If your child has a behavioral disorder like oppositional defiant disorder (ODD), conduct disorder (CD), or attention deficit hyperactivity disorder (ADHD), you may be wondering what your options are for dental treatment.
In general, children with behavioral disorders are more likely to have poor oral health. According to a recent study, children with behavioral disorders are more likely to have dental anxiety, behavior management problems during dental procedures, and they are more likely to have what the study calls “DMFT” scores, which stands for decayed, missing, and filled teeth.
You may be wondering, “what is the dental field doing to help these children and parents like you?”
The American Academy of Pediatric Dentistry (AAPD) has published a reference manual on “Behavior Guidance for the Pediatric Dental Patient.” In the manual, they outline best practices for dentists working with children who have behavioral disorders. We are going to talk about a few of these today!
Dental Care for Children with Behavioral Disorders
Children with behavioral disorders may respond appropriately to a dental environment or procedure until they are afraid or they feel like the situation is out of their control.
The goal of your child’s dentist will be to provide the dental care your child needs without causing undue fear or helplessness.
The way that they do this is through behavior guidance.
“Behavior guidance is the process by which practitioners help patients identify appropriate and inappropriate behavior, learn problem-solving strategies, and develop impulse-control, empathy, and self-esteem.”Behavior Guidance for the Pediatric Dental Patient, AAPD
Many behavior guidance techniques are communication techniques. Here are a few techniques your child’s dentist may try to help them succeed at their appointment:
Ex. 1. Positive Pre-Visit Imagery – Your child’s dentist may show your child images of positive experiences in a dental environment or during a dental procedure while your child is in the waiting room, giving them the opportunity to know what to expect and ask questions while they feel safe.
Ex. 2. Direct Observation – Your child’s dentist may allow your child to watch a video of another young patient receiving a dental procedure or they may be allowed to view a procedure live before their own. This gives your child the opportunity to know what they need to do for their procedure and to ask more questions.
Ex. 3. “Tell-Show-Do” – For each procedure your child’s dentist performs, they may verbally explain to your child what they are about to do, then demonstrate the procedure for your child on a stuffed animal or something else, then finally conduct the procedure. This desensitizes your child to the “scariness” of the procedure and can shape their response.
You may have also heard of techniques like “positive reinforcement” and “distraction.” A well-trained pediatric dentist will enlist any of these communication techniques that they consider necessary for your child to have a positive experience.
If the dentist has tried everything in the book but it has not worked, if your child’s health is in good condition, and if your child’s dental needs are deemed significant enough, they may recommend sedation to conduct the procedure. As a parent, you will be fully educated on the risks and benefits of sedation and your informed consent is required to proceed if the dentist has determined that sedation is best for your child.
The dental field continues to research and learn how to better serve children with behavioral disorders and their families. There are many techniques available that can help your child have a successful visit with the dentist! If you would like to work with a dentist who has experience working with children and enjoys helping families, learn more about Dr. Owen Mandanas. Dr. Mandanas is an integrative dentist who cares about the relationship between the mouth and the mind!