Babies-They usually do well for an exam or just cry a little. Give them their pacifier and they are as good as new.
One year Olds-they usually do quite well although if they are closer to two things can get a little loud.
Two Year Olds-They don't call this age the "terrible twos" for nothing. These kids are by far the hardest to examine. They almost always cry to be examined. I mean they really scream like there is no tomorrow. They fight too. This is the age that they begin to establish independence. This is especially true for the "headstrong" kids. They really don't like to lie down for an exam. I can look a little with them sitting up, but can't really do a complete exam. So, we have them lie down, the parent holds their hands, and I take a really quick look. I don't mind the noise, although the resistance can make the exam more difficult. I always hope the parents realize this kind of fussing is normal for this age. I don't want them to think the child is in any kind of real distress. I don't want them to be mad at me for just looking at their child's teeth. The parents I worry most about are the first timers. Parents who have more than one child often understand the normal reactions. I know the child is not traumatized for life just for counting their teeth. In fact these fussy two year olds often become model patients after a couple more years of regular visits.
Three Year Olds-this is a transition age. Some three year olds are just as fussy as the two year olds just bigger and stronger. Some are model patients who let you lay them down, clean their teeth, and often do fillings without protest. Even a particular three year old may respond differently depending on what side of the bed he woke up on that day. You know what I am talking about.
Four year Olds-I like four year olds. Most of the time they are the best patients. They hop up into the chair; let you take x-rays, fillings, whatever. They can't do this for long, but most do quite well. Again, there are exceptions. Some are as "head strong" as the two year olds.
Five through Eight-Regular kids. Most do quite well. I can communicate with these kids and can guide them through almost anything.
Eight to Eleven-Most do well, but these are the "needle-phobic" years. You can have a perfectly calm child who throws a giant fit if he thinks he is going to get a "shot". Read here for more info on that bad word: Pedo Lingo. After they have received appropriate anesthesia, they revert back to cooperative patients.
Teenagers--Most do well although some have typical teenager "attitudes". You have to take into account whether they are the "I'm too cool to care/whatever" type or (usually young ladies) who are extremely preoccupied with their appearance.
Special Needs Patients--If you take your child to a Pediatric Dentist, you will likely see other children around of all ages and temperaments. You also may see some patients who have medical or developmental conditions like Down's Syndrome, or Cerebral Palsy. These children are welcome in our offices. Some can be very loud or resistant to treatment. Even just an exam can be difficult. Others are some of the best behaved in the office. In other words, there is great variety in Pediatrics. You can expect lots of commotion and activity.
If you want more, go back to the home page or click here:Pediatric Dentistry
If you want more, go back to the home page or click here:Pediatric Dentistry
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37 comments:
I have a two year old needing crowns on two front teeth, and a molar. I went to one dentist who referred me to another dental clinic where they do the dental procedure with laughing gas. I just went to another office where they want to do the same procedures, but just strapping her down. She will not be cooperative at all during the procedure, so I don't know what is better. A friend's child was strapped down, and I was told she got a little traumatized after. What are your thoughts/concerns/suggestions?
As you can read here-two year olds can be quite resistant to Any dental treatment even just looking.
Most two year olds with multiple procedures we do under general anesthesia or at least some premedication --there area few, and I mean a very few that can do stuff (but not much stuff) with just laughing gas. Even with medication a two your old can be resistant--then you either "hold and go"--or stop the procedure...Read more about premedication and other stuff on this blog here and you may get a better feel for the alternatives.
I have three boys, ages 5, 4, and 1. My 5 and 4 year olds are horrendous at the dentist. The oldest has had tonsils out, a frenectomy, and his adenoids removed. My 4 year old has had three trips to the ER resulting in stitches on his face and mouth. Could these past issues contribute to their apprehension? The dental staff just tells us "it's normal" to have to hold them down kicking and screaming for a cleaning. This has been the solution every six months for several years now, and I'm just concerned and wondering if this truly is "normal"? Thanks - great, helpful blog!
You raise a lot of complex issues. Simply as I can here...I do see this from time to time. Kids who have, say hospital experiences, tend to be a little more anxious at the dentist, but usually only for a visit or two, then there seems to be no long term effect. Now, many times behavior has to do with something called temperment-the general way a person reacts to things. Lots of other factors too. I usually see things improve with age.
I have a 2 year old who will be going to her first dental appointment for a cleaning. My friend's little girl went and did fine. I'm really anxious about the appointment and I don't know what to expect. I don't want her to be strapped down, but is that realistic? What should I expect?
Well, you can see my post here is pretty thurough. Of course, the dentist/staff should do nothing you do not approve of. Most of the time just holding hands of the child (yes sometimes that is restraint) is all that is needed to get a quick look. If something other than an exam is needed, like fillings, then there are lots of good ways like sedation that might be available for that kind of thing. (read more under general topics behavior management on the sidebar).
A good dental visit for a two year old usually consists of some fussing, a quick exam (usually not a cleaning unless it is pretty fast) and a nice toy and a smile afterwards.
Your site is really helpful!! Thank you so much for putting it up.There is not much that isn't covered and I appreciate that. Your advice makes me feel at ease, Thank you!
great
To avoid this certain unwanted behaviors of our children we must always stress the importance of brushing and flossing to their children and monitor their compliance at home.
My now 7 year old used to be just fine going to the dentist. Even had a filling done and was a pretty good patient. When we went back for our next visit/cleaning she was So scared and has been ever sense. She feels like she's going to throw up she says because she's scared and when they lay her back it gets worse so now I'm having a hard time just getting a cleaning done and there might be a new cavity. How do I get her back to comfortable?
steph--
Each child is different and different from time to time. I would suggest first go to a pediatric dentist. Now things will not likely change right away, we still have kids that are anxious. However, as a child continues to visit the dentist and mature, things most often get much better. Medications can help as well depending on what is being done.
I have seen some some "good" kids who have had their tonsils out and are anxious at the dentist for their next visit even though it has nothing to do with the dentist. After a short while, they are just fine and back to great behavior.
My 8 year old son just had to have 5 fillings in between teeth from not flossing good enough. They gave him some laughing gas and when they poked him with the needles to numb his mouth he freaked and was not cooperative after that. We ended up getting him back on the chair and used the velcro board to hold him down and get it done. The whole time he was yelling and crying and saying it hurt. I started to think that maybe it really did hurt and he wasn't numb. Does getting fillilngs really hurt? I'm stressing cause that was the worst experience ever as a mom and now my 3 year old is going in for a crown on one of her teeth. We have definitely changed the way teeth are taken care of at our house. I vow to never have to put my babies through this again.
Gosh, I know that must have been a difficult experience for him and for you. I have seen kids get upset even after numbing. Often kids react to things like noise and vibrations not necessarily anything that you would think is that bad. Why is it that one child has a difficult time and the next (who might be a 4 year old) does just fine doing the same exact thing? It seems to do partially with individual variation and what we call "temperment" or personality styles. Some are very verbal or vocal, others very laid back. Anxiety can cause some kids to say it hurts and all we are doing is placing a cotton Q-tip in their gum. There are kids who do not even need numbing and others that seems to be reactive even with lots of numbing and just small procedures. Often we use medications to reduce the anxiety as you can read here on the blog. There is a small number of kids (usually 9 -12yr old boys) that seem to be very very anxious about injections, and will resist suddenly and violently, but after the numbing is over, they usually do just fine. The key things are 1. that we do everything possible to make things as easy as possible for these children, 2. Each child reacts differently and differently on different days, 3. Anxiety management is an important consideration and is often mitigated by medications as benign as laughing gas or sedation or even general anesthesia.
I have a 3 year old daughter and she just came from tha dentist a couple of hours ago she got an x- ray and i was told that she has like 6 or 7 cavities and i was actually shocked like OMG and he explained to me how she was going to have to get sedated to get crowns and Im just really worried and scared. I just want to know how this is going to work and what to expect???
The younger they are the less reliable medications can be. I'd discuss with your pediatric dentist. Also, there is a lot here on the blog about sedation and behavior. Kids are unpredictable as far as behavior. With three year olds I often say it depends on which side of the bed they wake up on. Not surprising to have a three yr. old with cavities though. They often start in between the teeth where we can't see till we get an x-ray or it gets large enough to see.
My 3 year old has white discolouration on her teeth at the bases of most of them and a small cavity on her second to front tooth at the top I took her to the dentist today but all she did was scream and wouldnt even allow the dentist to see her mouth let alone inside it If she continues like this at appointments what are the options for treating her successfully?
Not uncommon for a two or three year old to protest. Read more here on the blog about behavior management, sedation, and hospital dentistry. Treatment (and behavior management) options should be discussed with your pediatric dentist.
I have a 7 year old that is in the beginning stages of braces and she had to have a mold done and was unable to tolerate it due to her Extreme gage reflex. We had to hold her down and fight with her and she vomitted all over the dentist and asperated. She will have to have more molds of her mouth taken any suggestions how to make this better or what to do different. Normally she is very cooperative at the dentist.
A gag reflex especially for impressions is not a situation exclusive to children. Adults occasionally have a hard time too with that. Still, I do not usually start orthodontic treatment on a very young child unless first it is indicated and second that they are fairly cooperative. Depending on what is being done sometimes an impression just for diagnostic models is not necessary or possible. If an impression is needed to fabricate an appliance like a simple expander (something sometimes done on younger kids), they you have to decide if it is possible and how far you want to go with that. Mild sedation can help or just nitrous oxide (laughing gas) can reduce a gag reflex. All this has to be balanced with what you are trying to do how time critical it is and if it is worth all the fuss. Sometimes it is just best to wait till the patient is older (however, no guarantee a gag reflex will improve (although it can with age).
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My one year old had two cavities on the upper teeth; the dentist said to wait until he's older to treat. Now at almost 2, his two front teeth have cavities also. First, what do u think about a fluoride filling ( don't know the name) that might last 3-6 mo , in order to prevent further decay? The dentist suggests Valium , laughing gas, and a jacket; my 2 yr old will be upset- very. Is it worth it for just a temp filling in your opinion ?
Also do these fluoride fillings give off a lot of fluoride in general which could effect the perm teeth?
Thanks!
Well, decay progresses on unless it is taken care of. I don't know what you mean by fluoride fillings. I suspect they mean glass ionomer restorative material. That does release fluoride in very small amounts--no problem at all. Unless the decay is totally removed, any restorative material is a temporary measure. Some dentists lightly scoop out some decay and place a glass ionomer (which can be an acceptable restorative) to buy time till there is more cooperation. YOu can read here when that might be...
My 10 year old daughter is scheduled to get 3 teeth pulled on Friday. Our dentist refered us to an oral surgeon. The oral surgeon saw my daughter once and has recommended IV sedation for the procedure. My daughter is generally calm and not usually afraid of shots or needles. His office keeps saying that the shots given in the roof of the mouth are painful and therefore she will be more comfortable with the IV sedation. I am more nervous than she is about the IV sedation. She is very petite weighing only 52 lbs. How concerned should I be about the actual IV sedation and her recovery afterwards? They're telling me she will be "out of it' and may vomit later. I don't like the sound of that. They have also said that I can't be present in the room for the procedure. I would like to be there while they get the IV started. Is that a reasonable request - to be there when she falls asleep and to be there when she wakes up? Thank you for your time.
We use in-office oral sedation almost every day. These kinds of things should be properly diagnosed, dosed and done in accordance with [roper guidelines of monitoring, health status etc. Read more on the blog here about sedation and general anesthesia. Oral surgeons often use IV sedation or even general anesthesia.
In our office we allow parents back, but it is understandable if an oral surgeon wants to maintain the surgical suite differently, an controlled environment--kind of like an operating room. It's always ok to ask.
Why cant we have more dentists like u in our town? My baby girl is 4 and when i took her to the denstist it was her first time. They did some work on her but they strapped her down and didnt let me in there with her, when i came back when she was done they told me that she was so uncooperative that they couldnt finish, i feel like im just as traumatized as she is. When i went back for her she was really sweaty and clamy, and her face around her eyes was purple and blotchy. She told me that they choked her. When i asked about it they said that she had a hard time dealing with the water. Why is it that we as parents have no other options besides strapping them down and giving them lauging gas, or giving them medicine to work on them. Why cant i as a parent lay down with my child and hold her still? Idk it sounds like a dumb idea but i hate that those are the only options. Putting her under while she gets work done isnt an option for me because i have read of all the deaths caused by that...but i have read of suffocation from the pappoose board as well. Idk what to do for my baby. She needs more work done but i just cant seem to brimg myself To take her.
My soon to be 17 year old daughter has nine cavities and refuses to cooperate with the dentist. She's very nervous and refuses to listen at times...
Also she has a great deal of dental anxiety..
What can I do to help her
She cries and screams and refuses the injections
Sounds lie a pediatric dentist would be the best one to consult. We see teens up to age 21 and sometimes older. Premedication or other methods can be employed to help with anxiety.
My 4 yr old daughter got 8 stainless steel crowns, long story that I dont't want to get into detail again because I get upset just thinking about it. I don't believe she needed all the crowns and at this point I'm just willing to forget what happened and see what I can do about it. A pediatric dentist will be changing 6 of them to zirconia crowns. I don't want to put her under general anesthesia because it would be an unecessary risk for a type of "cosmetic surgery". I am willing to do 2 at a time in 3 visits with some type of conscious sedation. Do you think this procedure can be done with office sedation?
Christine,
Behavior wise, I cannot say if sedation would "work". It all depends on the individual child and the given procedure. It very often does work well though. Something to discuss with the pediatric dentist. By the way, stainless steel crowns work very well, especially on back baby molars. I don't use them in the front, because of appearance. Otherwise, they are great for the back molars and are pretty much the standard of care.
my 6 yr old son cry a lot and doesnt like to seat in the chair when they put it down he gets really scared today is my 3 time taking him to the dentist and he wont let them clean his teeth so now they told me that he has high anxiety and to go to another dentist so they could put him to sleep for his cleaning im scared i dont know what to do
We don't put kids to sleep (general anesthesia) for just a cleaning, unless there are very unusual circumstances related to proper diagnosis of a given concern. An anxious 6 year old can be examined and if treatment needs are determined, can be managed in whatever way seems appropriate, whether it be general anesthesia, conscious sedation, or just proper behavior management. Some kids are anxious and resistant.
Hello , my son is 5 years old i took him to the dentist a week ago and they found out that he has 1 simply cavity that has to be taking care soon...I want to do it asap... they make an appointment for the next month to do the filling or is called something else ** they asked me if I want to do the rapper thing where they hold him tigh or if I want they to put him to sleep I'm new on this so , I'm so concern about what to do because my son has fobia he can't even handle tight hugs he gets so desperate.... what should I do about it ? Beside that he did a really calm and good job in his last appointment for his cleaning ��
Thank you
If a child is cooperative, there is no problem doing treatment in a "normal" way. We do it all the time. However, if he is uncooperative, you can consider pharmacological (sedation) or general anesthesia (asleep). Restraint, (in the form of anything from holding hands, to a physical restrianing wrap is another option). I bet the dental office was trying to inform you of your options. If you do not want the "tight hugs" of restraint, then tell them--but they may not be able to do any treatment without getting cooperation from the patient. Good luck.
I have a 2 year old her first visit is in a couple of days and i'm worried she won't cooperate she hates when we try to brush her teeth she screams and pushes us away so it's hard to really brush her teeth good she's getting like orange plaque or something and i'm anxious to know if they will do a cleaning for her first visit.
I have a 16 year old who has a mouth full of cavities and she refuses to brush her teeth. Needs to extract 4 molars because of extensive decay does not open her mouth for the dentist . Screams and cries as well as fight with the dentist for even an exam . She even had a wetting accident at her last visit she had to get an injection for a filling and we ended up not getting much done , she would not open her mouth without screaming and crying and fighting and is completely traumatized. She even saw a paedoatric dentist but was too embarrassed because she was the oldest kid there and the only one crying.
How to help
Anon-- There are 16-year-olds that have anxiety like that. It's a difficult situation of course. As a pediatric dentist, we actually see kids up to age 21, or even older if special needs. In-office options often include conscious sedation. If only extractions needed, an oral surgeon is also an option as they will be asleep for any treatment, similar to wisdom tooth removal. Oral surgeons only usually do tooth removal, not fillings, etc. So, we sometimes have to take patients to the operating room for general anesthesia for treatment. This is often preschoolers, but can also be older patients or adults.
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