DTUS2010

HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper · U.S. Edition Pediatric patients require a unique touch that may not be intuitive for some adults ‘Do you see me?’ (Photo/Marzanna Syncerz, www. dreamstime.com) By Cathy Hester Seckman, RDH As Thanksgiving host for my fam- ily one year, I was rushing around like a maniac finding space for cas- seroles, juggling desserts and corral- ling extra chairs. In the middle of the madness, a 4-year-old niece tugged at my shirt. “Aunt Cathy?” she asked anxious- ly, “did you see me yet?” I stopped in my tracks and bent to her level. “Hi, Morgan.” I smiled. “I’m glad you’re here.” I remember that episode when new patients come to our pediatric practice. They have the same desire Morgan had, to be seen. Children need to believe that peo- ple in power see them, know them and care about what happens to them. That’s what they’re really ask- ing with those anxious eyes: “Do you see me?” Bad examples Starting off right with a new pediat- ric patient will set the relationship up for success in future dental visits. Pediatric management, it is said, begins in the waiting room. Here are two bad examples I’ve witnessed. • A speech therapist came into a waiting room, walked up to a 5-year- old girl, looked down and bellowed, “Tiffany! I’m so glad to see you today!” Tiffany cringed behind her mother’s leg, obviously terrified. • A medical assistant entered a waiting room, eyes on a clipboard, and intoned, “Gavin Smith? Time to go.” Seven-year-old Gavin didn’t budge, just looked at his mother apprehensively. It’s easy to see what’s wrong with these examples. The therapist assumed a dominant position, used an intimidating voice and didn’t introduce or explain herself. The assistant didn’t make eye contact and didn’t explain what was going to happen. There was no mutual, caring connection in either case. Good examples include a two-minute warning Here are two better examples from a typical day in our pediatric prac- tice. • A dental assistant walks into the playroom and greets a child. “Hi, Anniston, my name’s Beth. I’m going to take care of you today. Hey, those are pretty cool shoes you have on. Do they light up? Wow!” “Anniston, the first thing we’re going to do is pick out a new tooth- brush, then the doctor will count your teeth, then you’ll be able to play some more. You and Mommy can come around the corner with me now to look at toothbrushes.” • A dental hygienist enters the playroom and stoops down to eye level with the child. “Hi, you must be Tyler. I’m Cathy. How do you like that car race game? Are you the red car guy? Looks like you’re winning.” “I’m going to clean your teeth today, Tyler. I’ll show you all my cool stuff, then I’ll polish your teeth with an electric toothbrush and put fluoride vitamins on them, then you can come back and play. I’ll be ready in two minutes, Tyler, so go ahead and race some more. I’ll be back.” In these examples, a personal connection is established first. Chil- dren can be confident that we see them, know them and care about them well before treatment begins. I’ve also discovered that the two- minute warning is a great way to relieve anxiety. Behavior guidance Basic behavior guidance in the oper- atory is easier once a comfortable relationship is established. Tell- show-do, voice control, nonverbal communication, positive reinforce- ment and distraction can be inte- grated as part of an ongoing subjec- tive process for each patient. The American Academy of Pediat- ric Dentistry (AAPD) offers descrip- tions for each technique. • Tell-show-do: Verbal explana- tions appropriate to the patient’s developmental level; demonstra- tions of the visual, auditory, olfac- tory and tactile aspects of each pro- cedure in a nonthreatening setting; and completion of the procedure. • Voice control: Controlled altera- tion of voice volume, tone or pace to influence and direct behavior. • Nonverbal communication: Reinforcement and guidance of behavior through appropriate con- tact, posture, facial expression and body language. • Positive reinforcement: Positive voice modulation, facial expression, g HT page 2B September 2010 www.dental-tribune.com Vol. 3, No. 9 AD