Hand Over Mouth Exercise

Hand over mouth exercise (HOME) is a conditioning method used by dentists to control a child (typically over 3 years old) who will not cooperate while undergoing a dental procedure. The HOME method is used as a last resort and, according to a recent study in the journal Pediatric Dentistry, has fallen out of favor over the past two decades.

History

• The origin of the HOME method can be traced back to 1929 when Dr. Evangeline Jordan wrote, "If a normal child will not listen, but continues to cry and struggle...hold a folded napkin over the child's mouth...and gently but firmly hold his mouth shut." It was thought that screams increased the condition of hysteria, but if the mouth was held closed the child soon begins to reason. She believed the HOME method should be used on so-called normal, healthy children over the age of 3. Dr. Jordan also stressed that the HOME method should not be used routinely, but as a method of last resort.

  HOME gained notoriety again in the 1970s, when several studies were conducted on the method. Since then, the popularity of HOME has diminished in each decade. According to a Department of Dentistry study conducted in 2001, the use of the HOME method decreased by 50 percent between 1989 and 1999.

Alternative Solutions

• There have been significant changes in pediatric dentistry since the HOME method was conceived in 1929. Advancements in dental procedures and pain management medication have made trips to the dentist far less fearful for children. Also, there are many dental practices whose only function is to cater to the specific needs of children. Check with the American Dental Association (ADA) for a list of Pediatric Dentists in your area.

  Ideally, a dentist would like to address the child's anxiety before the level of hysteria is reached. This can be accomplished by creating an environment that is more comforting to the child. It is not uncommon today to see bright colors throughout a dental office, or to see televisions above a dentist's chair playing cartoons. These strategies are often used to make the child more at ease.

  If the child is still suffering from anxiety, there are other options available that are considered more favorable than the HOME method. Nitrous Oxide is a blend of two gases, oxygen and nitrous oxide, that is absorbed by the body and has a calming effect. Chloral hydrate sedation is an oral sedation that is also used to help the child become more relaxed during dental procedures.

  Talk to your dentist to see what method is best for your child.