“Successful” Children’s Dentistry

June 2010

One of the greatest rewards of being a family dentist is the ability to help a child overcome their innate fear of dental care. This remains a pivotal moment in a child’s psychological growth and development and molds their future ability to cope with dental care on a rational level. A child’s first dental visit and all subsequent visits should result in a victory for the child’s dental and psychological needs.

Sophie, a recent new patient, provides a great example of how successful stages of Children’s dentistry results in a positive dental experience. Sophie is eight years old. She had two primary “baby teeth” molars that were normally supposed to be in her mouth for two more years, but had developed advanced decay, and was causing here pain. She understood the teeth had to be extracted. However, there was a large emotional and psychological gap that had to be met before she would allow me to remove her teeth. After numerous questions and answers and developing her trust and confidence, Sophie gave me the green light to proceed. The first hurdle of getting her numb was resolved by using painless computer anesthesia. This challenging step earned Sophie’s trust. The second hurdle of tooth extraction for her was resolved by symbolically using a plastic cup to simulate tooth extraction. Sophie became the pretend dentist and pulled the cup off my fingers (with a little resistance) imagining it was her tooth being extracted. She could imagine the force required to pull on the tooth and how the procedure would occur. Sophie’s actual treatment and her positive experience were now a measurable success and mom was further very pleased, having been more nervous than her child.

Needles, “white coat syndrome”, pain, fear of the unknown, poor communication and lack of proper time with the child are negative factors that enter into the equation of potentially “poor” dental visits. These factors need to be dealt with carefully by the doctor, the dental staff, the parents and the young patient.

For now, take a moment and pretend you are a six year-old sitting at home and preparing to go see the dentist for your first filling. You might be reflecting on past visits at your physician and remember getting shots, creating negative associations with your dental visit. Your parents may have told you openly that you may need a shot in the mouth to numb the tooth and made you very scared. The only real information the child will have to go on is whatever the dentist, the dental staff and parents have provided him or her. Therefore, communication is very important.

Typically, a child will come to the dentist for a dental check up and will receive a diagnosis and treatment plan. During their check-up, the dentist and staff should carefully explain what a cavity is, why it formed, how to prevent future cavities and most importantly how we can easily and simply make their cavity go away. My philosophy is to talk to young patients like an adult until they understand the information and are relaxed about it. Today’s dentistry is wonderful for children because of modern technology that not only makes diagnosis and communication better, but also allows today’s youth to relate much better to their dental needs. Intraoral photographs of the child’s very own tooth allow them to see their cavity and provides a great way for them to visually understand the process, ask questions, and become comfortable with the upcoming filling procedure. An animated educational video at their check up appointment shows the child how a cavity procedure is performed, improves their understanding about the procedure, alleviates their apprehension of the unknown and is done in advance of the upcoming dental appointment. A Diagnodent Laser is a small wand that is placed over the tooth to comfortably diagnose decay, and is another means to discuss the young patient’s dental needs. Other technology is the Computer Anesthesia that makes dental anesthesia completely comfortable and never a worry for young patients. Having cartoons on a monitor in front of the treatment chair affords them a level of distraction during the appointment. Traditional Nitrous Oxide therapy can be helpful but is not always necessary.

All the factors discussed above contribute to a successful formula that worked for Sophie and repeatedly work with most children. The most important factor in the success of pediatric dental care is communication before and during the dental appointment. A child-friendly office environment is also very important to make the child feel comfortable coming to the office.  Experience and a friendly attitude of the dentist and staff are appreciated by the child and result in successful dental care.

The first dental visit for a child should be interpreted as a unique opportunity to provide that child a positive experience and allow them to embrace dental care as a lifelong benefit without anxiety.