Received: June 08, 2018; Published: June 15, 2018
*Corresponding author: Mohammad Karimi, Internal Auditor & Documentations at Apple Dental Clinic, Iran
In times of day, children are usually well-mannered and show the necessary cooperation in various fields. A dentist must consider certain hours to provide dental care for children. The factors which are influential in this area at the onset of dental care include: feeding, thirst, the need to go to the bathroom, preparing children to go to the dentist by parents, complete dentist’s preparation for dental care, and having appropriate clothing for children during dental procedures. If these are taken into account, dental care goes well and will facilitate the progressing. It should be noted that non-compliance with this aspect will lead the child’s moodiness, tantrum and will cause increased anxiety and stress in children.
Keywords: Moodiness and Anxiety; Tantrum; Fatigue; Thirst; Hunger; Child Cooperation
Perhaps most colleagues, who are doing dental care for children in their offices, face a child with tearful eyes, sleepy and grumpy face, restless, impatient and anxious at the time of the child’s entry to the office. In such cases, after an initial examination of the child, it is recommended that dental work to be postponed until the next appropriate time. Certainly, those children will have not the necessary cooperation in this current situation. Of course, if there is an emergency case, the dentist will have no choice to perform the dental work.
During the twenty years of dental practice, experiences show that performing dental care for children should be given at certain times of the day. Before the dental procedures, many factors must be considered. Factors that may have contributed to the process of performing better dental care are included as the convenient hour of the day to do dental work, having rested child, being aware of the lack of fatigue, thirst and hunger of the children, no need to go to the bathroom, preparing children by parents before coming to the clinic, prepare the child by a dentist prior to starting dental procedures and lastly children wearing comfortable clothes while sitting on dental chair.
Experience shows that appropriate hours for kids’ oral care are between 10:30 to 12:00 in the morning and 17:00 to 19:00 in the afternoon. The information that has been collected in the last few years shows that in the early hours of the morning, the children suffer from sleepiness, nagging, anxiety, aggression and refusal to obey. If the appointment has been arranged at convenient hours of the day, it will not be difficult to manage children. It is recommended to arrange late morning appointment because children are more cooperative in the morning hours. In other words, children will have no excuses because they are awake and well at this time of day. Arriving a little before the appointment time, will let the child become familiar with the new surroundings.
If the patient is given an appointment in the morning, it is better that child go to bed early the night before so that can easily wake up in the morning. Every night and at every nap, sleep recharges the brain’s battery. Sleeping well increases the child attention span and allows him to be physically relaxed and mentally alert at the same time. Then, after a good night sleeping, the child will be at his personal best. It is noteworthy that child had not eaten a heavy meal just before bed time. Eating more near to bedtime, may result in disruptions to healthy sleep patterns. It has been emphasized avoid feeding child with the junk foods before bed time. Furthermore, reading a sweet bedtime story to comfort him and reduces his anxiety is recommended. In case of having afternoon dental appointment, it is better to have enough rest after lunch, especially if child has spent the morning in the kindergarten. Otherwise, we will see the moodiness, discomfort and anxiety in the child.
To begin dental work, the dentist is better to be assured that the child is eaten his breakfast so that during the performing oral care, child does not feel hunger. As a rule, breakfast should include eggs, bread, jam or honey with a small cup of milk. If parents add some fruits in the breakfast, child does not definitely feel hungry even a few hours after the dental work. After sleeping afternoon, it has been suggested child should be fed with a snack of fruit, nuts or sandwich of bread and cheese with walnuts. By doing so, parents can prevent their children from being hungry excuses when dentist is performing dental work.
Parents should keep in mind that dental work for children is associated with stress and anxiety. Both parents and dentists should try to reduce the effects of these two factors. It is obvious stress and anxiety in children, causes the need to go to the bathroom in children. As a result, before the performing the dental procedure, it is better for children to go to the bathroom so that they do not have any excuses during the work. Stopping the dental work by the dentist due to children’s toilet, has the impact on the process of providing dental care which causes the problems such as waste of time, long process of dental procedure and tiredness of the child. On the other hand, before starting work, the children should drink enough water so that they do not suffer from thirst caused by anxiety and stress. Many times, during the dental procedures, children have felt dry mouth, tongue and lips. Before entering the treatment room, if the child drinks some water, the dentist will not face this problem.
The best preparation for your child’s first visit to dental office is maintaining a positive attitude. Children pick up on adults’ apprehensions and if you make negative comments about trips to the dentist, you can be sure that your child will fear an unpleasant experience and act accordingly. Show your child the pictures of the office and staff on the web site. Let your child know that it’s important to keep his teeth and gums healthy, and that the doctor will help him to do that. Remember that your pediatric dentist is specially trained to handle fears and anxiety, and the staffs excel at putting children at ease during treatment. There’s some ground-breaking stuff out there – like a scanning wand that takes digital impressions, replacing the goopy stuff dentists sometimes use to take an impression of your child’s teeth, which can cause gagging and fear. Find out if your dentist uses it or any other new laser techniques.
This stage is the most critical stage of rendering dental procedures. This is where the thought of a dentist’s skills could affect the highest quality of the dental services and allow the dental work to be accomplished in the shortest time. In other words, prior to dental work, dentist gives some simple and rational explanation so that child can be fascinated by his explanations which might have a great effect on shortening of the processing time. A series of information about dental appliances, can affect children’s thinking. Children’s curiosity about dental instruments and how they work is a good opportunity for the dentist to show his extraordinary powers in this context. Continuing to talk and entertain children with stories and tales of dentistry can make the job very easy for an experienced and skilled dentist.
Parents should note that taking children to the dentist will develop the feelings of anxiety and stress. Therefore, the effects of these two factors should not be intensified. Cover tight clothing will cause the child feels discomfort, heat, thirst, fatigue and restlessness. So, wearing comfortable clothing is an important factor in reducing anxiety in children. He should not be forced to wear clothing that does not want to wear. Let the child choose his clothes. Wearing a necklace, earrings, bracelets, and hairclips should be avoided due to interruptions in doing dental work. In addition, do not wig girls’ hair. Because when the hair is woven into wigs or hairclips is over the back of the child’s head, the patient will suffer from neck pain and muscular fatigue after the dental procedures. Boys should wear comfortable pants. Do not put on, belts, tie and braces on their clothes. Children will be more cooperative and obedient when they feel comfortable.
A series of long-term experiences is recommended. The following can be used to accomplish high performance in children’s dental care.
a. Do not forget to smile. The patient expects to face a well-mannered dentist.
b. Try to examine the child only at the first meeting; or simple things like fluoride therapy and fissure sealants to be done. If there is an emergency case, it should be a top priority.
c. In each session, try to work in a quadrant area but do not proceed with more than 2 teeth. As a result, the patient will experience fatigue, and quality of dental work will be reduced.
d. During the Work, application of terminology that promotes the child’s anxiety is prohibited.
e. When you are working, give the pleasure of watching an attractive animation to the patient. With Playing these cartoons, children do not feel working time.
f. Sharp instruments should not be directly placed at the sight of children.
g. When injecting the local anesthesia, the indirect method is used. In this way, the fingers of left hand are placed in front of Childs’ eyes and then with the right hand gently start to inject. This method in article entitled “Why children are afraid of dental works” is explained comprehensively.
h. In case of good cooperation of the patient, encourage and glorify him while continuing dental work.
i. If child is cooperative, let one of the parents stay in the corner of the room where child can see her. This will encourage children to stay on their seats, and as a result they might not keep moving and scrambling until the end of procedures so that the dentist can finish his work in comfort. Of course this will come true if the parents do not interfere in the dental procedure.
j. During a dental procedure, the dentist should talk regularly with the child patient so that his mind is engaged in what dentist is talking about. In other words, the skill of a dentist, to entertain children by telling a story about a child who has already been to the dentist, can be a good example.
A dentist cannot offer dental care for children as well as adults at any time of the day. Most children are tired and grumpy in the hours of the day, respectively. Performing a dental work at these times, will be a disaster for both the parents and the dentist. Personal experiences has shown that the best time to do these kind of dental care is preferably 2 hours before noon and two hours before sunset. At these time of the day, kids don’t show irritability and temper tantrum; and they are more relaxed, thus it is expected more cooperation from them. In addition to what has already been mentioned, key factors such as fatigue, thirst, hunger, child preparation for dental work and wearing comfortable clothes can be impressionable.