment. A preschool-aged child presented with multiple dental caries requiring comprehensive restorative treatment. The treatment process was complicated by limited cooperation, dental anxiety, and an exaggerated gag reflex that interfered with intraoral examination and clinical procedures. An individualized behavior guidance approach was implemented, including communication techniques, gradual exposure, positive reinforcement, distraction techniques, and modification of clinical procedures according to the child’s tolerance. The treatment plan was adjusted based on the child’s behavioral responses and physiological limitations to minimize discomfort and improve cooperation. The implementation of individualized behavior guidance techniques improved the child’s acceptance of dental procedures and facilitated the progressive completion of required treatments. The approach reduced treatment-related anxiety and enabled clinicians to manage the gag reflex more effectively during dental care. Successful dental management of preschool children with multiple caries and a hyperactive gag reflex requires comprehensive assessment, individualized behavior guidance strategies, and appropriate adaptation of treatment procedures. A patient-centered approach can enhance cooperation, improve treatment feasibility, and promote positive dental experiences in young children.]]>
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