You either love them or find them challenging, but treating children can be one of the most rewarding aspects of dentistry. For every penny that we have heard ‘I had the worst experience as a child…’ we would all be millionaires.
On a serious note, it is vital to portray a positive image of dentistry to a child at an early age. We believe that the image of dentistry for children needs to be presented in a positive light in order to ensure continuing good oral health through their life.
Having completed various posts including rotating at Great Ormond Street, Harley Street and paediatric community care, we have come up with these tops tips which, we may have learnt the hard way.
1. Tell, show, do
Easier said than done in some cases – especially if they turn up at a young age with raging toothache. We all learnt it in some form at university, however its importance becomes clear in practice. In order to build a rapport with a child you need to be flexible to ensure that they understand the message and advice that you are giving.
Research shows that children learn with different senses, so some relate better to touching, seeing or feeling. As a healthcare professional, you need to engage in each of those senses to make sure the child isn’t intimidated by you or your surroundings. Ultimately this will ensure that you are able to build a relationship with the child.
An example of ‘tell, show, do’ would be to introduce the patient to the different instruments that are used; these can look very frightening.
For example, you could tell them about the 3-in-1, explaining that it is like a magical wand and show them how it works by blowing cold air or spraying water into the spittoon, and then by using the 3-in-1 during your clinical exam. This acclimatises them to the environment and instruments while allowing you to conduct your examination effectively.
This is probably one of the most important points because this sets the standards of how effective your communication skills are with the child. Your ability to assess what tone, type of language and delivery of information is a life skill that you will develop as you increase your clinical practice. We are so used to dental jargon that even adults can get easily confused, therefore for a child it is imperative to make sure you give them the required information effectively.
Changing language doesn’t mean you fabricate the truth, but tell the truth in a child-friendly manner. The commonest situation this comes up in is when giving local anaesthetic (LA). It is easy to say ‘it’s not going to hurt’ or ‘it will only take a second’, but the moment you go against what you said the child will lose faith in you and anything that you do here-forth. A way we have worked around this is telling the child to close their eyes as we are putting their tooth to sleep, and when administering the LA we inform them that we are hugging and pinching the tooth before it goes to sleep.
A few examples of child friendly alternatives that we commonly use are:
- Cotton wool rolls: tooth pillows
- Fluoride varnish: nail varnish for teeth
- Dental light: sunshine
- Suction: vacuum
- Dental mirror: selfie-stick.
At the same time if you have quite a mature child please avoid patronisation – it does not go down well.
The best part of a child’s visit to the dentist is the reward. This goes without saying, but please avoid sugar-containing treats as this defeats the purpose of their visit.
We find in practice and community that the child veers towards the sticker packs on arrival, therefore it is a good motivation tool to get them through the examination/treatment. This is a way of positive reinforcement; therefore it is important to be used as an effective tool to commend good behaviour.
Good reward examples are:
- Diet diaries
- Tooth brushing charts
Rewards form part of the conclusion of the appointment, so ensure that the child is commended sufficiently, as the last part of the appointment is what we hope they remember the most. It will ensure that they come back!
4. Treat the child, not the parent
Those of you who know what we mean will understand that sometimes the barrier we face isn’t with the child but the parent. Effective communication and rapport with the parent can be challenging, but just as important as with the child. The majority of the time parents will appreciate the time and effort taken in building the relationship with the child.
Teamwork plays an important role in handling the child and their family, for example reception staff can entertain siblings, nurses can converse with parents whilst you engage with the child. You need to work within your comfort zone and if you find overbearing parents affecting your ability to treat the patient it is advisable to control the situation.
This can be done by kindly asking the parent if they mind waiting in reception for the patient or sitting on the side of the surgery, as their presence may be distracting.
Positive vibes will produce positive results. When treating a child it is important to enter their world, whether this be creating a fairy tale, magic or being an action hero. This can uplift your day as well as creating a brilliant atmosphere in your dental setting. This will help to improve the child’s outlook on dental treatment and in the long term help them maintain their oral health. Remember, we were all a child at some point, therefore we should all be able to relate to this.
In conclusion, children shouldn’t seem like a frightening prospect to treat. We should be looking forward to positively reinforce dentistry to the next generation and those after.
Shivana Anand is a King’s College London newly qualified dentist. She is currently doing her dental core training at UCLH & The Eastman in maxillofacial and oral surgery. She also works at Harley St Dental Studio part time. Shivana enjoys her role as an honorary tutor at Guy’s Hospital. She is the co-founder of Dental Training Consultants, which is a group that organises courses for undergraduates to aid in their dental foundation interviews.
Komal Bhabra is a King’s College London qualified dentist. She is currently working in Community Dental Services in paediatric and special care dentistry alongside general practice. She completed her dental core training at the Eastman Dental Hospital in oral and maxillofacial surgery. Komal enjoys teaching and has involved herself in undergraduate mock interviews and providing oral health education to primary schools around London.