23
Volume3 Issue1
|
I
ssues and
P
eople
Patient Communication Scenario:
HOWWOULDYOUDEALWITHA
FEARFULCHILD?
Watchan interview
withDrs. Anderson
andChambers at
Howcommon is thisscenario inCanadian
dentalpractices today?
RA:
As apediatricdentist, I seea lot of these
childrenon referral but I think it’s common in
general practice.
CC:
It’s verycommon. Studies show that on
average, 1 in10childrenhas a significant
medical fear or phobia, includingdental-
relatedanxiety.
Whatmakeskidsafraidof thedentist?
CC:
Thereareavarietyof reasonswhy kids
become fearful aroundmedical or dental
procedures. One is they’vehadanegative
experienceand it primes them to feel
anxious thenext time. But somechildren just
haveamoreanxious temperament, even if
everythinghasgonewell.
RA:
The literature shows thereareacouple
of thingswecanuse topredict achild’s
behaviour. One is theparent’s feelings about
going toadental appointment; if theparent
is fearful, thechild isgoing tobe fearful. The
other one is toask theparent how they think
thechild isgoing todoat theappointment.
What’syouradviceonhow todeal
with the fearful childdescribed in the
scenario?
RA
:Wehave toconsider if this is anacute
situation—doweabsolutelyneed toget
somethingdoneor canwedelay treatment
andworkonbuildinga trustful relationship
with theparent andchild.
CC:
One thingyouhave to take into
account is achild’s agebecause their
developmental level is key towhat they’re
able tounderstand. Often, it justmeans
takingacoupleof extraminutes tomake
things clear; explainwhat’sgoing tohappen,
demonstrate, or showaphoto. Distraction is
suchaneffective strategy inyoungchildren.
Research shows that evenprompting
children to take somedeepbreathsbeforea
procedurecancalm themdown.
Sometimes it’s theparentwho isovercome
by their ownanxiety. Give someclear
directives to theparent aboutwhat they
couldbe sayingor doing tobehelpful.
General goodbehaviourmanagement
principles includebeingclear, givingcalm
Weaskedapediatricdentist anda clinical psychologist for theiradvice.Dr.RossAnderson
isdivisionheadandassistant professor in thedepartment of dental clinical services, division
of pediatricdentistry, atDalhousieUniversity.Dr.ChristineChambers is aprofessor in the
departments of pediatrics andpsychologyandneuroscienceatDalhousieUniversity.
OnOasisDiscussions,wepresenteddentistswith the following scenario:
An8-year-oldgirl coming in for routinedentalwork refuses toget in thechair. She is visiblyupset and shaking, as isher
mother. Despiteyour best attempt to reassureher, she still refuses toundergo treatment.
Hermother explains that both sheandher daughter havehadbadexperiences at thedentist before, andaregenerally
afraidof needles andmedical visits. Howdoyouhandle this situation?
ChristineChambers
RossAnderson
