Parental Behavior in the Pediatric Dental Office

Isn't it difficult to work on kids? Well, no not really. It's the parents that can cause much of the stress. We as Pediatric Dentists are trained to recognize patterns of behavior and adapt stategies to change or accomidate the behavior in order to accomplish the desired treatment. We see hundreds of kids a week. We see all developmental stages and ages. We see kids in all kinds of moods and with all kinds of personalities. The parents of these patients know their child quite well, but have also developed an interactive dynamic with their child that they often do not realize exists, and that can occasionally hamper our efforts to accomplish what we are trying to do.

An example might be a parent who has an anxious child. Why is the child anxious? Perhaps, because the mother has either said something about her own difficult experiences at the dentist, conveys unspoken anxiety or has actually used words or phrases that increase the child's reactions. See "Pedo Lingo" for more information on how we use language with children. Parents can be "overloving". They react to every sound or word the child expresses. The child who just wants a little extra attention whines a little causing the parent to say something like, "oh, my poor baby." The child has the parent wrapped around his or her little finger.

Another case frequently encountered is the parent wishing to be present during some kind of treatment. Some dentists do not allow parental prescence during treatment at all. By the way, in our office we allow parents into the treatment area. It is often necessary and desirable to communicate treatment needs, and for many children, parental presence is helpful. I like them to see what we are doing. Many times I do prefer, if I am doing an operative procedure (fillings or something like that), for the parent to be to the side or better yet, if they choose, in the reception area. This way the child's full attention is on me and not the parent. In addition, it can make the dentist distracted trying to manage the child AND the parent. Of course, little bitty children, I need the parent there to help. I like them to be present. Older kids, well, I have seen parents holding the hand of their 16 year old teenager during a simple orthodontic appointment. Seems like more and more parents want to be present than in the past. Gets a lot more crowded these days in the operatory. I'd rather have parents back than sitting worring too much in the reception area. If they are back, they can see what is going on and know it's not such a big deal.

Some parents think their presence will help calm an anxious child. Someties it does. Although we allow parents be present during treatment, we sometimes like them to be apart from the immediate discussion and communication between the dentist or assistant and the child. If the parent is hovering and interacting with the child, the communication is just not there with the dentist. It makes it much harder to communicate with the child. Example: Dentist: "Johnny, how old are you?" "He's 7 years old" (Mom answered the question not the child)(by the way, I don't mind a parent answering, this is just an illistration). Or, Dentist speaking: "Johnny, I'm going to put some sleepy juice in your mouth to help your tooth go to sleep". Mom then steps in and says, "You're ok, it's not going to hurt a bit", just squeeze my hand if it hurts." The child then is anxious. Hurts? What is going to hurt? What's going to be ok? It might not be ok??? He has already forgotten what the dentist said. Dentist: "Johnny, open your mouth, please", Johnny looks at mom who's hovering nearby. Mom says, "Johnny open your mouth" Johnny never looks at the dentist. This is going to be tough. You would be surprised how much better many children do once the parent leaves the treatment area (or at least around the corner). It is my observation that if a child is crying and the whole thing just makes a parent's anxiety level too high, it is not unreasonable to consider other options for treatment such as sedation or general ansthesia.

Having said all this, a lot of us parents simply can't help trying to help our children the best we can. Hey, I understand that. So, in summary. Love and support your child, but let your child establish some independance. If you have questions, by all means you are welcome to come back with your child even for the most difficult procedures. However, let the dentist and staff use their skills and training to manage the child and the treatment. They don't need to divert their attentions onto an anxious hovering parent in addition to all the other stuff they are thinking about.