Paediatric Dentistry

What to do if your child won’t tolerate dental treatment.

Many patients will require dental treatment during their childhood, this may range from a simple check-up and clean to more extensive work. Taking your child to the dentist early on can, not only prevent serious dental problems, but also reinforce positive attitudes towards the dentist and thereby increasing the chance that they will be cooperative should treatment be required.

Unfortunately some child patients will be uncooperative, the days of the parent restraining a child in the chair while the dentist forcibly does the work are mostly gone and only used in very extreme circumstances. Research has shown that an early bad experience can result in life-long dental anxiety [1]. So, if your child needs dental work but is uncooperative what are the options?

Delaying treatment:

If the child dental patient has only minor issues with minimal symptoms your dentist may elect to delay treatment. Often your dentist may insist the parent brush the child’s teeth each evening and reduce sugary foods and drinks. If small cavities are present, it might be possible to place quick temporary fillings (without any anaesthetic/needles). The idea is to slow down the decay process, give the child a positive experience and then try at a later date to treat the teeth properly. Quite often after a few good experiences at the dentist, the child will be more cooperative at future appointments and ideal dental treatment can be performed.

Happy Gas (Nitrous Oxide):

Happy gas is safe and is a great way to reduce dental anxiety for children (and adults). Used in short appointments (30-45mins), happy gas can allow the dentist to complete a filling or extraction without stressing the child patient. While it works very well for most children, the child must be cooperative enough to allow the mask to be placed over the nose so it is not a solution for all children.

General Anaesthetic (GA):

Should the child patient require a lot of work or if they require urgent work (such as an overtly infected tooth or severe pain) and if they are uncooperative, general anaesthetic is the best option. The child is put to sleep by an anaesthetist and all dental work is completed in one visit. After the GA session is completed it is important to follow your dentist’s advice regarding oral hygiene and diet to prevent any future problems and the child will need regular check-ups.

Dr Michael B. Russo

BCom, BDent, Grad. Dip. Clin. Dent. (Oral Implants)

 

1. Rice, A. and A. Liddell, Determinants of positive and negative attitudes toward dentistry. Journal (Canadian Dental Association), 1998. 64(3): p. 213-8.