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Addressing Dental Anxiety in Kids: A Parent’s Guide

Star Light — Tue, 01 Apr 2025 11:00:16 +0000

Dental anxiety in kids is common, but it doesn’t have to prevent them from getting the oral health care they need. Learn the causes, symptoms, and effective ways parents and pediatric dentists can help children feel more comfortable during dental visits.

My childhood dental experiences took place in Damascus, Syria where I was born and raised. Our family dentist was a well-trained practitioner who took pride in his care. However, the encounters were far from warm and fuzzy. With a keen interest in the health field, and a desire to work in a small practice setting, I pursued a degree in dentistry, often wondering how I could make a difference in the profession. The answer came when I chose to become a pediatric dentist.

Desiring an entirely different dental experience for the kids whom I cared for, the quest of my career became focused on offering state-of-the-art pediatric dental care in an environment that is comfortable, educational and fun.

Pediatric Dentistry From Parental Perspectives:

As parents, we want the best for our children, especially when it comes to their health. But navigating pediatric dental care can feel overwhelming. It’s not just a matter of teeth. Questions like “How should I expect my child to behave at the dentist?” And, “How do I handle my child’s dental anxiety?” Can come up.

Dental visits can stir up memories and feelings for parents that may be a lot to handle. Emotions are processed differently by each of us and tend to shape how we navigate future experiences. Well-meaning parents can project their own impressions onto their child’s experience or misinterpret their behavior. This is why the availability for cultivating a bond of trust between the family and the dental team is one of the most important factors in choosing a dental home.

Parental Involvement In The Dental Setting:

When I was a pediatric dental resident at the University of Southern California, a big topic of discussion was whether parents should be invited to sit in on dental procedures or not. The older faculty members had mostly set up their practices so that parents remained in the waiting room. I remember thinking that this seemed unreasonable and that other options should be considered.

Their argument was that parents do not go to school with their children nor do they interfere with a teacher in a classroom, so why should they be part of a dental visit? With a doubt, this mindset has transformed as have parenting approaches. Fast forward years later and parents take an active part in most dental visits and procedures. For an interesting read on parenting styles and children’s behavior in the dental setting, here is a good read:

The Influence of Parenting Style on Child Behavior and Dental Anxiety

Our office has always had an open door policy. We want children to feel supported and aim to help parents be informed, and confident about their child’s oral health. That said, as a seasoned pediatric dentist, I now find myself mindfully considering the smoothest path of care for each of my patients. Sometimes, this may be to ask a parent’s permission to allow space for me to interact and communicate with their child as they watch from a short distance.

Other times, it may be in the child’s and family’s best interest for the parent to comfort their little one with hand holding or closeness. This evolution has come about from deepening my connections with families and believing that honoring children’s individuality and personal capacities is what fosters a feeling of safety and comfort in the dental setting. Here is another publication that highlights the parent-child-dentist relationship interaction:

Correlation of Personality, Temperament, and Behavior of Children in the Dental Environment

Pediatric Dentistry Through A Child’s eyes:

Being a pediatric dentist is a multifaceted path of service. On one hand, it involves a one-on-one relationship with kids and on the other, it requires collaboration and communication with the adult parent who is making decisions for their child’s care. The nature of dental services is highly personal. Working near someone’s face requires them to receive and welcome you into their personal space.

This is a lot to ask of young children and teenagers. Gentle guidance, engaging conversations and dental education help to create bonds of lasting trust. Routine dental care such as examinations and cleanings that start at a young age get children used to what to expect during their dental visits. And most importantly, positive reinforcement is a big part of looking forward to appointments. When a feeling of fun, joy and excitement is cultivated, dental visits become an experience that kids look forward to.

When Dental Care Needs To Go Beyond Routine:

In the United States and globally, dental caries remains the most common chronic disease of childhood with many children experiencing dental decay by the time they enter kindergarten. As advocates for dental health, we believe that educating families as early as possible on infant and toddler oral care is an important step in fostering dental well-being and preventing cavities from ever occurring. The next step is reversing early incidences of caries using minimally involved processes like cavity-hardening medicaments.

To further nurture positive dental experiences, we make every attempt to reduce exposure to involved dental treatments by employing the latest dental technologies, like our Solea laser . However, when complex restorations/fillings or surgical procedures are needed, it is a time to thoughtfully plan how such procedures are to be comfortably and successfully completed while maintaining a positive future dental outlook.

What It’s Like To Place A Filling In A Child’s Mouth:

To understand what it’s like to place a dental filling on a child’s tooth, Imagine having to remove a portion of diseased tissue from a human body and then carefully replacing it with a synthetic, biocompatible material that must perform and last. Now imagine that this surgical procedure is taking place on a body part that is the size of a pea and is highly sensitized with a core of nerves and blood vessels.

This body part being worked on is also situated in a dark and wet area. To top that off, the whole body is in constant motion and the environment is highly interactive. For a pediatric dentist to complete care that is successful while ensuring the comfort of the child and the satisfaction of the parent, a lot of stars need to align.

A Paradigm Shift In Understanding Dental Procedures:

When I first began my career in pediatric dentistry, I thought that I needed to have answers and solutions to every dental situation that I encountered. It took some time for me to understand that my true role is to be an educator on child dental well-being and a facilitator of gentle dental care when needed.

With this, I hope to shed some light on what evidence-based science paired with heart-felt pediatric dental wisdom can offer; allowing each family to make the decisions that they feel are appropriate for their children. If we are to believe in comfort, then we need to understand the nature of dental procedures and to be open to facilitating necessary care with the adjuncts that modern medicine offers rather than look to how dentistry was performed decades ago.

Why Sedation Options Are Vital:

Advanced dental procedures are surgical in nature. Teeth are no different than any body part like a finger, an ear or a tonsil. If a child needs to have their tonsils removed or ear tubes placed, no one in this day and age would consider completing such a procedure with local anesthesia. So why are we, in the dental profession asked to do so?

The comfort and safety of nitrous oxide inhalation sedation and minimal oral sedation are well-established. The use of deep sedation for young children with extensive needs and children with special health care needs is clearly outlined by the polices and guidelines issued by the American Academy of Pediatric Dentistry.

research on oral health policies

It is understandable that parents of young children can be cautious about proceeding with deep sedation for dental care but are we considering the alternative? Are we doing our job of fostering positive dental well-being when we subject a child to procedures that are beyond what they are able to comfortably tolerate?

American Academy of Pediatric Dentistry. Use of anesthesia providers in the administration of office-based deep sedation/general anesthesia to the pediatric dental patient. The ReferenceManual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2024:430-4.

At our office, we have created a sedation suite that follows the guidelines of the AAPD to ensure safety and facilitation of excellent dental care. Here is a link a video to introduce you to our setup: sedation video

The Parent-Dentist Partnership: Working Together for Healthy Smiles

A pediatric dentist is more than just a doctor. We are your partner in ensuring your child’s long-term oral health. Open communication, regular visits, and proactive home care create the foundation for a lifetime of healthy, happy smiles.

A Roadmap For Dental Wellness:

Parental dental care: Caring for our children in love and devotion starts with ensuring that we, as parents, are taking care of ourselves. As we model good practices to our children, they will hopefully follow in similar, healthy patterns. Furthermore, scientific evidence has demonstrated that parents in dental health share healthier oral flora with their off-spring. This means that keeping our dental care in check, offers our children a better chance of enjoying dental wellness.
Early dental visits: First dental visit for baby is when the first tooth comes in!
Establishing a dental home: Building a bond of trust and consistency is key for fostering good communication and continued dental care for every child.
Promoting oral and dental wellness: Teaming up in close collaboration with your dental home, let’s build dental health together!
Prevention: Spotting any potential issues as early as possible so that solutions can be simple and comfortable.
Early treatment: For any issues that arise, early detection means easier treatments like pain-free and anesthesia-free Solea laser care.
Sedation facilitation: Mindful planning for comprehensive care, when needed, is key to ensuring excellent and effective treatment while maintaining a positive dental outlook.

Parental Questions:

1-My child is scared of going to the dentist. What can I do?

Prepare them with positivity: If your dental experiences were wonderful, share that with them. If they were less than wonderful, remember that their experience can be completely different.
Use euphemisms: Words are powerful. Words like “toothbrush”, “counting teeth”, “dental mirror” are much better than words like “pain” or “uncomfortable” or “shot”
Read books/watch videos: Many kid-friendly books and videos show happy, relaxed dental visits. (Link to our child/teen video)
Start early: The younger a child visits the dentist, the more comfortable they’ll be over time.
Consider laser dentistry if treatment is needed: Technology like the Solea laser allows for a needle-free, drill-free
Ask about sedation options: Comfortable dentistry needs to be facilitated.

2- How can I help make my child’s dental visit a positive experience?

Schedule appointments in the morning: Kids are more cooperative when they’re well-rested.

Bring a comfort item: A favorite stuffed animal or blanket can provide reassurance.

Excite them about the experience: Talk about the movies, prizes and exciting toothpaste flavors that they can choose from!

3- My child has special needs. How can we plan for this?

Feel free to schedule a phone consultation so that we can talk about the specifics of your sweetheart and how we can accommodate for what makes them most comfortable. The more information you can share with us, the better prepared our team will be to receive your family in comfort and facilitation.

4- My child has a dental emergency and I’m not sure where to start?

It is always best to have an established relationship with a dental home in health before need. This way, your child is best prepared to tackle any urgent situations that can come up like bumps or falls. However, we can always facilitate emergency care with the same gentle, trust-building approach when necessary. Prioritizing your child’s comfort is always the goal.

Schedule your child’s first dental visit today! Contact us here.

The post Addressing Dental Anxiety in Kids: A Parent’s Guide appeared first on Pediatric Dentist & Orthodontist Los Angeles Smiles Pediatric Dentistry and Orthodontics.

A Parent’s Guide to Pediatric Dentistry: Key Information for Your Child’s Healthy Smile

admin — Sat, 01 Feb 2025 18:18:59 +0000

From fostering dental health to tackling early orthodontics, dental check-ups are childhood adventures that need to be fun, interactive experiences that families look forward to. How can we make this happen? Here’s how we do it at our office, Smiles Pediatric Dentistry & Orthodontic, in Los Angeles: Early dental visits that foster well-being and get kids comfortable with routine exams and interactive dental cleanings from a young age sprinkled with a lot of tender, loving dental care!

Are Baby Teeth Worth Investing in:

The answer is a resounding yes! The twenty baby teeth that emerge into a small child’s mouth are not all exfoliated at once. When parents ask “How long will this baby tooth stay in the mouth? The answer to that question will depend on the tooth in question. Anterior or front primary teeth will exfoliate between the age of 6 to 8 years, but the posterior teeth or molars can be present for many more years. 2nd primary molars can remain in the mouth until the teenage years!

What does “mixed dentition” mean:

Mixed dentition is a period of time when a child has both baby and permanent teeth in their mouth. The process of growing permanent or adult teeth in the mouth is a gradual one. It occurs progressively over a span of several years. The first baby teeth that are switched to permanent teeth are the incisors. This happens between the ages of 6 to 8 years. During this time, the first permanent molar will also emerge behind the baby molars. This is why the number of permanent teeth is more than the twenty primary ones. A second permanent molar will follow around age 12 and finally a third molars or “wisdom teeth” will being to emerge in the late teens.

Importance of understanding the stages of dental development:

When we understand that dental development is continuous and that primary and permanent teeth are present in the mouth simultaneously and for several years, we begin to see how fostering dental health early on plants that seeds for dental well-being to come. When kids experience early childhood caries in primary teeth and their permanent begin to come in, the newly erupted teeth can be vulnerable to similar issues.

What are cavities:

Dental caries or “cavities” remains the most common chronic disease of childhood. Cavities are notoriously known as “holes” in teeth. While it is true that dental caries is demonstrated in tooth structure breakdown, this occurrence is the outcome of the disease not the cause of it. The root cause of a cavity is bacterial, with specific oral bacteria that has an affinity to adhering to tooth surfaces.

How do cavities happen:

The saying: “Sip all day, get decay” holds scientific evidence. The frequency and duration of exposure to sugars and starches is a key factor in facilitating dental caries or cavities. The process is simple: Human mouths have an extensive oral flora called the oral microbiome. Similar to our gut, a multitude of microorganisms live and thrive in our mouths. Some of these are friendly, others produce harmful acids that are cavity-causing. Harmful bacteria feed off of foods with high sugar levels. The longer it takes a food to clear the mouth, the better fuel it provides. The more frequent the intake of such foods, the more these bugs can overwhelm the healthy counterparts causing more cavities.

What is the source of cavity-causing bacteria:

Babies are not born with harmful oral flora. They acquire it from the adults in the family by salivary exchanges. If parents have active, untreated cavities, they can pass along this bacteria to their offspring. This is called vertical transmission. Toddlers can acquire caries-causing bacteria from siblings or school mates. This is called horizontal transmission. Here is a good read on early caries transmission.

Fostering dental health for children:

Starting early dental visits and getting kids on a consistent rhythm of bi-yearly dental check-ups puts the family in gear to prioritize oral care. It also allows building a bond of trust with a dental home that can guide the process of home care through continuous, age-appropriate dental education. Proper oral hygiene can help to clear harmful plaque build-up and promote oral health. Here are some oral health tips to follow:

Brush twice a day: Use fluoride toothpaste or remineralizing toothpaste (rice-sized amount for toddlers, pea-sized for kids over 3).
Floss daily: Once teeth touch, start flossing! This is the only way to clear plaque build up from in between teeth.
Limit the frequency of sugary snacks and drinks: Juice (even if diluted with water) and sticky foods can increase cavity risk but it is the frequency and duration of exposure that is the critical factor. A piece of birthday cake or a treat is fine.
Understand the clearance factor of foods: The stickier the food, the longer it takes to clear tooth surfaces. Crunchy fruits and vegetables help to naturally clean tooth surfaces.
Encourage water drinking: Water not only hydrates, it helps to wash the mouth.
Keep on track with dental visits: Professional cleanings help remove plaque and catch problems early.

Understanding the Role of Baby Teeth & Orthodontic Health:

Primary teeth set the foundation for permanent teeth. Each primary tooth sets that stage for its successor. The health of primary teeth in terms of structure and position is super important for the permanent tooth that follows. Here’s why:

Primary teeth hold space for permanent teeth: Premature loss of baby teeth can lead to space loss and crowding.
Baby teeth affect speech development: Healthy baby teeth help kids pronounce words correctly.
Early Orthodontics can be started in primary or mixed dentition: For kids with bite issues or jaw misalignment, early orthodontics can prevent future complications and primary teeth can serve as sound foundations for orthodontic appliances.

Nurturing positive dental experiences:

The first and foremost goal of a dental home is to ensure positive dental experiences for children, no matter what their dental needs are. Positive experiences ensure that kids grow up feeling confident and comfortable in the dental setting. It also means that they are informed and educated on how to promote their own oral health in addition to becoming empowered on decision making when the are old enough to do so. Early collaborations with parents is the first step on this journey but continued team work is needed for the process to progress over time. Here are some recommendations for smooth dental visits:

Gear up for the dental visit with excitement: Let kids know that it feels good to have shiny, sparkly teeth and get them ready for fun toothpaste flavors.
Allow us to help guide the visit with our magical techniques: We love to explain the dental visits to our young friends in child-friendly terms!
Give kids some Grace: Kids are just like adults. Some days are smooth and others, breaks may be needed. When we gently understand this, we can relax about the shifts that can occur. After all, it’s the overall long term health that we are after.
Celebrate the wins: Achievements are worth celebrating! A healthy check-up, a growth milestone or a successful treatment outcome, kids thrive on positive reinforcement.

How we keep dental matters fun:

Like relaxing on a plane flight, sometimes sitting for a good while takes some facilitation. This is where good conversations, stories, distractions and a good movie come to play! TVs on ceilings work magic for young kids with lots of energy. Plus, they offer something that the kids really look forward to and allow us to really get great dental care completed as time flies by for the kids! Prizes, gifts and goodie bags are part of the deal too. These are things that kids always remember and value and are sure to make them (and us) smile!

Into the teenage years:

What makes pediatric dentistry so special is that we get to watch kids grow up. Nothing is as special as being part of the beautiful evolution of growth View our Smiles Champions.

Parents often ask how long their kids can keep coming to our office. We say: They are welcome until they turn 21! As our practice has grown and our preschoolers have become college students, we’ve continuously expanded our scope of practice to include state-of-the-art offerings to our teenage clientele. From Esthetic Teenage Dentistry to Orthodontics for Teens and 3D Printing solutions, our portfolio of dental offerings is as unique as the teenagers and young adults that love coming to see us.

Q&A:

1. What is the dental balance concept about?

The concept of the caries balance was first published by Dr. John Featherstone in 1999 in an attempt to simplify the key factors involved in dental caries progression or reversal and make them readily applicable in clinical practice and easily understandable. The concept was included in a review that provided a simple summary of the science of caries prevention and was then embraced as part of a two-day consensus meeting in California to review the relevant literature on caries prevention and propose practical means for caries management by risk assessment in the dental office and in community health settings.

In a nutshell, think of a balance scale that holds tooth remineralizing factors on one side and tooth demineralizing factors on the other. Whatever side is heavier will tip the balance in its favor. Factors that are health promoting include: A balanced diet, good oral hygiene and exposure to fluoride. Negative factors include: Frequent exposure to surgery foods, plaque build up and poor oral hygiene.

2. What are some remineralizing agents that can be used to stop cavities?

There are several agents that can help remineralize early dental caries:

Agents that can be used in home products:

Fluoride in all of its forms from toothpaste to mouth rinses.
MI paste, a topical cream designed for dental use that contains a special milk-derived protein known as Recaldent (CPP-ACP).
Nano-hydroxyapatite, a mineral naturally found in teeth, which can be added to toothpastes.

Agents that can be applied in the dental office:

Sliver Diamine Fluoride: A liquid medication that treats and prevents cavities.
Curodont Repair: A brush-on agent that remineralizes early cavities.
Stem Cell-Derived Hydrogels for Enamel Repair: Scientists are developing hydrogels containing stem cell-derived proteins and growth factors to encourage remineralization of early cavities.

3. My child has experienced cavities, how can I turn this around?

Depending on the extent of the cavities, we will always select minimally involved options as the first choice of care. Many times, these early interventions, along with a home care prevention plan, can shift the balance of the oral environment in favor of the remineralization of early cavities rather than their progression. For cavities that are more involved or have not responded to remineralization therapy, we will create a thoughtful treatment plan that is a good match for your child and family. Sedation options, as needed, will be discussed to ensure your child’s comfort. A continued prevention plan will be built in to ensure post treatment success and foster dental health.

4. I’m a bit concerned about sedation; can it be bypassed?

We are advocates of child well-being on all levels. Emotional, physiological and developmental well-being are part of the big well-being picture. We are also supporters of informed decision making, continued education, training and team collaboration. This is why we offer multiple levels of state-of-the-art sedation options that are safe, efficient and effective. We invite you to share your specific concerns with us so that we can help guide you towards your comfort with evidence-based knowledge and pediatric dental wisdom.

The post A Parent’s Guide to Pediatric Dentistry: Key Information for Your Child’s Healthy Smile appeared first on Pediatric Dentist & Orthodontist Los Angeles Smiles Pediatric Dentistry and Orthodontics.