Behavior Management in Pediatric Dentistry

Getting patients to a dentist can be a hat trick. Fortunately for patients of all ages, today's dental student is required to pursue a rigorous course of behavior management study, so graduates are as adroit at calming fears as they are at molar repair. Of all the specialties within dentistry, pediatric practitioners receive the most intense training---techniques that have revolutionized the way kids and parents approach visits.

Technique

• Master the "Tell-Show-Do" technique of behavior modification espoused by dental schools. You can use this three-pronged system of comfort and behavior management by first internalizing age-appropriate phrases that match the ages of your patients. Then demonstrate, in kid terms, what's going on with the child's teeth using pictures, books, models and other aids so they have some understanding about what you're doing to their teeth. You then provide final behavioral reassurances using verbal and nonverbal positive reinforcement once you've completed the treatment.

Voice Control

• Practice optimal voice control techniques. Aim for voice modulation that wins over the child, gets her attention and convinces her that there's nothing to fear from the dental treatment process. Choose words, phrases and actions that counter negative reactions in kids so they become accustomed to being in your care while being treated. Learn to listen for fear or discomfort cues so you can quickly remedy a problem.

Facial Expressions

• Observe yourself in a mirror to see whether you inadvertently transfer personal feelings to your patient with unconscious posture, facial expressions or body language that silently sends an alarm. Children focus on a furrowed brow, grim mouth and other nonverbal cues while in the dental chair, so ask your staff to check frequently for such facial expressions. Additionally, make certain the mask you don for hygienic purposes doesn't trigger the internal alarm of your smallest patients.

Proven Distractions

• Take the word "distraction" to new heights by installing colorful ceiling mobiles or a ceiling-mount television capable of showing children's programming or DVDs. Ask chair-side assistants to use puppets to hold dental instruments or play fun games so kids are distracted from the work you're doing. Paint treatment rooms in bright colors with whimsical murals. Treatment breaks are great distractions if your patient schedule isn't tight.

Parental Presence

• Invite parents to provide comfort and distraction, as few behavior management techniques are as effective as the presence of Mom, Dad or caretaker in the child's treatment room. That stated, parent presence continues to stir up big debates among pediatric practitioners, so adopt a parental presence behavior management policy only if you're already an advocate.

Advanced Behavioral Techniques

• Use mild sedatives as a behavior management tool only if a child is healthy, parents consent and treatment warrants exposing a child to Nitrous Oxide. Read the American Association of Pediatric Dentistry's "Appropriate Use of Nitrous Oxide for Pediatric Dental Patients" white paper before employing this type of anesthesia. Be cautious if you are considering "protective stabilization" behavior management---an extreme form of patient immobilization that's best paired with general sedation and used sparingly.