Difficulty taking your children to the dentist? – Stuart Davidson explains why it should be Childs Play!
The management of the child patient in dental practice is a challenge faced by many dentists on a daily basis. The successful treatment of children can be a particularly rewarding experience but like all aspects of dentistry it requires good communication skills, clinical knowledge and a degree of practice!
Children account for a significant proportion of the population and developing a rapport at an early age can result in a long term relationship between dentist and patient with the end result being a healthy, functional, stable and attractive smile.
In order to successfully treat kids it is essential to have a good understanding of the factors affecting anxiety in children. Often for children this is a fear of the unknown. The dental surgery is full of unknown people and unknown objects that often produce frightening noises and can induce a ‘fight-or flight’ response. When treating kids it is important to adopt a long-term approach creating a positive attitude towards prevention and treatment where required.
The Royal College of Surgeons of England Guidance suggests that the behaviour of children can be categorized in three ways
- ‘Co-operative’: The child is able to participate in dental care.
- ‘Potentially co-operative’: The child may be able to participate in dental care with the adjunct of appropriate behavior management techniques
- ‘Lacking co-operative ability’: The child is pre-co-operative, for example, very young children.
It is very important to set achievable goals and work with children and their parents towards achieving these goals.
Techniques we use in Ivy Cottage Dental Practice
Tell-Show-Do – This technique is extremely popular and is helpful in acclimatising children to the dental surgery and treatment. There are 3 phases, initially an explanation of the equipment or procedure, followed by a demonstration of the equipment or procedure (e.g. polishing the child’s nail) followed by doing treatment.
Positive Reinforcement – This technique involves acknowledgement, praise and reward for examples of positive behaviour whilst ignoring negative behaviour. For example, stickers or bravery certificates.
Distraction – It can be useful to remove the focus of the child’s attention from the anxiety-causing factor. A useful example of distraction is having the child choose the music played in the surgery. Gangnam Style still seems to be a favourite in my surgery much and the nurses have even been known to dance in the surgery!
Non-Verbal Communication – These are non-verbal signals and cues which can help to reassure the child and provide a sense of control to the patient. A particularly effective example of non-verbal communication is the use of stop signals. A signal is agreed between dentist and patient to indicate that he or she would like to stop treatment. It is essential that if this technique is used the dentist does stop when requested as often the child will test out the deal on offer before committing to treatment.
Modelling – A particularly useful technique for an anxious child with a co-operative sibling/parent. The child can watch the brothers and sisters taking part in treatment and feel reassured by a positive experience. Often this can remove a fear of the unknown.
Relaxation – Simple relaxation techniques using breathing exercises or progressive muscular relaxation can be useful but require a degree of co-operation. In my personal experience this technique is more useful in teenage or adult patients.