Woo-Young Yoon explains how thinking out of the box can help to combat dental fear and anxiety in paediatric patients.
Many children struggle with dental fear and anxiety (DFA) related to a trip to the dentist. This calls for some creative solutions. The reasons for these feelings are varied, but addressing them is essential – for best practice, oral health and overall wellbeing.
Because of the diverse causes of DFA, paediatric dentists often face challenges in diagnosis, behaviour management and successful treatment outcomes of young nervous patients.
There are many techniques, either used independently or combined, that can help to manage dental fear. Behavioural management techniques include distraction, tell-show-do, acclimatisation and positive reinforcement, modelling, voice control and enhancing control.
Tooth extraction is still the most common hospital procedure in six to 10 year olds (OHID, 2022). General anaesthetics involve risks; therefore, all efforts should be made to try to avoid them. However, there may be no other option in some circumstances. Ideally, all efforts should be made to try to treat the patient using other adjuncts, such as conscious sedation.
Depending on the level of their cooperation, the patient may benefit from an adjunct such as inhalation sedation. Local anaesthetic alone may not be sufficient to treat the patient successfully in the chair.
For some anxious/phobic patients, including ‘pre-cooperative’ children, dental treatment may not be possible using behavioural and/or conscious sedation techniques alone. General anaesthesia may also be indicated if a large amount of dental treatment is required or because of medical problems and/or the complexity of the dental procedure.’
So treatment would be considered either:
- Local anaesthetic (LA) alone (which would not help for patients who are anxious as this is often what they commonly fear)
- LA plus inhalation sedation
- Referral for treatment under general anaesthetic.
Dr Woo-Young Yoon
Dr Woo-Young Yoon is a paediatric dentist for Love Teeth Kids, a child-focused clinic and the newest addition to dentist and entrepreneur Kunal Patel’s Love Teeth brand.
Located in the southwest London suburb of Worcester Park, the paediatric practice meets the specific needs of its young cohort. It cleverly includes a games station, a lounge area filled with toys from popular Disney films, and TVs strategically placed throughout the practice, all designed to help distract the most nervous children. The setting reflects Woo-Young’s ethos perfectly.
She also practises as a general dentist in Borough Dental Care. Her journey is fascinating. It began at King’s College London, where she honed her skills and passion for helping children achieve healthy smiles. After graduating, she trained in Sussex NHS Community Foundation Trust dental services for special care and paediatric patients. Her commitment expanded as she delved into community hospital work, focusing on easing patients’ anxieties. Woo-young’s tenure as a paediatric dentist allowed her to treat referred children and enhance her ability to plan and execute treatments compassionately.
Her dedication to continuous learning has since led her to the Eastman for an MSc in paediatric dentistry. Woo-young’s diverse experiences and specialised training in inhalation sedation mean her approach to caring for young patients is fundamentally holistic. Her core belief lies in fostering positive dental experiences early on, establishing a foundation for lifelong oral health. With her exceptional ability to connect with children to create a comforting atmosphere, she has made it her mission to make dental visits less daunting for children.
Here, Woo-Young shares her methods for shaping the best possible dental experience from a child’s first visit.
Building trust from the first appointment is essential
Young patients often don’t know what to expect, which can be challenging. If they do not wish to enter the surgery or allow an examination, we must make them feel comfortable. I often start a conversation with paediatric patients outside the surgery, in the playing or waiting area. This allows patients to become more familiar with me and the environment. Occasionally, it involves discussing oral care habits and nutrition. We also use our small dragon toy with teeth to practise brushing methods.
We also empower them to pause or stop if they feel overwhelmed. I prefer a gradual approach, introducing elements and giving patients that control. Positive body language, using appropriate voice control, embracing tell-show-do and positive reinforcement are all essential methods to help secure trust.
Speaking with parents/carers before an appointment helps meet specific needs or requirements before the patient is in the chair
Our excellent reception team are often the first to speak to the parent. They can leave notes for me on the file if I need to be aware of anything beforehand. From the moment they step into the practice to the moment they leave it, it is essential to ensure a positive experience. While in the surgery, it’s all about observing and listening.
Treatment plans should be tailored according to the level of cooperation and caries risk
Dental disease can mean a lot of treatment – so there are increased opportunities for an unpleasant experience. Therefore, it is essential to stage and plan how treatment will be done and what techniques will be used to ensure the patient does not suffer. Through a complete examination, the problems are identified, and treatment options are discussed with the parent. It is essential to assess cooperation in treatment planning.
At Love Teeth Kids, our special comprehensive stabilisation sessions are dedicated to extensively educating patients and their parents about the significance of oral health
We make it a point to provide take-home assignments like dietary guidelines or brushing schedules. This ensures patients and parents comprehend the importance of good habits at home.
Using their toothbrush, we demonstrate effective brushing techniques, emphasising the importance of using a mirror to show children their teeth and gums. This visual aid helps everyone understand what areas to target for cleaning.
Surprisingly, even adults I encounter in my general practice could benefit from guidance on more effective brushing methods!
Inhalation sedation for children can be a beneficial adjunct as it can help to reduce fear and anxiety, facilitate cooperation and promote a future positive attitude towards treatment
Inhalation sedation does not entirely put the patient to sleep, so interaction is maintained throughout the procedure. Therefore, it is a safe adjunct to treatment when managing a process that could otherwise be more unpleasant for the patient.
Young patients often fear the injection and pain, and The Wand has introduced the concept of ‘painless injection’, which means treatment is generally more tolerated
It’s a compact, pen-like handpiece with computer-controlled technology that administers local anaesthesia comfortably and non-intimidatingly. The Wand has helped build an overall more positive experience. Many don’t even notice they are being numbed, which is one of the most important (and challenging) steps in treating a patient with dental fear.
As well as the pain of the injection, younger patients can also get upset about the feeling of being numb and not being able to feel a large area of their face. In some cases, they can panic and get quite upset about this. A significant difference The Wand makes is that, through single tooth anaesthesia (STA), it can avoid the need for infiltrations or blocks. The intraligamentary technique means that just holding The Wand like a perio probe next to the tooth can numb the single tooth.
It also looks like a pen, which looks less scary than our usual metal local anaesthetic syringes that children often get scared about – so I often need to hide. Plus, patients also like the name!
I enjoy seeing paediatric patients as this age group is crucial when building trust and confidence to foster a lifetime of healthy smiles
The importance of making a patient feel safe cannot be overstated. I am always open to learning new techniques and advancements in dentistry. These can help make a patient feel more comfortable and looked after. I am committed to developing my skills with the latest technology and further training in paediatric dentistry.
For more information on The Wand STA please visit DentalSky.com or give them a call on 0800 294 4700.
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