Preparing Children for a Comfortable Dental Visit

Today we're going to be talking about the little ones, our children.

You know, many parents unknowingly create fear in children. It's quite common that in preparing their children, words like "be brave" or "it's nothing to be scared of" are used.

Children may not associate going to the dentist with the need to be scared or brave. But if a patient had a bad experience in the past, they could project their fear onto their children without being fully aware of it.

The words they use and the nonverbal cues that they may give off as they're preparing to visit the dentist or while in the dental office.

Children pick up on those cues. So we discourage parents from preparing their children for a dental visit.

We say allow the team to answer any questions that the children may have once they've arrived in the office because we know that there are certain buzzwords that we want to use and others we certainly wish to stay far from.

As dentists and dental assistants, we want to emphasize the need to have healthy, clean teeth that keep their smiles looking good and their mouth smelling fresh.

We do not, under any circumstances, want parents to threaten their children by telling them that they're going to get “a shot” if they don't behave.

So we are very intentional in the dental office about the words we use, even if we're speaking about giving an anesthetic and it requires a syringe, aka “the shot.”

We're going to word it in such a way that we're actually describing what we're doing. So if a child is sitting in the chair, and they need to get an anesthetic for a tooth, the first thing we're going to do is dry the area and put on some topical anesthetic.

So we're going to say things like, "Okay, you have a boo-boo in your tooth and we have to get it fixed. But we want to make sure that you are as comfortable as you can possibly be.”

So the next thing is to share with the child what you're doing, because the worst and most frightening thing is when children are not sure what's going to happen next.

They're in an environment where they're not necessarily comfortable, and they see all these strange things around them.

And so, the fear of the unknown can be a real problem for our children.

So let me get back to my scenario. We're going to explain to the child that "...we're going to dry the area and we're going to put on some jelly, but it's not the kind of jelly that you put on your bread. It's a special kind of jelly, and it may feel or taste a little strange, but we're going to use Mr. Thirsty, which is a suction to take out any water or any taste in your mouth."

I literally told my dental assistants to stay there and to keep the area dry, as well as to make sure the topical stays where we wanted it.

If that dental assistant puts the topical on, loads up the mouth with cotton rolls and turns her back to do other things, you don't know if that area is going to be flooded out with saliva.

And if it is, then that topical anesthetic does not work as effectively. So I asked my dental assistants to sit down and hold the topical in place while keeping a dry field around it.

We warm our dental carpules, so that even if our children are going to get an anesthetic, we want it to be as comfortable as possible. In our dental office, we use the smallest gauge possible depending on where we're working on in the mouth.

Most of the time, we can use a 30 gauge needle because most of the time we can infiltrate, which means putting anesthetic right by the tooth that we're working on.

The topical is held in place for two to three minutes, so by the time I get to that patient, and I have a 30 gauge needle engaged in a syringe, and the carpule has been warmed slightly to mimic body temperature, I can gently inject that anesthetic in and the patient is comfortable.

And as I'm going to give that anesthetic, I will explain to them that I need them to close their eyes. So you know, we don't get any of this solution in their eyes because it's going to put the area to sleep, and we don't want their eyes to go to sleep.

This is for younger children. For older children, 12 years and older, we can negotiate what we're doing because every personality is different.

But in general, this is the language we can use for the younger children… “Close your eyes, and you may feel the pinch, or you may not feel anything at all, but the important thing is not to move. Because if you move, then I can't guarantee that it's going to be comfortable.”

Invariably, they cooperate; they do what you ask them to do. And when you're finished, you say, “Well, I'm finished. But I'm just going to hold my finger here to make sure that the medicine goes in all the way. Then I'm going to put you up so you can rinse out your mouth and wash out that yucky taste.”

So we have shared as we're going along exactly what the child should expect, without using those words that will automatically bring about anxiety or fear in the child.

When we're talking about an initial visit or a first visit, I generally do not plan to do anything other than allow the child to get accustomed to what is in the room, how the chair works, what the instruments are on the bracket table, and what each one is for.

And depending on the child and a little bit of anxiety, we can demonstrate in the patient chair, or we can demonstrate as the patient sits in her or his parents’ lap, in the dental chair, whatever is going to make that child feel comfortable.

I generally ask that my assistants set up and put everything in place before the child is seated, because watching somebody put strange things on the tray before it's explained to you can be nerve racking, especially if you don't know what to expect, or if your mom has already told you to be brave, or if your aunt threatened you last week with giving you “a shot” if you don't behave.

Demonstrating how things work in areas other than the mouth decreases the child's level of anxiety.

For instance, many times we’ll put water in a cup and then we'll show how well the saliva ejector or the soft suction works when we put it into the water, and the child is able to see that the water level is going down because the suction is taking some of that water out.

Then we talk about Mr. Thirsty, which is the big high vacuum suction that will remove that water from that cup at twice the speed. And sometimes I'll say to the kids, “If you're really good, it will give you a little kiss,” and I just tap the cheek with that high vacuum and they feel that suction on and off. And that's it.

When we're looking at scalars, or instruments that we use to clean teeth, oftentimes I'll just pick up their fingernails and show them that the scalar rubbed against that fingernail does not hurt. And I let them know that this is similar to what will happen when we use this instrument on their teeth.

So we're kind of proving to them that these instruments, although they look new and different and strange, we use them in such a way that they will remain comfortable.

A cheerful, energetic, and engaging dental assistant can really enhance a child's first visit. And it can transform an intimidating and frightening experience for a child into a playful and exploratory visit.

Treats and rewards at the end of each visit are like the icing on the cake.

Especially if we explain to them what they did to earn this treat. And that will be a great incentive for their next visit. Now you and I know that the more frequently we do things, the less intimidating they become until they become second nature or, you know, some things that we don't even think about.

The same is true for children: the more frequently they visit the dentist, the less strange and intimidating a visit will feel.

Firstly, because the more you do something, the less threatening it feels. But secondly, because children who have regular dental visits have fewer cavities. So the visits are more comfortable and rewarding.

There are many, many children in my practice. They look forward to coming into the dental office. In fact, they'll remind their parents that it's time to go and have their teeth cleaned or it's time to visit the dentist.

A dental assistant who understands how to make children comfortable in a dental office is a definite asset to the office. He or she can set the tone for the visit.

So by the time the dental hygienist or the dentist is ready to care for that child, they’re already relaxed and settled and ready for treatment.

Every great office has a child whisperer. Someone who is great with kids and knows just what to say and do to make their visit fun and enjoyable.

I wonder, could that be you?

Charles Swindoll says, "Each day of our lives we make deposits in the memory banks of our children."

So let's be deliberate about creating great memories for the children that we serve in our dental offices.

So my child whisperers, we've just had a great session talking about some very basic, simple things that we can do to make a difference in a child's dental visit.

We can create life-long, fond memories, and isn't that what we want? We want to make sure that when our children start out, their first visit is great.

And it just keeps getting awesome, to the point that they never want to miss a dental visit.

And that means that we're more likely to have someone from childhood to adulthood with great oral health habits, who comes regularly, is not intimidated by the dental chair, and just overall has a great dental experience. And we, as dental assistants and dentists, can make that happen.

Because you know what? We are better together. Blessings. I'll see you next time.

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This is Episode 7 of my Irreplaceable Dental Assistant podcast.

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