Preparing for the Visit
How to Manage Your Apprehensive Child Before and During a Dental Visit
Parents often feel helpless when a child is fearful or apprehensive about going to the dentist. The following information will help you to prepare your child to ensure a less stressful and more successful visit.
Schedule a morning appointment. Children are more rested in the morning, and morning appointments usually have less waiting time than after school. If your child is in school, worry may overshadow the school day. Also a child who is tired has much lower ability to cope with stress.
Do not promise an expensive present if your child is “good.” Your little one may assume that he is about to do something that you perceive to be very difficult or even painful. A surprise waiting to be given after the appointment is a better idea. Do not tell your child to be brave or that nothing will hurt.
During any waiting time, sit beside your child on the couch and read a story. This puts the child in a more relaxed frame of mind. Free play should be avoided.
If your child is scheduled for fillings, say as little as possible regarding the events of the visit. Your tone of voice or body language could accidentally create heightened fear. The parent who is more comfortable with dental treatment should do the talking and accompany the child for the visit. Apprehensive or fearful children often do better with Dad. In general, Mothers are more emotional and anxious regarding the visit. Maternal anxiety will transfer to the child.
If local anesthesia (an injection to numb the teeth) is to be used, do not discuss this with your child. The injection usually elicits the most fear. In some cases, the use of local anesthesia may not be necessary. A topical anesthetic ointment is always used to numb the tissue before the injection which rarely causes any discomfort. When the procedure is completed and the distractions are gone, the sensation of being numb may be very distressful. The child may describe the feeling as “hurt.” We stress that the tooth went to sleep and will awaken just as the child goes to sleep every night and awakens in the morning. If the child asks you about a “shot”, answer that you do not know. Studies have shown that anxiety has a strong influence on the effectiveness of local anesthesia. If a lower tooth has been restored, the child will be reminded not to chew his lip or tongue.
By four years of age, an emotionally and physically healthy child should be able to separate for an examination and possibly treatment. In general, most children over the age of four do much better when we can have their undivided attention.
If you are going to be present for treatment, it is very important that we function as a team. Overall, you should be a silent partner. You may pat your child or offer some quiet words of support, but remain calm and keep your voice low. Parents may become the “court of appeals” as the child attempts to delay treatment by reaching out for a hug or telling the parent “just one more thing.”
If your child is crying, listen to the sound of the crying. Compensatory crying has a steady tone and seems to help some children to “get through” the procedure.
If your child cannot cooperate with you present, we suggest that you leave the room. Most often the child will calm down and we can begin the procedure. You may leave your car keys with your child so she knows that you are still close by.
If you do not plan to be in the room for treatment, it is usually better to separate in the reception room rather than after he is in the chair for treatment.
Permitting your child to undergo treatment without your presence sends two messages. First, that this is not a scary situation and it is OK if you are not in the room and second, that you have confidence in him and his ability to undergo the procedure. You provide a great sense of empowerment in your child.
We shall recognize and understand the limitations and strengths of each and every child. We respect the dignity of the child and the developing psyche. With our mutual efforts, both you and your child can begin to look forward to the next dental visit!
Dr. Jane A. Soxman
Pediatric Dentistry