Professionalism in paediatric dentistry

paediatric patients
‘The key rule is: treatment should only be carried out if it is in the best interest of the patient.’

Amardeep Singh Dhadwal provides you with top tips for when treating paediatric patients.

A magical journey

Try to make a child’s dental journey magical. As a paediatric dentist, you have the opportunity to create a positive dental experience, environment and opinion for your patients.

Whilst you should always strive to accomplish this, be prepared for changes in behaviour. You may find that a child who is completely compliant and as good as gold in the first appointment may decide that they no longer want to comply at the subsequent appointment.

This reiterates the importance of establishing a good rapport, gaining a child’s trust and creating a friendly and fun dental atmosphere. One way of achieving this is by tailoring your history-taking process to get to know each child as an individual.

For example, this could involve asking the child about their favourite television show and using this to initiate conversations. Another great tip is to change the names of the instruments: the mirror can become ‘the magic mirror’ and the probe can become a ‘walking stick’ – use items that a child can relate to.

The bigger picture

Think about the bigger picture; understand a child’s lifestyle as well as their teeth. When treating paediatric patients, it is often easy to play the ‘blame game’ – particularly in children with multiple carious lesions and a highly cariogenic diet.

Whilst parents do have a responsibility to ensure that their child follows a sufficient oral hygiene routine and consumes a healthy and balanced diet, they may face factors outside of their control that influence their ability to supervise their children, feed them accordingly at suitable times and, in many observed cases, afford dentifrices and toothbrushes.

This is where empathy becomes crucial as there is a greater need for you to sit alongside the parent, to identify oral hygiene related and dietary factors that increase the risk of caries, and to use your findings and observations as a springboard for a helpful and fair discussion between the parent, child and yourself. This can be used to create a well-formulated and personalised treatment plan that is reasonable and suitable for an individual case.

Crystal clear

Be crystal clear on paper and in person. Obtaining informed consent is equally as crucial when treating paediatric patients as it is for adult patients. It is an issue that undergraduates find particularly daunting but, with a few quick pointers, your doubts can be put to rest.

The key rule is: treatment should only be carried out if it is in the best interest of the patient. Once this has been determined, consent is obtained from the person who has ‘parental responsibility’ over the child unless the child is deemed ‘Gillick-competent’.

Written consent is equally as important as verbal consent and all written documentation must be filled out neatly, legibly and accurately with a clear breakdown of all treatment options, alternatives, risks and benefits. Try to avoid using jargon as consent should be comprehensible for parents and they should be able to refer to written documentation at their own discretion.

Children are more aware of their surroundings than it is often assumed. Consequently, it is fundamental that they are provided with a suitable ‘child-friendly’ explanation of their treatment.

This should involve a discussion of what is being carried out and why; for example, a description of caries removal could be ‘I need to use the buzzing bumble bee to remove those naughty bugs inside your tooth.’ Finally, as a paediatric dentist, you can influence a child’s ‘dental destiny’: focus on prevention, provide first class restorative treatment and promote a positive dental experience and environment.

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