Unlocking dental confidence in children

Sarah Mack shares her tips for adapting your dentistry to young patients to create dental-confident children and tackle the childhood oral health crisis.

We all do our very best to nurture our little ones – not too much screen time, try to get them outside as much as possible, make sure you’re hiding vegetables in every meal. We feel pressured to make sure they are attending the correct clubs, the best schools and wearing the best clothes.

Yet as a population we are failing in one area: making sure they have good dental health. Specifically, remaining decay free in their primary dentition.

In 2013, more than one third of children under five had experienced decay. This steeply rose to almost 50% by the age of eight (NHS, 2013). Sadly, over 10 years later these statistics have worsened. We are experiencing waiting lists of over 18 months for children to be treated in secondary care settings in the NHS.

As clinicians we are all too aware of the devastating impact dental pathology can have on children. Worse still, the most common barrier to seeking treatment is dental phobia. The ability to gain the confidence of a child and their family members to ensure they return for their recommended recall poses a challenge in itself. Rapport building takes time, confidence and patience.

However, there are some simple things we can do within our clinic settings to unlock confidence in the child. You can also develop your confidence in your own ability to make their experience a positive one they are happy to repeat.

Laying the foundation

In the event of a diagnosis and treatment being required, the foundation should already have been laid. The provision of an ‘about your child’ form when the child is registered will allow you to quickly gain rapport with the child. The form should collect specific information such as hobbies, favourite colours, phobias and history of previous dentistry. This will be your armoury to avoid repeating any past issues.

Another suggestion is reducing barriers to attendance. For example, always ensure there are after school or Saturday appointments available. You should also allow for lateness on occasion.

Before I had children, I would be exasperated at late arrivals. I didn’t understand how people could possibly be late for an examination. Now with two toddlers, getting out of the house on time is like mobilising an army for battle most days. So please think twice before you feel inclined to say, ‘too late, please rebook.’

Use your imagination

When providing treatment, make it exciting! The dental chair is a wonderful opportunity to use your imagination – space ships, planes, helicopters. Create a story about what exactly you’re going to do before it happens.

Show them on an oral health toy or large set of demo teeth what you are going to do in a language they can understand. These are also good aids to showing children (and their parents) areas that are being missed when brushing or good brushing technique.

Provide some fun sunglasses and give the children choice as to what they would like to wear. This is giving them the decisive power and therefore the confidence in an environment they are not comfortable in. Reassure them and praise them for every small goal they achieve.

The provision of an inexpensive gesture such as a balloon, badge or branded toy is also simple but effective. This reinforces a positive message about their visit and can be an ideal practice marketing outlet.

Supporting parents

Include the parents in the treatment phase, but try to alleviate their time by the chairside. In my experience, parents often exacerbate a concern more than helping it. Use your wonderful team to help give them confidence.

Recognise the importance of post-treatment care and support (for the child and parent!). Give out information sheets to reassure them about what to expect following treatment and provide pain relief advice. Schedule a follow-up call after treatment if you feel it’s helpful.

When all else fails

When barriers to treatment are too great and there are issues with the provision of dental treatment in primary care, my advice would be always try first but don’t exhaust the situation. If a child is non-compliant, close the window of opportunity on this occasion, end positively and explain to the parent you’ll give them a call to explain options moving forwards. Be positive and do not make anybody feel like its been a waste of appointment. You are trying to make sure this small person has a great experience regardless of treatment outcome.

Perhaps a dentist in your practice could offer inhalation sedation to enable especially anxious or non-compliant children to access the dental treatment they need. If this is required and not possible in your practice, consider referring to a clinic offering paediatric sedation.