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Volume3 Issue1
I
ssues and
P
eople
commands, not asking toomanyquestionsof thechild,
andgiving thechild something to look forward toat
theendof thedental appointment. That treat from the
treasurechest, thepraise for doingagood job—theseare
all verymeaningful for children.
RA:
Sometimes it’shelpful to involve thechild in the
procedure, even if it’s just getting them toopen their
mouth, allowing them toholdan instrument, or letting
them raise their handupwhen theyneed to talk.
Onceyoumanage toget thechild into thechair, do
youkeep theparent in the room?
RA:
Workingwithparents is key.Many times I chatwith the
parent alonebefore thechildcomes into the roomand
I’ll say, ‘We recognize thedifficultyhere, I’d really likeyour
help so I can build trustwithyour child; if youdon’tmind,
I’ll askyou tochime inwhen I’mchattingwithyour child.’
I lovehavingparents in the room. I’malwayseyeing the
situation—does thechildneedextracomfort? If thechild is
reachingherhandsout and theparent isacross the room,
I’ll say, ‘Tell youwhat, I’mgoing togetmom tocomeand
holdyour foot soyouknowmommy’s there.Would thatbe
agood thing todo?’
Howcanweprevent thissituation fromhappening?
RA:
It starts longbefore thechildarrives at theoffice.
Dentists can sendout lettersor use theirwebsites to
outlinewhat youhope toaccomplish inavisit. For anxious
children, youcanget them tocome inand tour theoffice
before their appointment. Help themestablisha friendship
witha staffmemberwho isgoodwith kids. Doan
assessment aheadof time toobtainpast dental,medical,
social history. You reallyhave to knowyour patient and
what they’recapableof. Often, thefirst place Imeet kids is
in thewaiting room,wherewecanchat anddo thehigh
fives.
CC:
Some familiesget so stressedabout taking their
children toadental appointment that theydon’t tell
them inadvancebecause theydon’twant their kids to
give themany resistance. Soachildcan showupand
only realize in thewaiting roomwhat is about tohappen.
Dentists can takea kid-friendlyapproach through the
materialsprovided in thewaiting roomand in the
typesof objects andactivities that areavailable in the
operatory. Thinkabout some simple things tohelp
make theexperiencepositive for thechildand family.
RA:
We shouldbeestablishing these relationshipswith
families in thefirst year of life. First visit, first tooth—
that’sourmainmessage. Sowecanworkwithchildren
from thebeginning toprevent problems later on.
Whendoyoucall inoutsidehelp?
RA:
I’mapediatricdentistwith training inguiding
behaviours, either pharmacologicallyor non-
pharmacologically, but I oftenhave to relyonother
experts. I’mnot averse tomaking referrals toother
practitioners, likeapsychologist,whocanhelp.
CC:
A lot of parents, healthprofessionals anddentists
aren’t awareof howhelpful a trainedpsychologist
canbe in treatingphobias. If theanxietyand fear is
so severe that the situationcannot bemanaged in
the room, it is appropriate to refer toapsychologist
withexpertise inexposure techniques andcognitive
behavioural strategies. Sometimes thechild, the family,
andeven thedentistmaybe inover their head, anda
littlebit of support can turn the situationaround.
a
Theviewsexpressedare thoseof theauthoranddonotnecessarily reflect theopinionsor
official policiesof theCanadianDentalAssociation.
This interviewhasbeeneditedand condensed.
Resourcesondental visits for
theanxiouschild
GuidelineonBehaviorGuidance forthe
PediatricDentalPatient,
by theAmerican
AcademyofPediatricDentistry.
TheAutismSpeaksDental Tool Kit includes
adentalguide for familiesandavideoon
dentalhealth forchildrenwithautism.
ReadDr. GillianSmith’s response to this scenario.
Dr. Smith, ageneral dentist based in Irelandwithpost-graduate
qualifications inconscious sedation, says that “havinga
scaredchild in thechair is a scenario I dealwitheveryday.”
