About one in ten children feel fear in connection with a dentist visit. It is most common in younger children.
Dental care can be due to many things. Often, the child has previously had bad experiences with dental treatment, for example that it has hurt or that the child has felt violated. The child may also have been affected by someone in their vicinity who has given a negative picture of dental care.
What is Dental Fear?
It is common for children to feel anxious or fearful of a dentist visit. The child may be worried about how the treatment will proceed. But usually they have control over the situation and it need not be regarded as dental fear.
Dental care fears can be more or less strong and you talk about mild, severe or extreme dental fears. It is called dental phobia if it becomes so strong that the child avoids coming to dental care. It can cause them to stop caring for their teeth completely.
A dental visit contains many factors that can be stressful. The child may meet unknown people, the environment is strange with loud noises, strong scents and bright light. They can feel exposed in the treatment chair, without having complete control over the surroundings and what is happening. Experiencing a lack of control can help the child develop dental fear.
When should I seek care?
If you suspect the child is feeling scared, you should first tell the child’s dental team. If you notice that the fear does not subside, you can talk to your regular dentist and request referral to specialist dental care for children and adolescents, pedodontics. There, the dental staff specializes in children and young people with dental concerns.
It is important that you, who accompanies the child to the dentist, tell the dentist if you suspect that the child feels fear. You can do this already when you make an appointment for the visit. You can agree on extra long visits or just come so that the child gets to know the environment and get to know the dentist. Shy children may need extra time to feel comfortable in an unfamiliar environment with strangers.
In order to treat dental fear, the dentist must get an idea of the child’s experiences of previous treatments by asking the child. What has been good and what has been bad?
By giving you time for a call, you can discuss with the child and the dentist how the treatment should be arranged.
The child’s age, conditions and possible illnesses can affect treatment. If the child has his or her own difficulties, eg neuropsychiatric diagnosis, the dental care professional needs to be informed so that the treatment is adapted to the child’s needs.
If the child has severe or extreme dental fear, the dentist can write a referral to a specialist clinic for child and adolescent dentistry, also called pedodontics. Such receptions are found in most county councils and regions.
Specialist dentists have a lot of experience in children with dental care and have access to many different treatment methods. In addition, specialist clinics collaborate with pediatricians, pediatric psychiatrists and psychologists if needed. Most often, the child is offered cognitive behavioral therapy, KBT.
To get used to gradually
For the child to dare to participate in a dental treatment, it must practice and get used to the situation. This is usually called in-school training and means that dental professionals guide the child through various steps, step by step.
The child may start with an easy situation, for example having his teeth examined with a mirror in his mouth. The dental care professional tells you first and shows how to do it. Then the child has to try.
Dental staff try to adapt the requirements and difficulties to what the child is believed to be capable of. All the time, the child should be able to interrupt by signaling to the dentist in a way they have agreed, for example by raising his hand.
When the simple treatment situation works well and the child feels safe the severity increases. The dental care staff tells and shows the step and then the child is allowed to do just that. Little by little, the difficulties increase and the child thus receives a gradual training for increasingly difficult parts of the treatment.
This training is often performed by a dental hygienist or dental nurse with training for such tasks. This is done in collaboration with the child’s dentist.
If you are scared you get excited, and then you may find that it hurts more. Therefore, it is good if the child can use some relaxation technique. It is most common to learn different breathing exercises.
Nitrogen soothes the baby
All pediatric dental specialists and many general practitioners with further education have the opportunity to provide nitrous oxide. The child is trained in the use of nitrous oxide in connection with dental treatment when a small breathing mask is used on the child’s nose. The mask allows the child to breathe in a mixture of oxygen and nitrous oxide.
The nitrous oxide is odorless and can make the child calmer and less afraid. The dentist can adjust how much nitrous oxide is used. The child is constantly awake and able to participate in the treatment. After the treatment, the child can only breathe oxygen for a few minutes.
Nitrous oxide is usually used for slightly older children as it can be difficult to breathe only through the nose of the mask.
The child can receive sedative medicines. The medicine can be given as tablets or liquid by mouth. For smaller children, sedative medicine is usually given as a solution, known as enema, which is brought into the tail.
Most sedatives used in dental care work the next hour after it is given. After the treatment, the child may need to stay for an hour before going home. The child may need to be home from school or preschool for the rest of the day.
Dental care under anesthesia
If the baby’s teeth are very bad, and requires a lot of dental care, it is given under anesthesia. It may also be necessary if the child is not judged by the treatment in the usual way, depending on the care needs and maturity.
Getting anesthetized does not help the child solve the problem of dental fear, but it allows for the moment to treat the teeth. Afterward, the child can focus on training and treatment of the fear.
Stunning is important
Because pain is one of the most common causes of dental fear, treatment must be as painless as possible.
Anesthesia is the most important and common way to get pain relief. Stunning gets the baby every time there is a risk of it hurting. There are different types of stunning. An anesthetic ointment is used to make the feel of the syringe itself feel less. It is applied to the gums for a few minutes before the child should receive anesthesia.
In case of surgery that can cause pain, anesthesia is always offered regardless of age.
Prior to a planned treatment that can be painful, pain relief in the form of tablets or solution containing paracetamol or ibuprofen is used, for example.
The medicine is taken one hour before treatment in order for the medicine to have the best effect. If a tooth is difficult to anesthetize, for example, due to inflammation, the child may also receive pain relief medication. Soothing medicine is also used to make it easier to give anesthesia.
What you can do
If you suspect the child is worried about the dental visit, it is good to ask how it feels.
If the child is worried and feels uncomfortable about going to the dental office, it needs help to get over the fear as quickly as possible. It is important that you yourself are calm and set aside plenty of time for your visit to the dentist. The child needs to determine the pace himself during the dental visit. In this way, the child feels that he has control and can feel secure.
You can switch reception
If the child, or you who accompany the child, do not have confidence in the child’s dental staff, the team can be changed. At the same clinic or at other clinics, there may be interested child care teams who can deal with the fear.
A prerequisite for successful treatment of dental fear is that children, parents and dental teams can work together. Then it is important that, above all, the child feels safe and accepts the dental team.
Free dental care
Children and young people are entitled to dental care without having to pay for it. Free dental care is valid until the end of December the year you turn 23. This includes pretty much all examinations and treatments, whether you go to a private dentist or the dental office. In some regions, a higher age limit applies to free dental care.