Shocking figures from the NHS have revealed that having teeth pulled is the most common reason why children are admitted to hospital. Figures from the Health and Social Care Information Centre show that for the year beginning April 2013 more than 25,000 children aged between five and nine were admitted to hospital for dental treatments. Put into context, the next most frequent condition for the hospitalisation of children in this age group was tonsillitis at more than 11,000.
Many reasons have been cited for this, including: poor diet; increased consumption of sugar (with fizzy drinks identified as the main culprit); poor oral hygiene; and the failure of parents to take their children to a dentist, either because of cost or perceived anxiety – on the part of the child and the parent.
Certainly, all these reasons are troubling but they are addressable – we can improve diets, reduce sugar intake, get better at cleaning our teeth and maintaining good oral health.
But what’s harder to address, and of particular interest to me, is how we get over an almost ingrained fear of the dentist – especially for children.
The days when ‘difficult’ children were automatically given a general anaesthetic whenever they needed dental treatment are, thankfully in my opinion, long gone. General anaesthetic has taken its rightful place as just one of a number of options – behavioural and pharmaceutical – that are available to modern dentistry.
At Plymouth University Peninsula Schools of Medicine and Dentistry, the way in which we teach our students to deal with anxious children has at its base the General Dental Council guidelines, Standards for The Dental Team of : “..taking a holistic and preventative approach to patient care, taking into account the patient’s overall health, psychological and social needs, long term oral health needs and their desired outcomes.”
The first action taken is to seek to understand more about the phobia and distinguish between true phobia and general anxiety. Is the child really frightened of dentistry and/or the dentist, or is it the unknown that is worrying them? Is it the parents who are anxious? Or is it the dentist’s anxiety about treating children?
Certainly there is a debate to be had about whether children are born with dental anxiety, or whether they pick it up from the environment around them. There is a poor public perception of dentists and dentistry, especially around the treatment of children, and this may be because as a profession there is perceived to be a lack of confidence about how to manage paediatric dentistry procedures – even though there are many protocols in journals and on the British Society of Paediatric Dentistry website.
Our students are shown that the management of anxiety in children (and by extension, their parents) is underpinned by exceptional communication.
Effective communication alongside excellent clinical standards will help to dispel anxiety and fear in the majority of anxious child patients. This in turn will encourage them to become life-long, enthusiastic and regular dental attendees. Some people have a natural talent for empathy, building rapport and effective communication techniques, while others may have to work at it.