Many children are afraid of treatment by a dentist. However, if the first visit to the dentist is well prepared, he will be relieved of much of his horror. Important roles are played by the parents and a sensitive dentist with his practice team.
Most children do not become acquainted with the dentist until they have toothache. But then not only the treatment is unpleasant – also the unknown persons, rooms, equipment, smells and noises are frightening. The child will not like to think back to the first visit to the dentist and the treatment and may only take a seat in the examination chair in the future with a lot of effort.
The treatment of children requires a lot of empathy: the dentist and his practice team have to put themselves in the shoes of the little patients and adapt the treatment to the child’s age. All this is best done in a relaxed atmosphere.
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Trial visit to the children’s dentist
The earlier the child gets to know the dentist and the practice, the more impartial he or she will be when it comes to regular examinations and treatments. If there is no specialised paediatric dentist nearby, this can easily be the dentist to whom the parents also go. Parents can first take their child there for their own check-up. In this way the child learns that a visit to the dentist is an everyday occurrence and does not have to be associated with fear. Even if they only stay in the waiting room and do not yet come with the treatment room, they can get to know the surroundings, sounds and smells. Usually, however, the curiosity is so great that the children accompany their parents to the treatment room, get to know the dentist and experience the treatment.
However, it is important that the parents themselves are not anxious patients. They should be able to radiate self-confidence, calm and trust to the treating dentist during the treatment. If this is not the case, the child should better stay in the waiting room.
When should the child go to the dentist for the first time?
At the latest when a part of the milk teeth has broken through, parents should arrange a first independent dental appointment for their child. Paediatric dentists even recommend that you take your child to a preventive check-up from the very first milk tooth. In this way, the child can gradually grow into its role as a patient on the dentist’s chair and experience the visit as something normal right from the start.
The first visit to the dentist with the child also provides important information for parents. The dentist and the practice team will give you useful tips for the right dental care for your child. Questions about the use of soothers and bottles, the use of fluorides, malpositioned teeth and healthy nutrition can also be answered.
The child should be prepared for the visit already at home: The parents explain the process in small games or with the help of the cuddly toy. Both frightening, negative remarks and euphemistic statements (“That doesn’t hurt at all”) should be avoided. It is better for parents to refrain from overly detailed descriptions of the processes and various instruments.
What makes a good children’s dentist
The dentist may also discuss the first appointment with the parents in advance and explain what the little patients and the accompanying person can expect. Many pediatric dentists and their practice staff are specially trained in dealing with the young patients. For their treatment, they use special behavioural psychological methods for children and explain their work in a language suitable for children. Parents can also point out possible fears of the child and ask for different treatment methods.
Parents should take enough time for the first visit to the dentist with their child. It is important to be restrained as a parent – the child is the centre of attention. The child is the first to be greeted and, if he or she is old enough, can go to the treatment room alone with the dentist or assistant. In the case of very young children, the parents go with the child, but should be restrained and not constantly try to mediate between the child and the dentist.
During the first visit, the dentist and child can, for example, examine a cuddly toy that they have brought with them. The paediatric dentist can also explain the various instruments and how they are used in the mouth in a child-friendly way. During the first visit to the dentist, it does not matter whether the child can only be examined or whether treatment in the true sense of the word can already take place.
Parents should also avoid promising the child a reward after the visit to the dentist. This could put too much pressure on the young patient and make treatment more difficult.
With toothache to the paediatric dentist
Such a gentle approach is not always possible. Sometimes a child comes with toothache and must be treated immediately. Older children are quite capable of recognising that it is time to drill and that this can hurt.
A good paediatric dentist gives the young patient the opportunity to influence the treatment, for example, whether a drill or a hand tool is used, whether drilling is done with or without water flushing.
A good paediatric dentist also arranges certain signals and gestures with the child when it hurts or when a break is needed. In the case of smaller children, the dentist is dependent on the cooperation of the parents.
Calming and anaesthesia for children
In children, there are various ways of anesthetizing and calming to prevent or reduce excitement and pain during treatment. This is especially important if you are a very anxious child.
The dentist has the following options for a painless treatment of children – if he does not offer this on his own, parents should actively inquire:
Anaesthetic injections have become standard in the treatment of adults and are also used in children. In order to make the injection of anaesthetic injections as painless as possible, a pleasant-tasting anaesthetic gel can be applied to the gums beforehand.
A very painless method of caries removal is laser treatment. These special dental lasers work with high-energy light and without disturbing loud vibrations. Small surgical interventions in the area of the oral cavity can also be performed with these lasers.
Particularly anxious or uncooperative children can make dental treatment very difficult or even impossible. They are often sedated with a sedative. The medication makes them sleepy and minimizes anxiety. Often the children cannot remember the dental treatment afterwards – so they do not associate negative feelings with it. The drug is often administered in juice or tablet form and the child should be monitored by an anaesthetist during sedation.
A general anaesthetic is advisable for treatments that take longer or require several sessions (e.g. extensive caries removal). In this way the child is not unnecessarily or repeatedly put under stress.
An alternative to general anaesthesia by intubation is the use of laughing gas via a nose mask. The nitrous oxide used has a calming and anxiolytic effect. The sensitivity for pain decreases strongly, also the gag reflex is extremely reduced. During the treatment, however, the child remains responsive and can cooperate. Laughing gas can also be used for longer treatments, an anaesthetist does not have to be present.
Not all possibilities of the painless treatment of children are paid in every case by the legal health insurance companies. Before a possible treatment, parents should inform themselves about the costs at the pediatric dentist.