A hygienist's view of children

by Joanne M. Pasienza, RDH

It is said that first impressions are lasting. As a dental hygienist, this is a phrase I always try to remember when reaching out to young children. I have learned over the years that, for some children, fear of the unknown is often the greatest fear of all. When a small child comes into the office, especially if this is his or her first dental visit, my main objective is to make this experience as wonderful as possible.

There are certain guidelines I try to follow, but I feel there are no rules set in stone when it comes to dealing with children. Every child and every situation is so unique that I try to be as flexible and compliant as possible. I feel that kindness is essential and that patience goes a long way in earning the trust and respect from a pediatric patient. In most cases, I never object to a parent being with the child during treatment. Having Mom or Dad present often gives the child a sense of security and support.

Children love to receive gifts, so I usually begin by letting them choose a new toothbrush and some floss to take home with them. Some children are ready to sit in the treatment chair and others are very frightened of it. By first showing them the buttons on it go up and down, or back to a horizontal position, they are made aware and there are no surprises with movement. I try to explain and show them everything I will be doing — before I do it — in an effort to escalate their comfort level and eradicate any fears they may have.

Some initial visits consist of only a ride in the chair and perhaps counting their teeth. I always try to praise them for their efforts and remind them that they were the "best" patient I had seen that day. With children under the age of six, I always encourage independent brushing, but let them and their patients know how important it is that one of the parents brush the child's teeth thoroughly once a day and helps with flossing. I also encourage the use of fluoride rinses at bedtime to strengthen the enamel and make the teeth more resistant to decay.

Another topic I like to discuss with children and their parents is diet. It is important to avoid foods and liquids high in sugar and those that are sticky and retentive on the tooth surface. Foods like hard, crunchy fruits and vegetables which promote saliva flow, as well as popcorn and peanuts are better choices for snacks. Foods that contain sugars are better eaten with a meal, rather than in between meals. Many times it is the frequency rather than the amount of a sugared snack that is more damaging to the enamel.

Working as a hygienist over the past 20 years, I have had the privilege of working with some wonderful dentists who have taught me a great deal about dealing with small children. I worked for several years with Dr. Michael Glinka, a pediatric dentist in Maumee, Ohio. He demonstrated such patience and kindness toward his patients, offering praise and a positive outlook in almost any given situation. Not only was he exceptional with children, but he also displayed a genuine compassion for many of the handicapped patients we saw. Being the mother of a son who is both mentally and physically impaired, I learned a great deal from Dr. Glinka on special techniques that proved effective when working with these special-needs patients.

Eight years ago, I began working in the dental office of Drs. Charlick, Springstead, and Wilson Dental Associates in Brighton, Mich., where I am presently employed. Although we are not a pediatric practice, we see a large number of children and special-needs patients. In February — "Children's Dental Health Month" — many of our staff members visit more than 3,000 children in area schools, teaching and promoting dental education. Our efforts are focused on making these visits fun and informative.

One story I would like to share with you is that of a young mother whose son is severely handicapped. After being shuffled from one dental office to the next, she found herself in our office. Almost pleading, she wanted to know if anyone would be willing to help her son. Due to several medications, her son's gingival tissue was irritated and severely enlarged. He also presented with moderate calculus on more than two-thirds of his teeth. The previous dental office spent a total of five minutes to address his needs. I offered to see if I could possibly help her son without hurting him. With his mother close by and supporting his head and neck, and using a special bite-block, through ear-piercing screams, we were able to successfully clean the hardened plaque from his teeth. We put this young patient on a three-month recall and allowed one hour for his dental visits. Three years later, he no longer cries when his teeth are cleaned. Through patience and perseverance, he has learned that we are his friends. He has a beautiful smile today and, along with touching our hearts, he is a constant reminder that everyone deserves adequate dental treatment.

We are truly a matrix of professionals who have been given the opportunity to render a valuable service to others.

Editor's Note: In an effort to combine her love of dentistry, writing poetry, and illustrating, Pasienza was inspired to write "'P' is for Patience." It is her hope that after reading the book, young children will develop a greater understanding of the importance of developing good dental habits. Pasienza's book is available by calling (800) 788-7654 or by visiting www.dorrancepublishing.com. Proceeds from book sales benefit the St. Louis Center in Chelsea, Mich., a caring, residential, family living and learning environment providing for the physical, emotional, and spiritual needs of children and adults with developmental disabilities.

This article was originally printed in Dental Equipment & Materials January, 2003

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