Kids & Dentists

Recently, I’ve been hearing more and more of these horror stories about 5-yo kids with 7 cavities having to go through all these painful operations.  Oh man, if I get weak at the knees, I can’t imagine what it would do to my shy little 4-year old. 

Plus, I was that kid who in 5^th grade had the full-on headgear.  If you just painted my school’s mascot on my head, you would’ve mistaken me for a cornerback (well, a puny, 90-pounder cornerback).  Needless to say, I made lots of visits to my dentist. 

The main thing that I’ve learned about the dentist recently is that it can be a good experience, if we parents just get out of the way.  I asked our family dentist, Dr. Jane Maa of Savin Dental Associates, about her perspective on the care of our kids’ teeth.  I opted to include as much detail as possible here since this can get people pretty anxious.

How to Choose a Good Dentist For Your Kids

There’s really no great way to find a good dentist.  Even Dr. Maa admitted as much.  Nonetheless, Dr. Maa suggests the following:

• If you like your own dentist, you can ask if they take kids, and if so, starting at what age.  Most general dentists do see kids.
• You can look at directories and customer reviews (e.g. yelp.com, American Dental Association), but the best place is to start is your friends. Word-of-mouth is the best way to go.
• Pediatric dentists are typically really good – everything is set up for the kids. The chairs are smaller, the rooms are brighter, and you’ll have confidence that they know how to handle kids, even the junior monsters.  Just remember, that they are considered specialists and are usually more expensive.

How to Prepare Your Kid for Their Dentist Appointment

• Talk about the experience in a positive light.  “You’re so lucky to be going to the dental office. Only big boys and girls get to go.  Everyone at Dr. Savin’s office is so nice, and they’re all looking forward to meeting you.”  Talk about how going to the dentist makes our teeth shiny, healthy, and strong so we can eat well.  Maybe you’ll get a prize, and you’ll always get a new toothbrush. 
• Don’t talk about negative experiences.  Obviously don’t tell your kids your old horror stories (“and then my blood spurted right onto his glasses!”)  And explain to the older siblings not to do so either (“oh Johnny, the dentist is like that kid Sid in Toy Story!”).  Don’t use these words: afraid, hurt, pain, shots, bleeding.
• Read some books to them.  Some good ones:  Dora Goes to the Dentist, Berenstein Bears Visit the Dentist, and Going to the Dentist.  Don’t say “see, it’s not scary!” but instead say, “now that you're a big boy, you'll be able to visit the dentist like Dora, are you excited?!"   For slightly older kids, there are some interactive games at the American Dental Association.

How to Have a Good Visit to the Dentist

• When you get your child’s appointment at the office, ask the receptionist for the name of the hygienist.  Talk to your child about the hygienist ahead of time, using her name, the way you would talk to a friend.
• Believe it or not, kids do better without their parents in the treatment room.  The dentist has to establish a relationship of trust.  Staying in the room may cause your child to want sympathy and/or act up.  Some parents play into it and make the whole visit more difficult.  If you do stay in the room, simply tell your child firmly to pay attention to Dr. Maa and don’t say too much else so the child can be focused on the dentist.
• Don’t over-coddle your kids at the dentist.  Usually, the reason why kids misbehave at the dentist is because of their parents overprotecting them.  Or the kid will get a bad vibe from their parents.  Or sometimes, some parents threaten their kid to behave well OR parents who bribe them too much.  This creates a situation where the kid is bargaining with their parents through their fussing.  Just be firm and re-assuring, and let the dentists do their thing.

What to Expect When Your Kid’s in the Chair

I asked Dr. Maa for the “inside scoop” for how they work with kids at their office.  Here’s a little bit what she said:

“Younger kids that can't sit in the chair on their own (usually the first visit is between 1-2 years old) would require the parents to be in the room and even for the kid to sit on their lap.  Kids that are 3-4 yr usually can sit in the chair on their own so it's not crucial that the parents are in the room. The kids feel confident because they accomplished something on their own.

Normally, if parents want to be in the room, it's okay and we allow that.  Nonetheless, we like to have full attention of the kid so we can reassure them and help them have a good experience. If the parents are there smothering over the kid, it introduces bad habits for future visits. So, to be honest, it’s the parents who have to behave =)

Normally we follow the pattern: tell-show-do. We don't introduce anything in the mouth until we show them outside of the mouth first.  Then with kid's agreement, we use the instrument in their mouth. Usually that prevents any fearful events from occurring.

As for cleaning, if the patient starts crying, we stop what we're doing. Looking at the kid in the eye, using calm and firm voice to find out why they are crying and reassure them.  Cleaning appointment is usually the first step to build our relationship with the kid.  We talk things thru to gain their trust, individualize our procedures, and focus less on doing everything by the book .

If it's a filling appointment, again we simply tell them what we're going to do before we start. We DON"T tell them we're going to drill their teeth, we'll going to give them a shot.   Parents should also avoid those terms and try not to explain too much about filling procedures to their kids prior to their appointment.  We tell them we're going to clean out the buggies, there is a lot of water spraying and vibration.  Just like when they are scrubbing their body to clean them, we're scrubbing the tooth to clean them. We tell them we put the teeth to sleep so we can clean them well. We tell them that they are in control.  If they listen and follow our instructions well, they will not feel anything.  If there is too much water or if they need a break, they can raise their right hand and we’ll stop right away.  We teach them relaxation techniques and use nitrous oxide to help. 80-90 percent of kids don't need Novocain for filling; they do well as long as they have nitrous oxide.  They usually say they just feel a tickle on the teeth when we drill them.  If they do need Novocain, nitrous oxide is administered first so they feel less.  We do warn them they may feel a tiny pinch.  85 percent of the patients say they don’t even feel the pinch.  And as long as we have the TV on, it is a great distraction tool. 

Again, we use firm and calming voice to explain and reassure them throughout the appointment.  If the child does cry and we can't calm them down, sometimes we will use parents as leverage: “If you calm down and don't cry, I can have mommy or daddy sit in the room with you. They will sit in that stool and be in the room with you.”

Make sure your dentist goes over the recommended treatment before starting the treatment. If you are really unsure about whether a treatment is necessary, go get a 2^nd opinion.

How to Help Your Kid Avoid Those Cavities

While there are many reasons for cavity city to happen in your kids’ mouth (diet, genetics, oral hygiene), the #1 culprit is bad habits.  So, the key here is to start forming good habits from a very early age. 

• Don’t let your child go to sleep with bottle filled with juice (or anything other than water)
• At 5 years old, parents should take responsibility to make sure their kid brushes.  And if they eat anything afterwards, they have to brush again.  Flossing is also important – those back teeth start to grow really close together, so those cavities sneak up between the teeth very often.
• Don’t just be satisfied if your kid brushed. Check them out, too.
• Ask the dentist after each check-up where they saw the most plague build-up – chances are, these are the spots that are not getting brushed as well.

Thanks to Dr. Jane Maa of Savin Dental Associates for providing such great and detailed information.  Good luck out there, and remember to floss!

Other Resources

American Academy of Pediatric Dentistry: Parents Resource Page

Tips on Snacking

Dental Care for Babies

Having regular check up is the best for you child

American Dental Association