Dental Health is a right of each and
every child. The parents and the dentist/pediatric dentist share the
responsibility of delivering good preventive and therapeutic dental care to
children. The first dental visit of a child aims at building a partnership
between the dentist and the parent/s for fulfilling this objective.
Dental care is a continuous process,
which starts in the womb (in expectant mothers) and continues lifelong! The
dental management of children starts with education, counseling and preparation
of parents prior to the actual dental treatment. Good communication with the
parents is the key to successful management of children. This article throws
light on the timing, manner and importance of first dental visit of a child.
When Should a Child’s First Dental Visit be Scheduled?
The first dental visit is recommended
within six months of the eruption of the first tooth, and no later than the
child’s first birthday. This has many goals such as:
1. To check for decay and other
problems
2. To educate parents regarding
feeding, dietary care and oral hygiene
3. To identify the child’s fluoride
needs
4. To introduce child not only to
dentistry for regular care but also for developing familiarity with dental
atmosphere in a pleasant manner
Unfortunately, we doctors often come
across children with advanced dental conditions! This is primarily due to
either lack of information to parents on preventive dental care or absence of a
painful condition. Actually, interactions with parents at this stage could
definitely benefit children mainly in terms of preventing early childhood
caries.
However, rarely is the first dental
visit of a child so well planned! More often than not, we come across a child
with an acute condition or multiple dental problems. This article discusses the
issues pertinent to such first dental visits.
Preparation of Parents Prior to the Dental Treatment of the Child
The children are not just small
adults! They behave, expect and relate to the surrounding much differently.
While understanding and practicing dentistry for children a pediatric or a
dental surgeon also has to play roles of behavior therapist and a counselor! Parental
counseling is important before starting the treatment in order to avoid future
complications and misunderstandings. While doing so, we have to render them the
knowledge about dental treatment modalities and child management techniques.
The well-informed parents can themselves prepare the children well at home for
receiving treatment in a better manner. Pleasant visits to the dental office
promote the establishment of trust and confidence in a child that will last a
lifetime. Parents must make the child familiar with the dental clinic by having
casual meetings with the doctor and the staff. The aims of such visits are
exchange of information between parents and the doctor and establishing a good
communication between the doctor and the child.
The Goals of Preparation of Parents
Prior to the Dental Treatment
1. To assess their understanding and
level of motivation regarding the child’s dental care.
2. To get an idea about the concerns
and anxieties of parents related to dental care
3. To start an active conversation
with the child along with his/her parents
4. To help them understand and
practice preventive dental care for children
5. To create a healthy environment
prior to commencement of dental treatment of child.
The preparation of parents starts with
taking a prior appointment. Always inform about that this is first dental visit
of your child. A child’s first dental visit is comparable to his/her first day
at school. Many children do not like to be separated from parents and enter a
strange place. However, they soon get accustomed to the surrounding and enjoy
schooling. Every child is not able to learn A, B, C, D on first day of school;
same every child is not ready to get dental treatment on first visit of dental
clinic. Children are at times scared to visit a doctor/dentist. Often parent/s
or caretakers describe doctor as a person who uses injections as weapons. If a
child is eating many chocolates a day, for example, he/she is often threatened
with visiting a doctor! The mindset of children, therefore, becomes extremely
negative towards doctors. They imagine a visit to any doctor only as a punishment.
This makes the job of a doctor even more difficult. It may be a good idea to have
a conversation with parents in this regard prior to actually meeting the child.
What parents should do before their child's first visit to a dental clinic
1. Tell your child that you are going
to a friend/uncle who’s also a doctor and likes children and he may just check is/her
teeth. The newer generation is smarter; don’t fool them by telling a lie.
2. Tell him/her that getting teeth
examined regularly may help finding problems—blackness, cavities early.
3. If possible, both the parents must
remain present with the child in the first visit.
4. Give your doctor enough time to
talk to your child. The time spent initially on building rapport and gaining
his/her confidence will in turn save the time required for treatment later.
5. 85-90 % Children can cooperate for
all dental treatments. Help your doctor in not only treating the child but
instilling in him/her, a positive attitude towards dentistry.
6. Whenever the doctor wishes leave
your child alone with him. The direct communication between your child and the
doctor is the key to successful dental treatment.
7. Get your child’s complete medical
record.
8. Insist on understanding complete
treatment programme, including the preventive measures and follow-up.
What parents should not do before their child's first visit to a dental clinic
1. Do not tell your child about pain,
blood, injections, like negative and terror inducing words.
2. Don’t tell him/her something like -
“because you don’t brush your teeth properly, doctor will give you an injection”
or “because you eat chocolates, your spoiled teeth will be removed by doctor”!
3. Do not insist on starting the
treatment in the first appointment itself.
4. Do not voice your own fears about
dentistry (pain, blood, etc) in front of children. Your dentist can answer your
queries separately.
5. Avoid dental appointments during
the naptime or when he/she is too tired.
6. Don’t bribe him/her with a gift
beforehand. You may reward an appropriate behavior in the clinic (if obtained)
later.
7. Don’t make complaints of the
child’s behavior to the doctor. Also, don’t expect perfect behavior at all
visits.
8. Don’t promise him/her in advance
about the time the doctor would take to treat, the pain he/she might get, etc.
which can mislead him/her. Simply say you don’t know.
What Should be Done at the First Dental Visit?
Firstly, ask the purpose of the visit.
If there is any emergency care required, it must be delivered to the child as
soon as possible. The first visit is mainly a consultation with the doctor. It
has two goals:
1. To start developing a rapport with
the child and
2. To complete history taking,
diagnosis and treatment plan.
At times, radiographs are required to
come to a definite diagnosis. Depending upon the co-operation of the child and
urgency of diagnosis, the same may be taken in the first visit. Once a final
diagnosis is established, the parents shall be informed about the treatment
plan including preventive measures, approximate schedule for accomplishing it
and the rough estimate of the charges.
If no emergency care is required,
following procedures can be started in the first visit
1. Examination
2. Counseling of parents in relation
to prevention of dental diseases
3. Taking radiographs (one or more
depending upon the co-operation)
5. Introduction to dental
armamentarium with use of euphemisms; e.g.: Use of air-water syringe as cleaning
tools, Air-rotor hand piece as tooth-shower, etc.
Thanks
The main points of this article are
taken with his approval from the book "Child Management in Clinical
Dentistry" written by the eminent pediatric dental surgeon of India
Dr.Ashwin Jawdekar. I will be very grateful to Dr. Ashwin Jawdekar Sir.
આ આર્ટીકલ
ગુજરાતીમાં વાંચવા માટે “બાળકની ડેન્ટલ ક્લીનીકની પ્રથમ વિઝીટ” પર ક્લિક કરો.
