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Don't bite me! Calming dental fears

Published on: January 01, 2010

In the dentist chairIf a trip to the dentist has your child sobbing and clinging to the door frame, you’re not alone. Dental anxiety is common in kids — and some adults. But a new, kid-friendly approach among dentists is gaining ground, and there are ways you can make dental visits easier for kids to face.

What causes the fear?
The first step is understanding what causes dental fear. Dr. Brent Collett, a counselor for the Behavior Health Center at Seattle Children’s Hospital, says parents should start by taking a good look at their own fears. “Children look to parents for cues of how to feel about new and different situations,” Collett says. “Parents may not even know it, but they may be affecting their children by showing their own fears about going to the dentist.”

But even if you’re not projecting concerns, children can be naturally nervous about visiting the dentist, since allowing someone else to poke around in your mouth with instruments, a noisy cleaning tool or a drill can unnerve almost anyone.

Dr. Allan Pike, a pediatric dentist in Portland who wrote a book for dentists titled Creating a No-Fear Practice: Introducing Children to a Lifetime of Positive Dental Care, has worked with children for 34 years. He says some kids are born more cautious than others, and every new experience in their life is a big deal to them. A few children have had a negative dental experience in the past that makes them fearful, while other kids are thrown by the office environment. “They see the office looks like a doctor’s office,” Pike says. “The dentist is wearing a white coat, or sometimes a mask, and people are calling him ‘doctor,’ and they think, ‘When I go to the doctor they poke a needle in my arm and it hurts.’”

The ‘no fear’ approach
According to Pike, kids fear pain — and they also fear force. To help with this, Pike gives kids a little power at the very beginning. When meeting a new patient, Pike doesn’t call the child’s name in the waiting room, but calls the parent instead. Then he introduces himself, shakes the child’s hand and asks, “Is it OK if I talk with your mom?”

Pike then speaks one on one with the parent to describe his philosophy and ask questions to learn about the child’s individual temperament. In the dental chair, he lets the child know it’s OK to say “no” at any time, instructing kids to raise a hand if and when they want to stop. “They smile and they love it,” Pike says. “They always have to test me, because at first they’re not sure I’m really going to stop. So I make a big drama about stopping quickly and sitting up straight.” Once kids begin to understand there really is no force, they begin to relax and have trust.

In “no fear” practices, work is done with topical numbing when possible, but when novocaine is necessary, the use of nitrous oxide helps to calm kids’ nerves, and staff are careful to keep children from ever seeing a needle or knowing they have had an injection.

Some kid-friendly dental offices offer cartoon videos projected on the ceiling, funky sunglasses to wear while getting teeth cleaned and the ever-popular “toy chest” from which the child picks an item at the end of the visit.

When looking for a dentist for your child, call around and ask about their approach to fearful children. Choose one that uses methods that make sense to you. Then check out one of the many great kids’ books on visiting the dentist (visit for a list). Chances are, your child’s hero can help: Dora, Elmo, Blue and even SpongeBob all have books for fearful kids about visiting the dentist.

‘Progressive desensitization’
For extremely frightened kids, Pike advocates a process he calls “progressive desensitization.” It may take many visits, but the philosophy is that the memory of the experience is more important than the act of going to the dentist. If a child won’t let the dentist look in his mouth, he’s allowed to pick out a toy, make an appointment to try another day and go home. The next visit may involve the child allowing the dentist to clean just one tooth, or observing another child getting her teeth cleaned. Over time, a trust is built, and going to the dentist becomes a positive experience instead of a fearful one.

Creating a relationship with a dentist that’s based on trust rather than authority can help kids overcome dental anxiety. “We want them to love going to the dentist for life so they will keep up on their dental visits and avoid problems down the road,” Pike says. The payoff? Happier kids with healthier teeth.

Katie Amodei is a Lynnwood-based freelance reporter and mother of two. Her youngest child wears a Spiderman costume each time he visits his dentist.

Tips for helping your dentist-fearing child:

  • Visit early and often. Kids who start young get used to seeing the dentist. Don’t wait until there is a problem to visit!
  • Take it easy. Take the time to talk to the child about his feelings. Let your dentist know about your child’s fears so he or she can provide a slow, personalized re-introduction to dentistry.
  • Choose the right time. Don’t make an appointment at your child’s usual nap time. Try to make sure that your child is well rested for the visit.
  • Take a field trip. Before your child’s appointment, schedule a time to come in for a tour and to observe at the dentist’s office. It won’t seem so scary when it becomes more familiar.
  • Read to your child. Try the book Going to the Dentist, published by Usborne Books, or others that explain dental procedures in terms that are friendly and appealing to children.
  • Keep it simple. Explain to your child that the dentist will let him take a ride in the dental chair, count his teeth and make sure they’re healthy. If your dentist provides them, tell your child that after his appointment, he will get to pick out a prize!

Source: Dentists of Eastside Pediatric Dental Group


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