Dear Barry – I have a few young patients that seem nervous even before they step through the door. That’s something I struggle to overcome, so can you offer any tips?

How a child perceives the dentist will stay with them for life. Arguably, the vast majority of adult patents who exhibit fear when attending the dentist will have had a bad experience in childhood. Whether that perception is fair given the circumstances is entirely irrelevant; their anxiety is real, now.

So, how we look after those children today will help to direct their beliefs and behaviours about dentistry in the future and, long-term, this will have an impact on the health of the nation, the dental profession, and the dental team’s ability to run a successful business.

In line with this last point, it’s worth noting, almost as an aside, that how a child reacts to the practice will affect their parents’ willingness to return – for themselves or their child.

Making positive changes

It’s easy for me to write that communicating effectively with children is an important skill to develop and build upon. But how do you go about making positive changes?

In my opinion, the key to success is to find your ‘inner child’, because it allows you to build rapport with them on their level. When a child comes into the practice, I make myself more like them. I might become a bit more playful and even cheeky; I try to make them laugh and feel comfortable.

Many children are accompanied by their parents. In fact, in my experience, very few parents remain in the waiting room. This can be great in terms of providing a child with comfort, however it is important you engage with the child and not the parent. Talk to children using language they can understand and that isn’t scary; parents can learn about any preventive care or treatment needed at the same time.

As an example, if I need to administer local anaesthetic to a child, the first thing I do is say that I am going to rub yummy bubble gum-flavoured gel onto their gum, show them what I am going to use, and that they will feel pressure in that area but no pain.

Note that if you keep in mind the technique of tell, show and do, you won’t go far wrong.


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Distract and act

Distraction techniques are also great for patients, irrespective of age. So, I might ask a child to try to wiggle their little toes without wiggling their big toes; this way they turn their attention down to their feet. At the moment I’m asking them if they can do it, that’s when the needle goes in!

Why? Well, there is a well-known anecdote of a footballer breaking his leg but playing on because his focus and attention was on completing the match. Likewise, a colleague I lecture with fell off his bike while riding to a concert in which he was due to play the oboe. He fractured his hip, but he got back on his bike and rode for another five miles trying to get to the concert before the chain then came off his bike. It was only when his attention was draw to the chain over the concert that he felt the pain. So, what we know is that by distracting someone we can change their perception of pain.

The ‘gate theory of pain’ is worth taking into consideration here, too; in the circumstances mentioned above, this works by rubbing the area that is going to injected before the ‘jab’, stimulating the nerve’s signals to travel faster than they would otherwise. Thus, the child feels the rubbing sensation rather than the mild discomfort of the needle.

Once you have built rapport and trust, these families will be come to your practice for life! What more could you and they ask for?