Pediatric dentistry: principles and clinical practice

Pediatric dentistry is the branch of dentistry dealing with children from birth through adolescence. Each general dentist office has different policies concerning pediatric patients seen in their offices. If you could write the policy for pediatric patients what policy would you put into effect? Also write about any experience you have had concerning a scared child, special needs or etc. Please include behavior management techniques.

No one likes dentists, children least of all. Yet, in order to have children cooperate with the treatment, the dentist needs to find some effective methods to deal with their pediatric patients, and these, for maximum effect, would be based on behavior management techniques. The dentist's goal would be to ease fear and anxiety whilst promoting an understanding of the need for excellent oral health. The dentist who treats children should have an arsenal of behavior modification techniques at her bey, particularly since she may have to deal with reluctant and oppositional children who will test her patience to the hilt. Her communication skills, attitude, and manner will go far in alleviating the fear of the child. But she needs practical strategies too, and this essay will give us three such policies: show and tell methods; voice control, and nitrous oxide/oxygen inhalation. Use of these strategies would make the dentistry procedure a far more satisfying and helpful experience for both adult and child.

A long time ago, I saw a scared child of possibly eight or ten years, placed in the dentist chair. The child resisted. The grandmother pleaded; the dentist cajoled, and the child became more and squirmier until the dentist, in frustration, began his treatment. The child bit his hand. The dentist yelled. The drill pierced the roof of the child's mouth causing her to need medical treatment. The dentist chair is traumatic for the child, and no parent -- or other family member (or anyone for that matter) enjoys talking a child to the dentist. It takes a wizard or witch to placate the child, but with behavioral techniques, some solution can be found.

Three different ideas that can be shaped into policy are the following:

1. Tell-show-do behavior - Tell-show-do techniques and behavior should be a component of every dental office. This is important for adults and particularly so for children who tend to mentally exaggerate and bloat phenomena.

The technique is divided into three steps:

a. The dentist tells the child what she is going to do. Each step is broken down and the recounting is on the developmental level of the child

b. The dentist shows the child -- for instance showing the child specific tool with which she will do procedure

c. Completion of the procedure will come whilst dentist is showing and telling so that the child is with the dentist every step of the way.

All of this too is done in a gentle, compassionate manner on a level of the child's understanding.

The objectives of this policy are:

a. To familiarize the child with the dentist setting and eliminate fear

b. To shape the patient's response to the procedures with desensitization and explanation.

2. Nitrous oxide/oxygen inhalation -- This is a safe and effective technique for alleviating anxiety and for fostering communication. The onset of action is rapid, the effects are easily reversible, and recovery is complete. Nitrous oxide/oxygen inhalation also helps with analgesia, amnesia, and gag reflex reduction.

This step however should take particular patient into consideration and there are guidelines too on how to administer it. Directions are found in the Guideline on Use of Nitrous Oxide for Pediatric Dental Patients.

3. Voice control -- All dentists should train their practitioners to learn specific communication strategies and modulate their voice when speaking with child. Voice control consists of volume, tone, or pace to influence and direct the patient's behavior.