Kusp Pediatric Dentistry

Should parents be allowed to sit in on a child’s dental appointment?

The Millennials and Generation Z parents of today feel more comfortable being present in our operatories for their children’s visits than waiting in the waiting room. Modern parents have a very good understanding of what possible treatment options may be thanks to modern technology and are interested in being involved in their child’s treatment. What has created this shift in the parenting approach in the dental setting?  Understanding collective generational traits allows for a better understanding of modern parenting styles and how this ultimately impacts child behavior. As a young child, I remember my parents sending me to my dental cleaning or treatment appointment alone as they waited for me in the waiting room. As a Millennial parent, I can never imagine sending my second grader in for a dental cleaning or check up and not be sitting with her, asking questions, and supporting my child. While my parents may have not sat in on my appointments or asked the doctor lots of questions, as a whole my parents and most Millennial and Gen Z’s parents placed a strong emphasis on their children and their children’s success (Swanzen 2018). 

Dr. Adi Genish and her daughter smiling - Kusp Pediatric Dentistry in Beverley Hills, CA

As a result of this lasting child-parent partnerships, Millennials and Gen Zers have been found to be more highly-educated than previous generations, value family life, are collaborative, care about their personal goals, are inclusive and tolerant of others, and have emerged as a highly social generation (Monaco 2007, Pyoria 2017, Swanzen 2017). These general characteristics explain as a whole why today’s parenting style seems to be very “hands-on” and more involved. The involvement in decision making for their children and in particular wanting to minimize any discomfort for their children, is an important parenting characteristic that we are always trying to pay attention to. 

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As a general philosophy in our practice, we assume that parents are doing the best that they know how and we convey respect for any and all of their efforts. As parents ourselves we avoid judging and blaming parents at all costs and praise parents for all their efforts to care for their children.  We have so many parents that feel a strong sense of guilt when they find out their child has a cavity but, we try to remind parents that as perfect as we try to be, not everything our children experience is in our control. Our awareness of the contemporary parent’s approach to stress inducing experiences for their children is also as important to successful patient care as honing-in on a child’s emotional development and neurophysiology in our behavioral guidance approach.

So how do we manage a child’s behavior in a dental appointment?

Behavior guidance is a methodology utilized  to create a comfortable and effective working environment for both the doctor and the patient. This includes the various means by which a dentist can appropriately achieve treatment goals as well as assist the patient to have a positive experience while in the dental chair. Another way of describing “behavior guidance” is cognitive and environmental molding to achieve age (and medical condition) appropriate responses to the dental experience. Our ultimate goal is to achieve individual treatment goals with minimal amount of struggle. The goal for behavior guidance is to adequately master the ability to read and assess a patient before they sit in the dental chair, to determine how the parent may influence the performance of their child, and to make sure to maintain an open line of communication with the patient and the parent with a patient centered and family centered approach to the child’s care.

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What are some of the techniques we use in order to accomplish this?

Well of course, a little bit of magic! But also, paying very close attention to the child experience. Often, dentistry can be a stress inducing experience when we are dealing with more complicated treatment. We can help an emotional child identify what they are experiencing during a difficult appointment rather than try to fix it. Brene Brown in one of her many hugely popular parenting podcasts, “The Gifts of Imperfect Parenting” guides parents to manage their children through difficult experiences with compassion and empathy. Dentists, like parents, are encouraged to verbally label what a child may be experiencing in a difficult moment whether emotionally, physically, or mentally. By providing empathy children feel understood, supported, and are able to learn the value of this skill for their own use, rather than using shame or psychological control to achieve the behaviors we want. Rather than try to “fix it”, we as dentists in these challenging moments can help bridge the gap between the child’s emotional brain and logical brain while encouraging parents to model vulnerability with their children by sharing personal struggles that may mirror their experience. 

Further, child attachment theory almost justifies parental involvement in a child’s difficult experiences, suggesting that that sensitive and responsive parenting provides the foundation for the child’s sense of knowing that he or she will be responded to when necessary – this again is a powerful to develop a means to guide a patient through a difficult dental procedure. This is a big reason why we don’t just suggest, but truly encourage parental presence in the dental operatory for dental procedures. 

See also  Apitherapy