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Treating pediatric patients can be stressful for everyone: the dental team, the patient caregiver and the patient themselves. To achieve successful outcomes without inadvertently fostering fear and anxiety that may persist into later years, it is critical to develop good behavior management techniques.
We recently outlined some best practices for ensuring a child’s first dental visit is a positive one, which you can read here. But despite your best efforts, some children may still develop a fear of the dentist; a previous unpleasant dental or medical experience, parenting practices or a physical or mental disability are some of the many factors that can contribute to dental anxiety among children.
The American Academy of Pediatric Dentistry (AADP) recently revised its best practice document on behavior guidance for pediatric patients. In addition to tips on scheduling, creating a positive impression of the practice before the visit, and communication with caregivers as well as patients, it includes practical techniques for keeping children calm and engaged in the dental visit, such as:
- Tell-show-do: In this communication technique, the dental professional explains the procedure, demonstrates various aspects of it (sights, sounds, sensations) in a nonthreatening way, and then performs the procedure exactly as described.
- Ask-tell-ask: In this process, the patient is first asked about their feelings about the visit or planned procedure. Then, after the procedure is explained using language appropriate to the child’s age, they are asked again to assess their understanding and anxiety level. For children with limited language ability, a picture-card system can be used.
- Enhancing control: Allowing a fearful child to use a clear signal to ask for a “time out” can help give them a sense of control. This practice has been associated with better emotional control and reduced intraoperative pain.
- Distraction and sensory-adapted environments: Use of lower lighting, quieter settings, visual or auditory effects (such as projected images, videos, music or even virtual reality), or wraps or blankets may either help keep a child focused on something pleasant or be useful for children with sensory-processing difficulties.
- Nitrous oxide or sedation: Depending on the length of the procedure, the cooperativeness of the patient, and any existing dental anxieties, use of nitrous oxide or sedation is indicated to avoid creating or exacerbating dental fear or anxiety.
These calming techniques are only a few ways to reduce dental anxiety among pediatric patients. The AADP publication also lists the use of animal-assisted therapy, desensitization to dental setting and procedures, and memory restructuring.
For pediatric patients, even a routine hygiene appointment and exam can be a stressful experience. Besides pre-visit communication, positive reinforcement and patient education, following the calming techniques listed above can all help in reducing the anxiety and fear sometimes felt among pediatric patients at the dental office. Learn about additional calming techniques from the AADP’s Reference Manual of Pediatric Dentistry here.
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A version of this article originally appeared in the March edition of OnTarget. Read the latest edition and view current promotions at pattersondental.com/dental/ontarget.