Set up your practice with children's eyes: zm-online

This is the tip from Dr. Anne Lauenstein and Gehane El Chafei. They have a children’s dental practice in Beckum and know what to look out for so that the children are happy to come and the dentist can work successfully.

In the children’s dental practice Milchzahnsafari the children can romp, read or play together with the game console in the waiting room according to their mood in the ball bath. © Thorsten Ahrendt

Pediatric dentistry should be performed by specially trained dentists and dental personnel (Behrendt et al. 2009). Ideally, there should be barrier-free rooms for the treatment of children – for wheelchairs and prams – preferably on the ground floor. As a practice location, it has good transport connections and is ideally located in the immediate vicinity of schools and kindergartens (Einwag et al. 2008, Behrendt et al. 2009). Parking is important for parents with handicapped children or prams.

When furnishing the rooms, you have many possibilities to create a combination of a wellness landscape suitable for children and hygienic practice furnishings (Beckers-Lingener 2011, Einwag et al. 2008). In the spirit of Corporate Identity (CI), it is advisable to set up a children’s dental practice “with children’s eyes” and to design it structurally. Already the reception area should look inviting for the child. At this point, you should consciously avoid using typical sterile practice furniture, as this could be frightening for a child – especially if he or she has already had bad experiences with the dentist.

Get yourself some fish!

When furnishing and designing a children’s dental practice, there is a motto or theme that is reflected in the practice logo, the practice name, the furnishing and the colour design of the practice premises. This leads to a whole and brings peace and order into the practice. Keep an eye on the desired target group for the practice: Young people probably identify less with teddy bears or balloons than smaller children.

The waiting area can be used for playing and romping. This has several advantages: The children can let off steam beforehand and the games distract before the actual dental treatment. In addition, waiting times when playing with other children can be bridged. Ideally, in addition to play facilities, there should also be opportunities for retreat and relaxation. How about an aquarium?

Previously published in the series Praxisgestaltung

Set up your practice with children’s eyes!

This is the tip from Dr. Anne Lauenstein and Gehane El Chafei. They have a children’s dental practice in Beckum and know what to look out for so that the children are happy to come and the dentist can work successfully.

Positive atmosphere in mint and apple green

Some patients have been coming for generations. When the daughter joins her father’s practice, this is a welcome occasion for a facelift: “Brighter, more modern and fresher” is the new credo of Dr. Zoltán and Dr. Reka Jekelfalussy in Menden, Sauerland.

Above the practice, below the wine cellar

“Perhaps the dental practice in Auerbach will find your attention,” wrote Dr. Thilo Körnig from Saxony. Of course! After all, the dentist turned a former slaughterhouse into a real piece of jewellery. And which practice can boast a historic wine cellar?

Old cinema flair in the new building

Dentist Inga Grafe-Bulmahn from Barnstorf near Diepholz decided to move her existing practice to new premises. A double challenge: Not only the furniture has to go with it – there used to be an old cinema at the place where the chic new building is now located – this charm also has to go with it.

Mountains, forests and sea

The dental practice of Christine Olfens and Dr. Asin Falch in Minden stands for a modernization of the existing premises. Characteristic for the redesign is the concentration on a colour line, more transparency and brightness in the reception area and the illustration with nature motifs.

Treatment in a former car rental company

Unusual locations should not be excluded from the outset: Despite all the prophecies of doom, dentist Annett Böljes decided to open her practice in the immediate vicinity of Bremen Airport – in a former car rental company. And look at this: the combination of concept, location and interior design works.

In a specialised pediatric dental practice, treatments under general anaesthesia are often unavoidable (Hagemann et al. 2006). These procedures are best carried out in our own rooms with wake-up facilities. It is important that the “operating rooms” are accessible without barriers. It makes sense to place these intervention rooms near the exit of the practice so that the treatments can be carried out undisturbed and the parents can leave the practice directly after the recovery phase.

A treatment room for children should not look like the one for adults, because many things are frightening for children. This means: Keep away from the sterile white colour or the “apple greens” frequently used in dental surgeries in children’s treatment rooms.

And do without the apple greens.

Instead, you can use warm colors and tones (Einwag et al. 2008). Awaken the children’s interest through the furnishings and accessories, as this increases the chance that they will enjoy entering the treatment room (Beckers-Lingener 2011). So-called pedoliegen have proven themselves due to their child-friendly design and smaller size. In addition, they invite the child to climb up a small staircase. The dental instruments (turbine, dental calculator, contra-angle handpiece, etc.) and the tray can be swivelled out of the chair body after the child has taken up the lying position.

A structured approach is essential for the success of dental treatment of small children. At the beginning, a comprehensive recovery plan should be drawn up and discussed with the parents in advance so that the valuable time window in which the child is cooperative and attentive is not “wasted” during the treatment session. Meaningful x-rays are obligatory. Furthermore, it must be clear in advance whether steel crowns are to be inserted after a pulpotomy or whether aesthetic full zirconia crowns are to be integrated at the parents’ request so that the child or parents are not disappointed after the treatment.

After a thorough cost-benefit assessment of different restorations in the milk dentition, the so-called “desired services”, it is absolutely necessary to clarify the costs and the consent of the legal guardian in advance of the treatment. We recommend that parents be present in the treatment room, but ask them to behave more calmly so that the child’s attention is drawn to the practitioner and not to persuading the parent. Only in this way can targeted behaviour be successful (Marcum et al. 1995, ASDCJ 1972).

The children’s treatment is aimed at quadrant rehabilitation, i.e. a complete quadrant is systematically treated in one session. It is advisable to start with the quadrant with the smallest carious lesions.

Pain elimination is the be-all and end-all

Treatment is additionally facilitated if infiltration of the upper jaw instead of anesthesia of the lower jaw is started (Koch Poulsen 2009). Local elimination of pain is a major criterion for successful treatment of children (Nakai et al. 2000).

The technical equipment of a modern treatment for children includes children’s crowns (Randall et al. 200), haemostyptics (E-III sulfate), wound dressing materials (ZOE / MTA), filling materials – preferably a compomer (Splieth Santamaria 2014) and a set of fixed placeholders. Silicone bite blocks to support the mouth opening, small coloured suction cannulas, a tasty surface anaesthetic and rubber dams in bright colours are helpful.

The “tell, show, do” technique (Eaton et al. 2005, Machen 1984) is quite successful and well-known in the behavior of children. However, it turns out to be difficult when video distraction occurs at the same time due to the often trance-like state of the child during the film.

Active behavioural guided tours can be used in simpler, quieter spaces, as can the telling of “dream or trance stories”. The treatment of an infant should last no longer than 20 minutes and end with a reward appropriate to the child’s age.

Conclusion: The dental treatment of children can be positively influenced by a child-friendly environment. Even if no children’s dental practice has been set up specifically for this purpose, a child-friendly treatment room with few accessories and aids can create a suitable treatment atmosphere.

The exact diagnosis, a comprehensible planning before the treatment and a pedodontic instrument are essential for the success of the pediatric treatment. In addition, the dentist should master minor behavioural practices.

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Christina Cherry
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