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Dental Anxiety in Children

Dental fear is still a common problem in both Irish children and adults. Not surprisingly, dentally anxious children often become anxious adults. Dental fear can and does prevent people from accessing the routine dental care they need. Unfortunately it may take severe pain or infection before a patient or parent with anxiety seeks dental care for themselves or their child. In the case of a child or adolescent, once dental pain or toothache is experienced, they are much more likely to be fearful patients in the future.

Taking the time to introduce children to the dental surgery step by step through play, helps to build trust and breaks down fear. Kerry Paediatric Dental Practice is dedicated exclusively to providing dental care in a compassionate, empathic and child friendly environment. All aspects of a child’s experience are important to us which is why each little detail is planned so carefully; it starts with how our receptionist greets them at the door, to the toys in the play area, the words and expressions we use, the decor in the surgery and the cartoons playing on the TV. It is always better if a child’s first visit does not involve treatment so they have a chance to get used to the dentist and their new surroundings. This can only happen if visits start early before problems begin. The recommendation from the Irish Dental Association is –“first tooth first visit”

Children of dentally anxious parents usually show more dental fear. Children pick up on both words and body language when their parents are anxious. Phrases such as “it’s not going to hurt”, or “don’t worry, they won’t hurt you” may scare a child. It is wise to avoid the use of words such as “hurt”, “pain”, “drill” or “needle” and focus on positive things like how grown up they are being or how gentle the dentist is. If you promise your child a gift they may understand that to mean that the worse they behave during the visit the more they get. Only good behaviour should be rewarded.

Most young children feel more comfortable and secure having a parent or sibling in the room during treatment. However, if one parent has dental fear it can be better for the other parent to accompany the child instead. The most natural instinct a parent will have is to reassure their child. This can sometimes make the child think something bad is going to happen even when it is not.

Good communication is really important to help prevent dental fear in children. Getting to know your dentist through regular check-ups helps with that. The majority of children cope with routine treatment by having a tooth numbed or frozen before a filling or extraction. It is a myth that baby teeth do not need to be put to sleep. They feel just as much pain and sensation as an adult tooth. Paediatric dentists have advanced training in dealing with young and fearful children through special techniques such as shaping behaviour and reinforcement. Hypnosis can be useful for phobic children and we use this and other desensitisation techniques at Kerry Paediatric Dental Practice.

For children with more serious anxiety inhalation sedation or “laughing gas” can help reduce fears. This is where your child breaths in a mix of oxygen and a sweet smelling gas called nitrous oxide. The child remains awake and responsive at all times. This is a very safe form of sedation which allows children to overcome anxiety and fears during treatment. It is still necessary to numb the tooth that is being treated when the child is sedated. General anaesthetic is where a child is put to sleep in hospital so their dental treatment can be done in one visit as a day case. This is a reliable and safe way of ensuring young or fearful children have high quality dental care with minimal distress. Dr Daly’s general anaesthetic facility is at the Bon Secours Hospital in Tralee.

It is recommended that a child should be seen when the first tooth erupts or by the age of one. This is to inform the parents how to begin preventive care, discuss habits, safe fluoride use, nursing practices and bottle use. Routine first visits, with professional cleaning, fluoride treatment and examinations, usually begins at age 2 ½ years old.

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