A Child’s First Dental Visit Fact Sheet Notes
First Dental Visit Introduction
The first dental visit of a child is retained in the long-term memory of a child. It is significant as it gives the first impression of dentistry or dental care to the child.
Table of Contents
A smooth first appointment, with no unpleasant experiences, makes the child positive towards dental care and treatment. Traumatic or unpleasant experience in the dental office elevates the baseline anxiety of the child.
Such a child’s cooperation may be poor and ultimately the child may become a bad dental patient. During the first dental visit of a child, certain dental procedures can be done but it is better to avoid some procedures.
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Protocol Of The First Dental Visit
There are certain procedures to be followed during the first dental visit of a child. Adhering to these will help reduce the anxiety of the first dental visit and create a positive attitude towards dental treatment.
The child should be warmly greeted and attended to by the receptionist and members of the dental team. The clinic environment should reduce the anxiety of the child for the effectiveness of the first dental visit.
Communication with the child should be emphasised for the following reasons:
- To understand the child’s baseline anxiety
- To develop trust in the child’s mind
- To reduce fear and anxiety
However, communication should not be overdone or overemphasised. The dental personnel should carry themselves as the authority figure or the decision maker in the dental clinic. A meaningless, lengthy conversation with no focus can nullify this authority figure presentation.
Children less than 2 years may be examined on a lap-to-lap position, with the parent and dentist on either side. Two- to three-year-old children may be examined on a patient-over-parent manoeuvre.
Recommended Dental Procedures and Those that are Avoided During the First Dental Visit
The procedures that can be performed and those that should be avoided during the first dental visit are enumerated in the Table. The tell-show-do technique, modelling and contingency management can be used for the behaviour management of the child.
If the child displays extreme negative behaviour, voice control may be used. In this case, the probable requirement of sedation or general anaesthesia for behaviour management and treatment may be discussed with the parent.
At the end of the visit, the children can be complimented with a post-operative gift This is contingency management. The first dental visit of a child is a success if the child’s fear or anxiety has reduced by at least a small percentage.
Paediatric Dental Clinic
The paediatric dental operatory is structurally the same as an adult dental operatory. Some conceptual modifications are suggested so that the clinical set-up appeals to children.
These modifications help the child to discriminate between a paediatric dental clinic and a stereotyped hospital setup. The children may have a relaxing experience and carry pleasant memories of the clinic back home.
The paediatric dental set-up should attend to the emotional immaturity of the children. The first dental visit should be interesting so that the children look forward to the subsequent visit to the clinic.
The clinic should be adequately spaced so that the children are able to walk around comfortably. The set-up should be well-illuminated and ventilated. The dental clinic can be divided into the waiting area and the dental operatory.
The role of the dental ancillary is equally important in the paediatric dental clinic.
1. Waiting Area
The waiting room of a paediatric dental set-up requires a lot of modification so that it appears like a play area. The walls should be painted in brilliant and vibrant colours. Comic characters or cartoons depicting a theme or story painted on the walls make it look better.
Soft toys, dolls, board games, crayons and painting books, comic books, children’s encyclopaedias and mounted video games are different ways of entertaining children with varied interests.
An aquarium will also add to the attraction of the room. The waiting room may also be furnished with small chairs and tables for children to be comfortably seated and indulge in board games.
If the waiting room is big enough, a rocking horse, a moving truck, a mini-adjustable slide or a wall-mounted mock-basketball frame and plastic balls may be accommodated.
The objective of these objects is to lower anxiety in children before dental treatment, which is a prerequisite for good behaviour while treatment.
2. Dental Operatory
The walls have to be white-averse. All hospital walls are generally white. The child can generalise the hospital and the dental clinic. When walls are painted with a colourful scheme, the child is able to differentiate the dental clinic from a hospital in his primitive understanding.
The dental chair can have brightly coloured upholstery. Small soft toys can be hung on the dental chair. Small stickers of comic characters on the dental chair and wall-mounted sof toys will create a pleasant atmosphere for a child to take up dental treatment.
Care should be taken so that the dental chair does not look like a circus gadget. A television mounted on the roof or in front of or above the dental chair serves as a mode of distraction to prevent anxiety during treatment.
Sharp instruments, huge equipment and injections should be kept away from the reach of children. They should be placed only in the operatory or in the sterilisation cabin.
The smell of acrylic, eugenol, medicines and strong phenol compounds (used as disinfectants) can be masked with the help of a room spray. The corridors and passages should be broad enough to allow movement of wheelchairs. Washbasins must be placed at a height compatible with children.
3. Dental Ancillary
The ancillary staff must have a good attitude and understanding of their independent role and responsibility to deliver dental care to children. They should be trained to communicate to children effectively and it must never be ‘overdone’.
They must wear a neat uniform and be groomed tidily. Ancillary staff be trained to deliver oral hygiene instructions and diet counselling to children and their parents.
A Child’s First Dental Visit Fact Sheet Summary
- A smooth first dental visit with no bad experiences makes the child positive towards dental care and treatment.
- Examination, investigation and non-injection treatment are only allowed in the first dental visit.
- A warm greeting, ambient friendly atmosphere, effective and precise communication, behaviour shaping to reduce fear/anxiety and a post-operative gift make the first dental visit a success.
- Two-year-olds and younger children need to be examined on a lap-to-lap (knee-to-knee) position and 2–3-year-olds on a patient-over-parent manoeuvre.
- A paediatric dental operatory needs some conceptual modifications during establishment.
- The waiting room has to be converted into a play area with vibrant colours, comic character paintings, toys and games, and small (kids) chairs and tables.
- The dental operatory should be white-averse with bright upholstery and modes of distraction.
- Dental ancillary staff needs to be trained to receive and handle children without overdoing their role.
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