Children’s visits to the dentist are often fraught with anxiety for parents and kids alike. A negative experience at the dentist as a child may result in continued anxiety over routine dental care even into adulthood. So, find out how to evaluate dental practitioners to reduce your and your child’s stress and prevent a traumatic childhood experience. Also, be prepared by knowing what to expect, your rights as a parent and how to prepare or help your child.

Your child and the dentist – behind closed doors

Anxiety over a child’s first visit to the dentist leads many parents to needlessly worry when they’re asked to remain in the lobby during their child’s checkup. Though negative experiences can occur at this stage, they aren’t the norm. Separating a child from parents usually results in fuller cooperation from a the patient.

When your child is placed in the care of the dental staff, they’ll try to make this first experience fun and informative. The dentist will explain and demonstrate routine procedures to her and then perform the processes as discussed. Your child soon learns the dentist is someone to trust. When she child has non-routine dental work done, the dentist will similarly work with her to help alleviate fears.

If you’re still concerned with sending your child in alone, discuss it with your practitioner. Ask if your dentist will make an exception. If you’re still not satisfied, seek a dentist with policies that make you more comfortable.

Approaching scared or uncooperative children

There are many reasons children become fearful or uncooperative during a visit to the dentist. If your child arrives unprepared or senses your anxiety, she may develop undue worry. A past experience could also cause stress. Children who are ill or have a physical or mental disability, a behavioral disorder or developmental delay may also be challenging to treat. Whatever the reason, the way your dentist handles your child’s fears and behavior is vital to her emotional well being and ability to cope with future visits.

The American Academy of Pediatric Dentistry (AAPD) has developed guidelines for behavior management that dentists should follow. Your dentist should use the communication techniques learned in dental school, including positive reinforcement, distraction, voice control, non-verbal communication and the tell-show-do approach. These techniques all help reassure patients and gain their trust. In most cases, these approaches are sufficient, leading to visits that end on a positive note. When a practitioner lacks the expertise for handling a situation, your child should be referred to a dentist with the appropriate skills.

Child restraint and other non-routine approaches

Unfortunately, some children will require approaches beyond specialized communicative skills. The AAPD recommends several procedures when communication isn’t enough. Such strategies include immobilization, nitrous oxide, conscious sedation or general anesthesia. The circumstances under which any of these methods are used depend on several factors including the necessity of the dental work, the particular procedure and the reason your child isn’t able to cooperate.

Nitrous oxide or conscious sedation is sometimes used to calm children and prevent injurious movement. These relatively safe procedures may be indicated under several conditions. But in some instances, they should not be used.

Restraint or immobilization is another option. It can be used to prevent injury and gain cooperation as well, although some practitioners express concern with the use of this method.

Dr. Kimberly A. Loos, D.D.S. of San Jose, California explains at ParentsPlace.com, “I believe that because restraint might be viewed as some type of punishment by the child, it should be used exceedingly sparingly … While some think that the wrap may help the patient to feel secure, it may also serve to increase and intensify any feelings of helplessness the child might have.”

Loos reports she has treated hundreds of children and has only opted for the method on one occasion and with the parent’s consent. She acknowledges it may be appropriate for use with a child who’s not apprehensive, yet is unable to remain still for the procedure.

Finally, general anesthesia is occasionally required. This is usually needed only when other methods are deemed inappropriate, and necessary dental services otherwise couldn’t be rendered.

Whatever the situation, says the AAPD, these measures shouldn’t be executed without your prior consent.

Preventing an experience that heightens your child’s fears

• Contact your state’s board of dentistry when choosing a practitioner to make sure no disciplinary actions have been taken.
• Inform your dentist of any medical, behavioral or other conditions that might affect your child’s visit, so the dentist can communicate with your child accordingly.
• Pediatric dentists have specialized training for dealing with situations that can arise with children. Seek a pediatric dentist if you suspect your child may have difficulty with dental visits.

Tips for easing your child’s fears

• Read to your child before the first visit to the dentist. Try one of the following: “Going to the Dentist” by Helen Frost, “Open Wide: A Visit to the Dentist” by Cecile Schoberle and Barry Goldberg, “Freddie Visits the Dentist” by Nicola Smee or “The Berenstain Bears Visit the Dentist” by Stan Berenstain and Jan Berenstain.
• Share a DVD with your child such as “A Trip to the Dentist through Pinatta’s View” available from Amazon.com.
• Also, express positive feelings about your own dental experiences. Explain to your child the procedures she will undergo, while avoiding frightening terminology.
• If she is anxious, don’t try to soothe her by lying about a procedure or possible pain. Instead, try to alleviate fears that may be out of proportion to the situation.
• Finally, offer coping strategies to your child. Have her practice taking long deep breaths. If you know you’ll be attending to her throughout the procedure, you can offer your hand to squeeze.

DENTISTS THAT WILL MAKE YOU SMILE:

• Chevy Chase Pediatric Dentistry Karen Benitez, DDS, Board Certified 8401 Connecticut Ave., Ste. 650 Chevy Chase, MD 301-272-1246 www.chevychasekids.dentist hello@chevychasekids.dentist
• Falls Church Pediatric Dentistry Roselyne Gichana, DMD 6400 Arlington Blvd., Ste. 80 Falls Church, VA 703-533-5511 www.Fallschurchkids.com
• Pediatric Dental Care John Han, DDS 10614 Warwick Ave., Ste. B Fairfax, VA 703-383-3434 www.kidsfirstdentalcare.com
• Emmanuel Skordalakis, DDS, M.A. Diana Tsai, D.M.D. 46950 Jennings Farm Dr., Ste. 160 City, State Sterling, VA 703-421-3000 www.Skordalakisdds.com
• Vienna Pediatric Dentistry Dr. Sarah Ganjavi 301 Maple Ave., NW, #400 Vienna, VA 703-938-6600 www.ViennaPediatricDentistry.com email

Parent Input Please

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This month’s question: What is one way you make a visit to the dentist go more smoothly?