I don't typically write about work on the blog. In fact, I rather like to keep it separate from what I consider to be my "fun". But...there have been some experiences at the office lately that have made me realize that maybe a little Public Service Announcement is in order to help some clueless parents wake up. The basic premise of this post - think before you speak and follow the golden rule (you know, do unto others as you would have done unto you).
In my practice I see a lot of kids. A LOT. I would say nearly 80% of my day is filled with patients under the age of twelve. I enjoy that. Kids are usually a really fun part of my day. What I don't enjoy is when an ignorant parent ruins the child's experience with me before it even gets started, making it more difficult on everyone involved.
Nearly every child has some form of an innate fear of or nervousness around medical professionals. That's just the way it is. Things are foreign and scary. I expect that. But that small level of fear is typically easy to work through by building a little trust. In our office, we call this tell, show, do. Basically I tell the child what I'm going to do, show them what I'm going to use (sometimes demonstrating on my hand or theirs) and then we actually move forward with the procedure. This takes away a lot of the unknown and a good majority of kids learn quickly that we are there to help them and that sometimes it can even be fun to go to the dentist.
But...then there are the other, let's say 10%. These children are ruined for me. I will never gain their trust. I will never be able to work on them with everyone in the room being calm and comfortable. In fact, I may not be able to work on them at all. I may have to refer them for sedation dentistry or it may take me years to get them to trust me enough to even lay back in the chair. Why? Because these children have parents who have increased their fear and made the dental office a bad place to be.
There are three typical scenarios for this problem :
1. Mom or Dad had a bad experience as a kid or is phobic as an adult - and they share this with the child.
Okay...you had a rough time at a prior visit. Maybe you couldn't stay numb. Maybe you had a tooth that was in a lot of pain before getting worked on. There are unfortunate bad experiences out there. But please don't poison your child's idea of what it will be like.
Don't tell them "when Mommy was little it really hurt to go to the dentist and he/she was really mean." Really? Your kids trust you. They're going to believe you over me. If you're telling them that dentists are mean before they even meet me, what are the chances they even want to let me lay a finger on them? I'll tell you: slim to none.
2. Parents threaten their child with a trip to the dentist if they don't brush their teeth.
Please, please don't threaten your children in order to improve their oral hygiene. Don't tell them that if they don't brush they'll have to go to the dentist and get a shot. Are you kidding me? How would you react if someone said that to you? Imagine going in to see a physician for some ailment that needs treatment via surgery. What if the physician said to you "this procedure is really going to hurt - a lot. You're going to be totally miserable and I'm going to be really mean to you"? Would you want the surgery done? Of course not! You'd be reluctant and nervous.
THIS is what happens when you threaten your child. If you want to motivate your child to do a good job on their oral hygiene, help them, teach them and reward them. (All children under the age of seven need some assistance from adult. Some children will need help or "checking" into their preteen years.) Teach your child why it is important to have good oral hygiene. Let them know that leaving food on their teeth can let tooth bugs make holes and that once the bugs have made those holes, the tooth won't heal itself. It will be broken. Let them know that they need those teeth for many years to eat all the foods they love and they have to keep them safe. Don't threaten them with a painful procedure.
3. Children are incorrectly prepared for having treatment.
If I diagnose a cavity and you tell them on the car ride home that they're going to get a shot and it's really going to hurt, it no longer matters what else you or I have to say. All they have in their little heads is that the next time they set foot in my door, I'm going to hurt them.
I am not sadistic. I do not get pleasure out of torturing my poor little patients. I do not relish in their pain. Quite the opposite actually. The philosophy of my office is to never force a child to do something they don't want to do. The very rare exception to this rule is if I am involved in the procedure to a point where leaving things as is will cause them harm. At that point, we have to finish. But if we're seeing a patient for a cleaning and they are terrified of leaning back in the chair, we work with that. There is not force, there is no threatening. There is only reward. Positive reinforcement is the way to go. If a patient is a helper for me and we finish what we have planned, then they get to pick a prize. Most of my patients love that. The prize is a good motivator. Help me by doing the same. Use praise, not fear. If a child does get a cavity, it's not the end of the world. We'll fix it. They just have to work harder on keeping their teeth clean next time. Healthy teeth are happy teeth.
The key to keeping your child from being afraid of the dentist (or other medical professionals) is to talk on their level. If you're going to talk to them about a procedure, use what we call "soft language". Sure, you can prepare your kid for their filling appointment. But tell them that we're going to give their tooth some sleepy juice or that we're going to give it medicine to make it numb. Think before you speak. Don't say we're going to use a needle to give them a shot. Honestly, when I hear this come out of a parent's mouth, I just want to smack them across the face. Thanks. You've now managed to ruin the appointment for your child, my assistant or hygienist, and myself. We have done this hundreds of times. We know what we're doing. Trust us when we tell you how to approach these things.
Bottom line - do you want your kid to be happy or terrified? The majority of the outcome is up to you. Is there the possibility of a bad experience? Of course. Unfortunately they do happen. Are there still going to be some children terrified of the dentist even if the parents have done everything right? Yes. This does happen and sometimes it is very hard to work through.
I can't speak for all other providers, but I know that in my office we work very hard to prevent bad experiences. We listen to the child. We let them guide us in what we can do. We involve them, we teach them and we encourage them. The end goal for me is always a patient who will have a lifetime of good oral hygiene and good dental experiences. Having happy kids in my chair is what really makes my day worthwhile. There's nothing better than going to get a six-year-old from the waiting room and having them yell for everyone to hear "I love the dentist!" (And yes, this has happened.)
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