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Parental control and the treatment of pediatric patients

Oct. 22, 2019
As pediatric dental hygienists (and if you've ever had a child-patient, this is you!), we must be able to balance the comfort and care of our pediatric patients with parental control in the operatory. It's possible with these tips.

Given the choice, I would always choose to work in pediatric dentistry. When I make this bold statement to other dental hygienists and dental professionals, most of the time I get a blank stare followed by the question, “Why kids?” Sometimes there's the comment, “I cannot deal with those parents.” True, true, I understand. Children and their parents (or guardians) present challenges in the operatory. But to me it is a fun, rewarding challenge that educates and promotes oral hygiene. I find excitement knowing that I can create an awesome prophy experience that can lead to a lifetime of positive oral hygiene for a child.

Parents play a major role in pediatric dentistry and are the anchor for dental care. They have the responsibility of scheduling dental appointments, bringing children to appointments, paying for care, and ultimately taking responsibility for their children during treatment. Parents are inevitable in pediatric dentistry. As pediatric dental hygienists (and if you have ever had a child-patient, this is you!), we must be able to balance the comfort and care of our pediatric patients with parental control in the operatory. It is possible with these tips.

Provide  the parent with a quick step-by-step overview of the appointment

While in front of the child, introduce yourself to the parent with a smile. Provide a quick and exciting summary of the appointment so you can establish rapport with the parent and patient immediately. Making the parent feel comfortable is just as important as making the child comfortable.

A perfect example of this is, “Hi Lily and Mom! Are you ready to get your teeth pictures taken and have your teeth brushed? We are going to take pictures with our neat camera, brush your teeth with our cool, tickle toothbrush, and look at our sparkly teeth today. If you do well, we can get you a cool prize and a goodie bag to take home.”

Promote the waiting or stand-by area to the parents

If a parent has a sibling, seems anxious, or has a phone call, gently promote the importance of the waiting or stand-by area while acknowledging that distractions can negatively impact the appointment for their child. It's also great to explain that your top priority is the patient. As hygienists, we want to do everything that we can to ensure our patients are comfortable and safe during treatment. Always have an open door policy, allowing the parent to quickly check in and out on the child if necessary.

A great example of this is, “Hey Mom, we are going to go ahead and take Lily back to our special room so that we can start taking her pictures and brush her teeth. We are not allowed to have anyone in the room for the x-rays, so you are welcome to have a seat here and wait for her. If we need you, Mom, we will come back and get you right away.” It also does not hurt to reaffirm to the patient (in front of Mom) that if we need Mom, we can come back and get her.

We all know that some pediatric patients are not so willing. If the child proves to be extremely anxious or unruly, always encourage a quiet room. If that is not possible, allow the parent or guardian to sit in the operatory. To remain in control, immediately start with the “Tell-Show-Do” method and guide the parent with the proper assistance to treat the child safely. The most important person in the operatory is the patient.

Be quick and thorough

Sing, dance, entertain, and reward with praise as you complete radiographs and treat your pediatric patients! While quickly moving from one step to the next, I am a radio of songs and dance moves. The “Tell-Show-Do” method works well and allows for your patient to be comfortable and have fun. Most pediatric prophy appointments are shorter in length than adult prophy appointments. The longer you keep children away from their parents, the more parents can become anxious.

Allow the parent to be a part of the appointment

Building rapport is key! If time permits, have the parent and dentist meet, so that the parent is included in the appointment. The first appointment would be ideal. At the end of the appointment, it is good to allow the parent to be present at nonclinical moments. This gives you the opportunity to praise the patient, present oral hygiene instructions, discuss treatment, and (if your office permits) schedule any necessary appointments in the operatory setting.

Michele Brock Brown, MPH, RDH, is a licensed/registered public health pediatric dental hygienist for the states of South Carolina and Georgia. She is a Columbia, South Carolina, native who has experience treating children, teenagers, and young adults using  Medicaid and other government assistance. Brown enjoys treating pediatric patients, special needs patients, and patients with extreme fear and anxiety.

Brown earned her bachelor of science degree in biology with a dental concentration from Winthrop University in 2008 and an associate of applied science degree in dental hygiene from York Technical College in 2014. She earned her master of public health degree in health promotion from Liberty University in 2017.

Brown currently lives in Rock Hill, South Carolina  and works in public health dentistry with a mobile dental unit that primarily treats pediatric patients at local elementary, middle, and high schools.