by Kimberly Blaker
Freelance Parenting Writer
Sonoma Family Life, February 2016
A child’s visit to the dentist is often fraught with anxiety for parents and kids alike. A negative experience at the dentist as a child may result in continued anxiety over routine dental care even into adulthood. Discover how to evaluate dental practitioners to reduce yours and your child’s anxiety and prevent traumatic childhood experiences. Also, be prepared by knowing what to expect, your rights as a parent, and how to prepare or help your child.
Your child’s visit to the dentist–behind closed doors
Anxiety over a child’s first visit to the dentist leads many parents to worry needlessly when asked to remain in the lobby during their
child’s checkup. Though negative experiences can occur at this stage, it isn’t the norm. 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 the 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.
If you’re still concerned with sending your child in alone, discuss it with your practitioner. Ask if she will make an exception. If you’re still not satisfied, seek a dentist with policies that make you more comfortable.
Approaching scared or uncooperative children
There are many reasons children become fearful or uncooperative during a child’s visit to the dentist. If your child arrives unprepared or senses your anxiety, he may develop undue worry. A past experience could also cause anxiety. Children who are ill or have a physical or mental disability, a behavioral disorder, or developmental delay may also be difficult to treat. Whatever the reason, the way your dentist handles your child’s fears and behavior is important to your child’s emotional well being and ability to cope with future visits.
The American Academy of Pediatric Dentistry has developed guidelines for behavior management that dentists should follow. During your child’s visit to the dentist, he should use the communication techniques learned in dental school. These include positive reinforcement, distraction, voice control, non-verbal communication, and the tell-show-do approach. These techniques all help reassure patients and gain their trust. In most cases these approaches are effective, leading to visits that end on a positive note. When a practitioner lacks the expertise for handling a situation, your child should be referred to a dentist with the appropriate skills.
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 Hand-Over-Mouth (HOM), immobilization, 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 your child isn’t able to cooperate.
The Hand-Over-Mouth method is often used to gain your child’s cooperation so he can listen attentively while the dentist explains behavioral expectations. Defiance or hysterical behavior related to the dental visit might indicate the use of this measure. However, it should not be used during your child’s visit to the dentist if he is incapable of understanding and cooperating.
Nitrous Oxide or conscious sedation is sometimes used to calm children and prevent injurious movement. These relatively safe procedures may be indicated under several conditions. But in some instances, they should not be used.
Restraint or immobilization is another option. It 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. Though she acknowledges it may be appropriate for use with a child who’s not apprehensive yet unable to remain still for the procedure.
Finally, general anesthesia is occasionally necessary. This is usually used only when other methods are deemed inappropriate, and necessary dental services otherwise couldn’t be rendered.
Whatever the situation, says the AAPD, these measures shouldn’t be executed without your prior consent.
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 to the dentist so she 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
- Before your child’s first visit to the dentist, read 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 Berenstain 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 soothe 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. If you know you’ll be attending your child throughout the procedure, offer your hand to squeeze.
Kimberly Blaker is a freelance parenting writer. Find out more about her writing services on parenting.