Many people are afraid of the dentist. Unfortunately, much of this fear stems from a negative dental experience, typically during childhood. So, what happens when a child of a “dental-phobe” comes to the office? It is important for parents to remember that their anxieties don’t have to also be those of their children. As a dentist who treats many children, I find that parents or siblings who over-share about what is going to happen during the child’s dental appointments can set us up for failure before the child even comes to the office. Being honest with children is important, but they don’t need to know the exact details of what is going to happen.
It is important for the dental team to maintain a positive, upbeat attitude when treating children. This shows the child that the dentist’s office isn’t a scary place. When I see children for an appointment, especially if it is the first time, I like to prepare them by explaining what we will use during the procedure. Describing the procedure, as well as sensations and tastes they will experience, has been found to be very effective in reducing children’s dental anxiety. When giving the child anesthetic, they don’t need to know we’re using a needle. While they may feel some discomfort and react to it, I find that associating this discomfort with a needle makes the child react a lot more negatively than if they do not realize where the discomfort is coming from. Using a topical numbing gel and keeping the needle from the child’s view greatly helps to reduce their fear during this part of the procedure. Positive reinforcement and distraction techniques can help children get through the more difficult parts of the procedure and leaves them with a sense of pride and accomplishment.
There are many times when a general dentist is not successful in alleviating a child’s dental anxiety. This is when the importance of different anxiety-reducing treatments comes into play. Nitrous oxide, or “laughing gas”, is commonly used in treating fearful children and adults. While it does not change the procedure itself, it helps in reducing a child’s anxiety by making them feel more relaxed. If a child has more extensive dental decay, higher anxiety, or more difficult behavior, having them undergo multiple dental appointments may not be practical. This is when we would consider sending them to a pediatric dentist, who can complete the child’s full dental treatment, either in their office or in the OR, under general anesthesia. This way, the child’s visits to the office are reduced and all their treatment needs can be met while being sedated (“asleep”).
The field of dentistry has come a long way and many strategies can be used to alleviate a patient’s anxiety. We will do whatever is possible to treat our young patients, both to ensure they are brought back to good oral health and to start their dental experience in a positive way.