Introduction of the Dental Experience

Adults interacting with children must realize children view their surroundings from a different perspective than they do on both a psychological and physical level. Because of limited life experiences children may be more frightened when faced with a new and strange situation, resulting in a greater necessity for desensitization and appropriate terminology. Since children are smaller in stature and height their visual perception of their surroundings are different than adults.

For example:

pg06a

This is how a child may be perceived by an adult.

pg06b

Yet, this is how an adult may be perceived by a child.

When interacting with a young patient, the dentist tries to physically come down to the child’s level by sitting rather than standing. In addition, the dentist relaxes the patient by talking to the child and then slowly drawing the patient to them by taking their hand. A typical scenario would go like this:

pg06c

Hi Bobby, I’m Dr. Steve. How old are you? Three years old. Wow! You’re pretty old. Are you married? Do you have a girlfriend? (This line of questioning usually breaks the tension and brings a smile to the child). Do you know how to count? I love to count. How many fingers do you have? Let’s count. One, two, three, five. (Usually the child will catch the mistake and either correct you or laugh). Did I make a mistake? You better count with me. One, two, three, four, five. Great! How many fingers do you have on your other hand? One, two, three, four, five.

pg06d

How many ears do you have? (The child answers two). Are you sure you don’t have a third one in the back of your head? (child laughs).

pg06e

How many noses do you have? (The child will answer one or two if they count nostrils). Boy, you are really smart.

pg06f

How many bellybuttons do you have? (This question usually elicits a laugh because the word “bellybutton” is a funny word to children, especially if they are ticklish).

pg06g

Now for a very hard question. How many teeth do you have? You don’t know, then let’s count. One, two, three, four… Wow! You have a lot of teeth. It’s kind of hard for me to see all your teeth while you stand. It would be much easier if you sat in my chair.

Depending on the child’s maturity and security with the situation, the patient will climb into the chair on his own, or will need additional comfort by sitting on the parent’s lap.

The dentist repeats the counting process but now adds the mirror to the picture.

pg06i

Since you did such a great job, we’re going to count again but this time we’re going to use a mirror. Let’s count your fingers with the mirror. One, two, three, four, five, six, seven, eight, nine, ten.

pg06j

Terrific. Let’s count your ears. One, two.

pg06k

Let’s count your noses. One nose.

pg06l

Let’s count your bellybuttons. One bellybutton.

pg06m

Terrific. Now let’s count your teeth. One, two, three four, five, six, seven, eight, nine, ten, eleven, twelve, thirteen, fourteen, fifteen, sixteen, seventeen, eighteen, nineteen, twenty. Wow! You have a lot of teeth. I hope I didn’t make a mistake. Let’s count them one more time using a tooth counter.

The process is repeated using a tooth counter (explorer). By this time the patient should be comfortable enough to proceed with toothbrush instruction and if necessary a rubber cup prophylaxis and fluoride treatment.

If radiographs are deemed necessary, the reader is referred to the CE course Radiographic Techniques for the Pediatric Patient, in the www.dentalcare.com Continuing Education library. If treatment is necessary at a subsequent visit, similar techniques may be used to desensitize the patient to restorative procedures.