Say Aaah! Going to the dentist can be a scary experience. Some children are more comfortable and excited than others to go to the dentist, but each visit offers a new opportunity for parents to educate their children on what procedures will be performed and why it is important. Dr. Kelsey Stehli of Mertes Pediatric Dentistry in Hudson shares the top five worries that parents have for their children at the dentist and how to calm your kid’s nerves before their appointment.
1. Cavities
One of the most common procedures pediatric dentists perform is filling a cavity. According to the Mayo Clinic, a cavity is a permanently damaged area in teeth that develops into tiny holes. Untreated cavities can cause toothaches, infections, and tooth loss. The most common treatments include fluoride, fillings, and crowns.
“I think people are often surprised at how common it really is,” Stehli says. “Depending on where you look, some people say 40% of kids have a cavity by kindergarten, and some say 60% of kids by kindergarten will have a cavity. It’s far more common than I think a lot of people realize.”
Stehli explains that there are several reasons why young children are more susceptible to getting a cavity. Children’s teeth are very different from adult teeth, as the enamel on children’s teeth is very thin. They’re shaped with big broad contexts where the teeth come together, and they are more likely to pack food in.
“That’s why it’s actually really important to floss children’s teeth,” Stehli says. “I think a lot of people don’t really realize that.”
Young children are more susceptible to getting cavities, because children tend to graze their teeth throughout the day. Thirdly, young children tend to snack on lots of foods that contain carbohydrates, such as Goldfish or Cheerios. These foods contain carbohydrates that the bacteria can process down, and those will turn into cavities.
“I would avoid snacking in an unstructured way,” Stehli says. “I never want to deny a kid Goldfish, but at the same time, I don’t want them eating them over the course of two hours. The advice that we typically give is try to give the kiddos structured snacks throughout the day and try to limit them. We recommend limiting kids to two snacks a day.”
Although there are many ways to prevent cavities, children may still end up getting a cavity and needing a filling.
Stehli explains that when a child comes in to get a cavity filling, pediatric dentists first assess how nervous the child is about the procedure and explain what the procedure entails and the equipment they are using.
“For parents who are anxious about their child getting a cavity filled, it’s important to remember that the kids are really smart,” Stehli says. “They are really perceptive. If a parent is showing that they are anxious, often the kid will wonder if they should be anxious, too. Try not to let the kid pick up on that. There are some good videos that they can watch like ‘Daniel Tiger Goes to the Dentist,’ where they can see that it doesn’t have to be a scary experience.”
2. Fluoride treatments
According to healthline.com, fluoride is a natural mineral that builds strong teeth and prevents cavities. It supports healthy tooth enamel and fights the bacteria that harm teeth and gums. Fluoride treatments can be in the form of a rinse, foam, gel, or varnish. The treatment may be applied with a swab, brush, tray, or mouthwash. Fluoride treatments are typically done right after a traditional cleaning.
“My advice for kids who are nervous about the fluoride treatment is I tell them to open as big as they can,” Stehli says. “Once you open really big, I can really keep it away from your tongue. If they open as big as they can and take a big breath in through their nose, by the time they let that breath back out, we are done. For parents who are nervous, I would tell them that their child may not like the flavor of the fluoride right now, but it’s great for their teeth, and they can drink after just five minutes.”
3. Braces
The American Association of Orthodontists recommends children have their first growth and development evaluation by the time they are in middle school. At this time, kids are transitioning into their permanent teeth. Braces are very common, especially in this age group.
Stehli says that there are signs to know if a child will need braces in the future. Children as early as two years old show signs of needing braces, and she explains these concerns to the parents. Typically, dentists will let children get their six-year molars in the back and ideally have all four of their front teeth in on the top and the bottom before they start their first phase of braces.
Dentists often determine when children need braces during a cleaning.
“During an evaluation, we might decide that it’s time to see the orthodontist, and we will make that referral,” Stehli says. “Some kids really are looking forward to getting braces, and there’s things that they really want fixed. A lot of the time, depending on the age of the kid, we’ll talk with the parent, and then we’ll talk with the child and include them in the conversation.”
Stehli notes that some children may be disappointed in the slow progress their teeth make while wearing braces, but the first few months is when the most drastic changes occur.
“Kids will be surprised just how quickly things move around,” Stehli says. “If kiddos are feeling nervous about it, it might be fun to take a picture every day and watch things move around.”
4. X-Rays
Getting an X-ray can be a very scary experience. Stehli notes that dentists try to limit performing X-rays on children to minimize the amount of radiation kids receive. If dentists are taking an X-ray, it is either to look at growth and development and to evaluate for possible pathology, or to ensure that the child doesn’t have cavities or decay or bone loss.
“I would say kids struggle the most with gagging on the X-rays,” Stehli says. “When we’re doing it, we try to get it done very quickly. One thing that can be reassuring is even if your kid gags when they’re little, it doesn’t mean they will gag every time or gag when they get older.”
The actual radiation coming in takes a fraction of a second. If the dentist is afraid the child will gag, the dentist will put the X-ray in their mouth and have them bite down. The person who is helping the child bite will step out of the room quickly, and someone else will press the exposure button. Between biting on the X-ray and getting it started, the process takes two to three seconds.
Stehli compares the X-ray procedure to getting a haircut. The client comes and sits in a chair and gets draped with an apron, similar to going to a hairdresser.
“I think kids are used to this idea of dress up and things like that and getting the lead apron on,” Stehli says. “If the parents want a good way of explaining the procedure to their kids beforehand, they can kind of compare it to getting their hair cut.”
5. Fear of needles/drills
Many children have a fear of needles and may fear the sound of drills. Stehli says if a child is afraid of the tools used during a procedure, the dentist will gently explain the tool to the child.
“We use gentle language that the kids can really relate to,” Stehli says. “If we’re going to use the prophy angle, which is where we put the prophy paste when we’re going to clean teeth, we call that a ‘spin brush’ to the kid. If I am going to numb a child, I’ll tell them, ‘I’m going to use some sleepy juice, and I’m going to make you fall asleep.’”
Stehli says beyond explaining the tools, the dentists will allow the child to touch the tool and show them the different instruments. He explains it might be nerve-wracking for a child to have a stranger use tools in the child’s mouth, especially if it is their first dental experience.
Some children are more comfortable than others, and some may have a great dental experience one day and then have a bad day the next time they go. Stehli says each child is different, and it is important to gauge the comfort levels of each child.
“For parents who are nervous about their child at the dentist, I would encourage them to have faith in their children and to have faith in the team,” Stehli says. “Especially with pediatric dentists. We are really trained in behavior management for these kiddos. We are really trying to gauge what is most appropriate for their particular child and treating each child individually according to their needs.”
