Children’s visits to the dentist are often fraught with anxiety for parents and kids alike. As a child, a negative experience at the dentist may result in continued anxiety over routine dental care even into adulthood. Know what to expect, your rights as a parent, how to prepare or help your child, and how to evaluate dental practitioners to reduce anxiety and prevent traumatic childhood experiences.
Your child and the dentist— behind closed doors
Anxiety over a child’s first visit to the dentist leads many parents to worry needlessly when they are asked to remain in the lobby during their child’s checkup. Though negative experiences can occur at this stage, it is not the norm, and separating a child from parents usually results in fuller cooperation.When your child is placed in the care of the dental staff, they’ll try to make this first experience fun and informative. The dentist will explain and demonstrate routine procedures to your child, and then perform these procedures as discussed. Your child soon learns the dentist is someone to trust. When your child has non-routine dental work done, the dentist will work with your child in a similar manner to help alleviate fears.
“For a lot of kids, it’s comforting to have a parent in the room,” says Dr. Sebastiana Springmann, DDS, of New Town Dental Arts in Williamsburg. “We tailor visits to whatever will make the child comfortable. We have TVs and cable in every room so the kids can watch Disney Channel, SpongeBob or Nick.”
“Your dentist should use the communication techniques he or she learned in dental school, including positive reinforcement, distraction, voice control, non-verbal communication, and the tell-show-do approach. These all help to reassure patients and gain their trust.”
Approaching scared or uncooperative children
There are many reasons children may become fearful or uncooperative during a visit to the dentist. A child who arrives unprepared or senses a parent’s own fears may develop undue worry. A past experience could also cause anxiety. Children who are ill, have a physical or mental disability, a behavioral disorder, or developmental delay may also be difficult to treat. Whatever the reason, how your dentist handles your child’s fears and behavior is important to your child’s emotional well being and his ability to cope with future visits. The American Academy of Pediatric Dentistry (AAPD) has developed guidelines for behavior management that dentists should follow. Your dentist should use the communication techniques she learned in dental school, including positive reinforcement, distraction, voice control, non-verbal communication and the tell-show-do approach.
These approaches all help to reassure patients and gain their trust, and in most cases are effective, leading to visits that end on a positive note. Springmann notes that the best way to prevent anxieties is to introduce the child to the dentist early.
“Every child should have a dental home by age 1 so that they have an established relationship with a dentist,” Springmann says. “At that age, it’s more about how their teeth are looking, how they’re coming in, and that they’re developing normally.”
“A child who arrives unprepared or senses a parent’s own fears may develop undue worry.”
Child restraint and other non-routine approaches
Unfortunately, some children will require approaches beyond specialized communicative skills. The AAPD recommends several approaches when communication isn’t enough. Such approaches include nitrous oxide, conscious sedation, or general anesthesia. The circumstances under which any of these methods are used depends on several factors including the necessity of the dental work, the particular procedure, and the reason the child isn’t able to cooperate.
Nitrous Oxide or conscious sedation is sometimes used to calm children and to prevent injurious movement. These relatively safe procedures may be indicated under several conditions. In some instances, however, they should not be used.
Restraint or immobilization is another option. This can be used to prevent injury and gain cooperation as well, though some practitioners express concern with the use of this method.
Dr. Kimberly A. Loos, D.D.S. of San Jose, California, explains at ParentsPlace.com, “I believe that because restraint might be viewed as some type of punishment by the child, it should be used exceedingly sparingly. . . . While some think that the wrap may help the patient to feel secure, it may also serve to increase and intensify any feelings of helplessness the child might have.” Dr. Loos reports she has treated hundreds of children and has only opted for the method on one occasion and with the parent’s consent, but acknowledges it may be appropriate for use with a child who is not apprehensive yet is unable to remain still for the procedure.
Finally, general anesthesia is occasionally necessary. This is usually used only when necessary dental services otherwise could not be rendered.
“If your child needs to be sedated, that’s an appropriate time for us to refer them out to a pediatric dentist,” says Springmann.
Preventing an experience that heightens your child’s fears
Contact your state’s board of dentistry when choosing a practitioner to make sure no disciplinary actions have been taken.
Inform your dentist of any medical, behavior, or other conditions that might affect your child’s visit so the dentist can communicate with your child accordingly.
Pediatric dentists have specialized training for dealing with situations that can arise with children. Seek a pediatric dentist if you suspect your child may have difficulty with dental visits.
Tips for easing your child’s fears
- Read to your child before her first visit to the dentist. Try one of the following: Going to the Dentist by Helen Frost, Open Wide: A Visit to the Dentist by Cecile Schoberle and Barry Goldberg, Freddie Visits the Dentist by Nicola Smee, or The Berenstain Bears Visit the Dentist by Stan and Jan Berenstain.
- Share a DVD with your child such as “A Trip to the Dentist Through Pinatta’s View” from Amazon.com.
- Express positive feelings about your own dental experiences.
- Explain to your child the procedures he will undergo, but avoid frightening terminology.
- Don’t try to sooth your child by lying about a procedure or possible pain. Instead, try to alleviate fears that may be out of proportion to the situation.
- Offer coping strategies to your child. Have her practice taking long deep breaths, and if you know you’ll be attending your child throughout the procedure, offer your hand to squeeze.