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Should I Stay or Should I Go? The Dilemma of Going Back to Treatment with Your Child

Should you go back to treatment with your little Bobby or should you stay in reception and balance your checkbook? Pediatric dental practices differ on whether parents should accompany their children during treatment. In some offices, parents are required to accompany their children as a way to ensure parent education about good dental health. In other offices, children are encouraged to go back for treatment on their own. That way, the pediatric dentist and team can focus on the child, work directly with the child, and build a positive relationship with the child right away.

If you do go in with your child:

1. Stand or sit in a location where your child knows you are nearby but can not see your face. (Even a very young child is totally tuned in to your facial cues. It only takes one worried look to inadvertently upset your child.)

2. Be a silent observer. Let the pediatric dentist build rapport and provide positive coaching for your child.

3. If your child needs physical reassurance, you might consider holding your child’s hand or having your toddler sit on your lap.

If you do not go in with your child:

1. Be assured that the pediatric dentist or a member of the team will keep you carefully informed about your child’s dental health and development. Typically, this takes place in a one-on-one conversation right after the dental visit.

2. Stay at the dental office during the appointment. Although some parents are tempted to drop their children off and run errands, it is better to be there and not be needed than to be needed and not be there.

The Whats of Sedation

Physical Restraint

Possibilities in this category include asking the parent to hold the child on her lap with her arms hugging the child. Another approach is the use of a body wrap that holds the child’s arms and legs away from the mouth. Restraint may be recommended for children who are very young or have difficulty remembering the importance of keeping their hands away from dental instruments. Used only after alternative approaches have been considered, this approach is sometimes necessary to protect a child from the sharp, fast moving instruments required in dental treatment.

Conscious Sedation

This technique uses medications to help a child cope with anxiety and cooperate with needed dental treatment. In particular, it can prevent injury by helping a child stay still around the sharp or fast-moving instruments needed for treatment. It is called “conscious” sedation because the pediatric dentist selects a medication and dose unlikely to cause a loss of consciousness. (In other words, the child is relaxed but not asleep. He is able to respond to touch or voices.)

General Anesthesia

Medically speaking, general anesthesia is an induced state of unconsciousness. In practical terms, the patient is asleep and unable to respond to touch or voices. It is most often recommended for children who cannot tolerate the extensive treatment required to restore their dental health. For example, if a toddler was suffering from severe decay and required four root canals, the parents might agree that general anesthesia was the most comfortable way to complete treatment. All parents should know that children face the same risk under general anesthesia for dental treatment as for any other surgical procedure. The treatment should be provided only by highly qualified health professionals with experience in anesthesiology.

Courtesy of the American Academy of Pediatric Dentistry.