Tags: In This Issue, Health, Pediatric Health
Dr. Swati Singh and Dr. Sam Bullard, of Children's Dentistry of Indianapolis, tell their patients' parents to pick a time of the day for their appointment when their kids will have the best attention span.
Dr. Carol McKown of Carmel Pediatric Dentistry loves being a pediatric dentist. "You have this new little person with no previous dental experience who you can mold into an excellent dental patient with only positive thoughts about dentistry," she said.
But sometimes it's not that easy, as there are kids who fear dental office visits. Maybe the apprehension stemmed from past experiences, or they've heard horror stories from friends, siblings or relatives. Sometimes parents project their own fear on their children. At times it's just the unknown or idea of pain that makes kids fearful. But that's where a good pediatric dentist can step in to relieve children of their fears.
"It is important to be gentle and slow, showing the child each new part of the experience," McKown said. Pediatric dentists use non-threatening, "happy terms" to tell and show children what they're going to do during the procedures. Phrases like "The dental chair goes up and down like the horses on a merry-go-round," or "The chair goes back like a 'beddy-bye,'" and "The dental light is like sunshine on your teeth" are ones that McKown uses at her practice every day.
Dr. Jennifer Satterfield-Siegel, owner of Special Smiles, said she also uses the "tell, show and do" technique to demonstrate and talk about the procedure and then perform it on the child. She uses playful names for her dental instruments and uses counting techniques to count down how long she'll be using each tool. "I stop and put myself in the child's position and think, what would put me at ease in this situation?" she said.
Pediatric dentists use the tone of their voice and body language, such as frowns and smiles, to discourage misconduct and reinforce good behavior. "If a child reacts negatively for any portion of the treatment, I ignore this behavior and try to redirect them in a positive manner and then praise their good behavior," McKown said. If a child is too scared, many pediatric dentists encourage parents to sit in the examination area or in the dental chair with their children. "Parents can help me in the examination area by being positive and assuring the child that they are in good hands," McKown said.
Parents play an integral role in making sure their child's dental visit is a positive one. Dr. Swati Singh and Dr. Sam Bullard, of Children's Dentistry of Indianapolis, tell their patients' parents to pick a time of the day for their appointment when their kids will have the best attention span. They also encourage the parents to prepare their children for the visit by discussing what will happen and getting excited about it. "I suggest parents read and watch stories that capture the basics of a cleaning," Bullard said. "Do role playing at home for practice. Be positive and supportive about the appointment – no scary language such as the word 'shot.' Parents should bring a favorite toy or stuffed animal for the dental chair. And if possible, visit the office before the appointment for a tour to see the sights, sounds and smells so it won't be as intimidating."
If you choose to sit in the examination area to take part in the child's dental experience, be sure to uphold your supporting role for the dentist and put on your poker face to appear at ease with the procedures. "When the dentist is talking to the child, be careful not to answer the questions for them," Satterfield-Siegel said. "The dentist is checking on the child's development when they ask him or her direct questions. Intervening in the conversation interferes with the rapport that the dentist is trying to establish with the child." Also, if you get nervous or uncomfortable, your child will sense that and get nervous or uncomfortable, too. Bring a book or a magazine to distract yourself and allow the dental team to work their magic.
Sometimes serious anxiety is inevitable for kids, even after the parent has prepped the child and the pediatric dentist has done all they can to make the child feel calm. The dentist may use sedation to help the child relax and be more comfortable, if necessary. The two most common types of sedation that might be used in children are nitrous oxide ("laughing gas") or an oral sedative (such as Valium).
"I watch children's nonverbal cues to see if they're uncomfortable with the procedure," Satterfield-Siegel said. "If necessary, we have different levels of sedatives for kids. Maybe the next time they won't need it, but sometimes a child needs an extra dose of bravery to get them through."
"For some of the patients that are sensitive to sensory things, we have a beanbag chair that we place in the dental chair that allows them to feel safe and comfortable," Bullard said.
"It's important to find a pediatric dentist for your children because they have two years of advanced training beyond dental school," Dr. Michelle Edwards, of Children's Dental Center, said. "Children are not little adults and need not be approached that way. They have different teeth, they are growing, and there is a psychology component involved. Most importantly, pediatric dentists have that little something special about them in how they can connect with children. It isn't something that anyone can learn in school – it just happens."