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Dealing with Child Dental Fears

They scream. They whine. They throw tantrums. It's no wonder many parents become so frustrated with their children's anxiety that they consider not taking them to a pediatric dentist at all. It's stressful, but perfectly normal.

Children experience dental anxiety just as adults do, and this fear is intensified by a sense of the unknown. They just don't know what to expect, and that's scary. You want to do what you can to put their minds at ease, but don't really know where to start. To really address these concerns, it's important to understand where dental anxiety originates in children. There are essentially two types of dental fear: objective and subjective.

Objective fear is created when a child goes to the family dentist and has a negative experience, such as feeling pain or not understanding precisely what's happening. The only way to overcome objective fear is to return to the dentist and replace these negative experiences with positive ones. Over time, a child should become more comfortable, their anxiety dissipating. Subjective fear, on the other hand, does not spring from actual experiences at all. It may be implanted by images of terrifying dentists on television, by playground horror stories or by sensing mom's anxiety before her own dental appointment.

Education is a parent's best defense against subjective fear. To relieve a child's pre-dentist anxiety, discuss the appointment in positive terms. For instance, explain that the pediatric dentist is a friend who will count, clean and examine his or her teeth using neat tools. Let children know that despite playground rumors, a dental exam is painless. There are a number of children's books that can help, but try to avoid those that discuss advanced procedures like fillings and extractions. Stick to the basics, and your family dentist will go from there. If you struggle with dental anxiety yourself, try not to let it show, or leave these lessons to somebody else. Children are very perceptive.

Next, consider taking your child to a pediatric dentist. Pediatric dentists are specially trained in dealing with child dental fears. They use techniques such as modeling (demonstrating procedures on fake jaws or stuffed animals) to alleviate anxiety, and explain everything in simple, fun terms that a child can understand. Beyond that, however, pediatric dentists understand child dental health needs, such as identifying problems related to thumb-sucking or baby bottle tooth decay. The experience could be just as educational for the parent as it is for the child.

Finally, for the sake of both your children's teeth and emotional well-being, it's best to bring them to the family dentist before their first birthdays. Establishing positive experiences from such a young age will squelch both objective and subjective fears before they even materialize. It will also ensure that the dentist can identify and treat child dental care problems and help to establish a proper dental regimen right from the start!

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Management of Injury to Children's Permanent Teeth

Recent studies indicate that 25% of Americans between the ages of 6 and 50 years have experienced traumatic injury to permanent teeth. Ninety percent of traumatized teeth involve the upper incisors. The focus of contemporary treatment of dental traumatic injuries is conservative management of the affected tissues to maximize their excellent healing potential in children. The most important element in this process is the reduction of the time interval between the traumatic episode and the dental treatment. Dental treatment should therefore be sought immediately. It is for this reason that public information on dental trauma management is so critical, particularly in the following three areas.

Coronal Fractures -- Broken Crowns of Teeth

The predominant treatment goal in tooth crown fractures includes protecting the underlying pulp (nerve tissue) within the tooth from bacterial contamination and infection. Additional goals include keeping the adjacent teeth from moving into the space created by the missing tooth portion and restoring the esthetic appearance and function of the traumatized tooth.

Dental treatment of crown fractures involves the following steps. The affected teeth and surrounding soft tissues are cleansed with an antibacterial mouthwash and the exposed dental hard tissues are protected with either an applied protective medicament or an adhesive resin material. These measures provide a seal against bacterial penetration into the porous tooth structure and subsequent infection of the underlying pulp. A resin (plastic) restoration of the lost tooth portion is placed for esthetics and function. In cases where the missing tooth fragment can be found, it can be reattached to the remaining tooth portion with dental adhesives. The treated teeth are then monitored post-operatively for signs of possible infection over a period of several months to a year.

Tooth Displacement Injury -- Loosened or Dislodged Teeth

The predominant treatment goal for displaced teeth focuses on protecting the supporting tissue known as the periodontal ligament from bacterial invasion and subsequent infection resulting from the injury. This tissue surrounds the root of the affected tooth and has the primary function of attaching the tooth to the bone.

Dental treatment includes stabilizing the excessively loosened or displaced tooth by means of short-term splinting. The splinting device consists of an orthodontic brace wire attached to the affected tooth and adjacent teeth with resin adhesive for a one to two-week period. Additional treatment may include esthetic restoration of tooth portions damaged by the injury as previously mentioned, and post-treatment monitoring for signs of healing.

Tooth Avulsion -- Teeth That Have Been Knocked Out

Treatment goals for knocked-out teeth are focused on enhancing periodontal ligament survival. The critical variable is the length of time that the tooth has been out of the mouth without any means of providing hydration and nutrition to the periodontal ligament cells attached to the avulsed root surface. This time length is known as Extra-Oral-Dry-Time (EODT). If the EODT is less than one hour, the chances for periodontal ligament survival is quite good, provided the appropriate management is started immediately.

Dental treatment of avulsion involves minimizing the EODT by immediately replacing the tooth back into the socket or immediately placing it in a transport/storage solution to hydrate and nourish the periodontal ligament cells still attached to the root. The most readily available transport media is cool milk. Special tissue culture fluids are even better, but generally are available only from a dentist, drug stores, or school health clinics. On-site tooth avulsion management includes the following:

1) Rinse the knocked-out tooth under tap water only if there is dirt.

2) Replant the tooth in its socket and keep it held in position, or place it in milk (or culture fluid, if available).

3) Immediately take the child to a pediatric dentist who will stabilize the tooth with splinting devices previously mentioned and provide the necessary treatment of the pulp and the periodontal ligament.

The more we can do to enhance the excellent healing potential of the traumatized tissues in children, the better the outcome.

By Clifton O. Dummett, Jr., DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.