Family Forum / Parenting / Parenting / May 2008

Pediatric dentist.  My kids were both frightened of dentists, but they did
fine at the pediatric dentist, who had all sorts of kid-oriented things
around.

Would she be able to talk about what she thinks happens at the
dentist's, and *why* she's scared?  If talking about it directly is too
difficult, do you think she'd be able to draw a picture about it that
might help express her feelings/get her talking?  Or have a game where
her dolls go to the dentist and she can use that to act out what she
thinks will happen?  I've heard of people using those techniques to get
children talking, and, since Alli's so bright and imaginative, it would
be worth trying.  If you can find out *why* she's frightened, that in
itself might help with reassuring her.  The games might also help to
give her more idea of what will happen and help her feel more in
control.  You could also try telling her stories about a little girl who
goes to the dentist and is very scared but is brave enough to go and
finds the dentist isn't that bad.

All the  best,

Sarah

Is she sensitive to noise? My son never objected to visiting the
doctor but he used to hate the dentist because of the whining whirring
noises from dental equipment being used while he was sitting in the
waiting room. It doesn't seem to bother him so much now he's older.

All the best,

Cailleach

    It's a tough call, and one that only a parent can
ultimately make based on all the particulars and some pretty
in-depth knowledge of the individual child.  That said, what
I would usually do in that sort of situation is insist on going
forward.  Although the cat's out of the bag, I'd make no more
mention in advance of the appointment.  You might need to push
the appointment out a little ways.  When the time comes, talk
her through it firmly, but with every expectation that she
will do just fine.  If need be, work out strategy with the
dentist in advance.
    I think with some kids there's a very fine line to
walk.  In some cases, it's a phase or some other transitory
issue and you can afford to take a step back and wait.  With
other kids, their imaginations run amok and generate a lot
of fear, and you totally play into the fear and, in fact,
increase it by letting them off the hook.  If it wasn't that
bad, why would you let the child back out?  It must be *really*
bad!  It also reinforces the tactic:  if you're afraid of something,
make a huge fuss and mommy will let you off the hook.  Follow
that pattern, and more and more things will be fear-inducing
and require backing out of.  This pattern can be incredibly
destructive long term.
    In my experience, one of the most powerful things
for building trust between parent and child is finding a
way to support your child through difficult experiences.
We don't ever wish for those difficult situations to come
up, but when they do, I think it's important how we deal
with them.  You want her to come out the other end with
an experience that teaches her that 1) she can do it;
2) her mother's confidence in her abilities was not
misplaced; 3) her mother was truthful about what she
experienced; 4) her mother was an effective support
during the process.
    I'm not saying that every fear must be faced
head on.  For example, if a child was afraid of riding
a roller coaster, I probably wouldn't push it.  What's the
point?  I'm not aware of any requirement that one must
ride roller coasters.  Some people enjoy that sort of
thrill and some don't, and that's a personal preference
that should be respected.  Going to the dentist, on the
other hand, is necessary.  One might negotiate things
like which dentist, whether mom stays in the room or not,
whether there's a signal to ask the dentist/hygienist to
stop for a moment, etc., but not the fundamental issue
of whether there will be a cleaning and check-up.

Best wishes,
Ericka

The recommendation I was given was that, unless there appears to be a
problem, it is unneccessary for a child to see the dentist until they're
about 5yo. They suggest you take the child to the dentist from earlier to
"get them used to it" at our practice. #1 loves the dentist, and #2 doesn't
mind, but sits on my knee while the dentist "counts her teeth". But #1
didn't like the dentist until she was close on 5yo.
In your child's case, seeing as it's causing her so much worry, unless you
think there's work to be done, I'd cancel  the appointment. If there's
something you're worried about I'd ask the dentist (as you know her as a
mum) if you could see her informally, not in the dentists room.
Meanwhile, take her when you have your teeth checked (but not treatment) and
maybe she'll allow the dentist to see "what nice teeth she has" one day and
you can work from there.
Debbie

Fred Rogers book about visiting the dentist could help.  You could
also have her pretend to be a dentist and examine your teeth.

My daughter had a great stranger anxiety and was very shy, so it was
important to us that we find a dentist that allowed parents in the
exam room with the children. She felt much better when I told her that
she could lie on my chest and I'd hold her tight and be right there
with her -- that we would do it together. My daughter, however, had
cavities early on from her teeth not calcifying correctly, so she was
having work done from the getgo. I know this is unorthodox, and I was
surprised by it myself, by heh, if it works, ya know?--our dentist has
their family dog in the office with them and she comes and lays next
to the kids' chairs, and since my daughter was and is a huge animal
lover - it was a great thing for her. Within a year of multiple visits
(we used the amalgam fillings that fell out every few months and
needed to be replaced), she could sit in the chair all alone and not
even have to have me in the room with her. She learned to trust the
providers.

I avoided the pediatric dentists because I've heard some horror
stories. They won't let parents be with their children, they have
papoose strap devices to strap the kids down, etc. and I don't go for
that. I realize there may be some parents out there who might harm a
provider if it appeared they hurt their kids or something, but those
of us with common sense, which are the majority, know how to console
our kids and how to get them to cooperate. Even if they required
strapping down, a parent should be present too. Most just feel better
hearing mom's voice whispering "You're okay. I gotchya. Almost done.
You're doing a great job. You're so brave." or "Hold my hand and
squeeze it if you need anything."

We decided to go for the caps on 2 of my daughter's 6-year molars that
didn't calcify correctly before any decay occurred, because once it
starts on those teeth, it can go bad very fast. Our regular dentist
couldn't do them on an 8-year-old and referred us to a pediatric
dentist, but when I asked him which one was the most patient and
easiest to work with at that group, it took him far too long to choose
one. I got out a book and started calling. Capping teeth is far
different than getting a filling or a cleaning. I found a pediatric
dentist that would allow parents back there. They had me drug my
daughter before the visit, and she was out of it for a whole day. I'm
still not liking how that affected her and will have to tell anyone in
the future that she must be extra sensitive to the dosing or
something. Anyway, she was alert to the work they were doing to her
and I sat at the bottom of her chair rubbing her foot to let her know
I was there. The assistant held her hands down whenever she tried to
move, so I explained that she was taught to hold up a finger in a just-
a-minute fashion if she needed to swallow. At one point, that dentist
yelled at her about trying to lift her hands, which is when I told him
that. He could have been more patient, and I'd hate to see how he'd
treat her had I not been there. He got up and walked out at one point
without any explanation when she said it still hurt. (it takes me 2
shots and about 30 minutes to numb up, so it wouldn't be uncommon for
her to be the same way).

Play dentist with her and show her what the dentist will do (i was
told they don't do x-rays this young unless there is a potential
problem) -- clip a papertowel over her chest, lay her back, point a
flashlight in her mouth, put on some goggles, buy her some cool or
funky sunglasses (for dentist trips only to keep that bright light out
of her eyes, explain how they will use a pointy tool to take off any
sticky stuff from her teeth and that it doesn't hurt, but you can feel
it going over your teeth, and take a pencil and show her how they will
let her pick a flavor of fluoride to put on something that looks a lot
like that, but theirs spins and tickles a little, and that when she is
done, her teeth will feel smooth she won't be able to keep her tongue
off of them. lol. With the internet available these days, I might also
find some pictures of what might happen if you don't let the dentist
take a peak and clean your teeth - because this is why we go sort of
thing. kwim?

If that dentist is a good provider, she'll be ready at trying to make
your daughter feel as safe and secure as possible before just going
for it. Our's did. They might take the spinning thing and let her hold
it, push a button to spin it, and let her touch it with her finger to
feel it before putting it into her mouth. They might even let her hold
the device that sucks out the water and saliva when they are working
and let her do it herself...stuff like that.

Ring the dentist -- they will have some suggestions.  But sometimes it just
happens.  DS1 has always been perfectly fine with going to the dentist, but
DS2 is perfectly fine right up until he's put in the chair for the dentist to
"count his teeth"... then he shoves both hands over his mouth and starts to
cry!  Then he began to develop a problem -- there was a malformation of the
enamel on one tooth and I could see it starting to decay, but the little
monster still wouldn't cooperate with the dentist.  

I was referred to a nearby paediatric practice which my dentist assured me was
the best in Sydney.  Well, we went there, and it had the same positive
atmosphere as our regular practice, just groovier colours!  And DS2 was fine
right until he saw the dentist's chair!  Hands over mouth and howls again!

The specialist had a chat with him but he continued to howl.  So we forced the
issue:  DS2 sat on my lap, facing me, and he was then laid back onto the
specialist's knees while I held his hands.  The dentist was able to work but
DS2 could see me the whole time and he wasn't in the chair at all.  At the end
(and it was all of two minutes' work), DS2 was happy to shake the specialist's
hand and take a souvenir toy.  The specialist said he felt that it was OK to
force things in DS2's case because DS2 wasn't actually very scared:  this
practice specialises in children who have been traumatised by other dentists
(or, I suppose, other experiences), and who can be almost catatonic with
terror.  With them, they must go very slowly indeed.  

Obviously, this specialist made a professional judgement that went along with
my feeling about DS2.  I suspect, though I could be wrong, that DS2 might be
perfectly fine the next time we go to the dentist -- but the specialist has
advised that DS2 not be asked to do anything next time except maybe have a
ride in the chair if he likes.