Tips for treating children with behavioral issues: It doesn’t have to be painful

If you’re not used to treating children with behavioral issues or patients with special needs, the thought of having one of these patients in your chair can be a little intimidating. You might even be inclined to avoid it all together. But treating these patients can be a rewarding addition to your practice; you just have to take a little extra time to prepare.

From the time they enter the practice until the time you’re ready to perform any necessary procedures, there’s plenty you and your team can do to put these patients at ease, making their visit to your practice much more pleasant for them as well as you and your staff. We recently talked to Dr. Fred Margolis, a pediatric dentist who practices in Highland Park, Ill., about what dentists can do to make this happen. Here are some tips that can help make treating these patients a rewarding experience, rather than a stressful one.

It starts before they even enter the practice

New patient research forms are a great way to get to know a little about new patients before they even step into your practice.  Dr. Margolis recommends using this form for every new child and special needs patient. Your team should review this form the morning a new patient is scheduled to come in. That way, you know what behavior problems to expect and you can discuss ways to address any problems that may come up.

It’s also a good idea to call each new patient before that first appointment. This gives you the chance to talk with the parents or caregivers and find out if they can share any information that will help the first visit go smoothly. The parent may tell you about what behavior issues to expect and may give you advice on the best way to calm the child down if he or she gets upset.

“The parent of an autistic child may tell you the patient had a bad experience at a previous dental visit. With autism that could be caused by a number of things,” he said. “The autistic patient may want to listen to his music or may not want to have any sound at all in the office. Parents know; listen to the mothers. They know what their child can tolerate in a dental environment.”

This pre-appointment call also gives the parents a chance to ask you questions, which will help put them at ease as well.

When they arrive

If a child or special needs patient is visiting your office for the first time, it’s a good idea to go to the reception room to greet both child and parent, Dr. Margolis said. This gives you a chance to assess the patient’s behavior before he or she comes into the operatory.

Take the time to talk to the child about what he or she can expect during the visit, Dr. Margolis said. This will put them more at ease and will make them less likely to act out during the visit.

“I talk to the parent through the child. For example, I might say something like, ‘Today Johnny we’re going to count your teeth. Do you know how many teeth you have? I’m also going to clean your teeth with a special toothbrush that tickles. I’m going to use toothpaste, what flavor do you like,’ and you give them a choice,” he said. “Don’t give the choice do you want to come into the operatory. The choice is tutti fruitti, strawberry, or chocolate toothpaste.”

This short talk with the patients gives you the opportunity to make sure the parent or guardian understands what’s going to happen during the first visit, and for you to obtain informed consent. It also gives you an idea of how the parent will act during the appointment, and if it’s better for the parent to stay in the waiting room. If it’s a special needs patient, you’ll likely want the parent there to help put the patient at ease, whether that’s by holding the patient’s hand or having the patient sit on the parent’s lap in the dental chair.

Keep it positive

Positive re-enforcement is a great way to turn children with behavior problems into star patients. Dr. Margolis gives his pediatric patients sticker charts. The child receives a sticker for brushing in the morning and at night, and for other positives related to their dental health. If they bring the chart filled with stickers to their next appointment, they’ll receive a special gift.

Make it familiar

When a child or special needs patient first sits in your dental chair, you need to put that patient at ease. Children know what a toothbrush is, so start off by handing them one and asking them to show you how they brush. Then, take the opportunity to show them how they can get their teeth even more clean. This gives you the chance to educate both the child and the parent if the parent is in the room. 

Show, tell, do is another great way to put patients at ease and familiarize them with what’s going to happen in a typical dental appointment, Dr. Margolis said. Tell the patient what you’re doing and show him or her with the mouth mirror. Have the patient hold the mouth mirror while you place it in his or her mouth together.

Take away the unknown

A lot of patients, children or adults are afraid of the unknown. They don’t know what to expect when they come to the dentist, and they’re uncomfortable with that, and with children that could lead to behavior issues while they’re in the dental chair. To help put patients’ fears at ease, Dr. Margolis created a five-minute video on his website. The video shows a typical appointment at Dr. Margolis‘ office and prepares them for what’s going to happen. 

Dr. Margolis also offers office tours. New patients can come in and check out the office, without worrying about what will happen when they get in the chair.

It makes a difference

With just a little extra effort, you can make a difference in these patients’ lives. Dr. Margolis sees children and special needs patients that other dentists can’t or won’t see, and he’s able to provide the care they need to keep their mouths healthy. It’s rewarding to be that person, and something you can do if you take the time to prepare your office for these patients.

It comes down to helping to ease their fears and making the experience as comfortable as possible. If you do that, children who were once unruly will be much better behaved, and special needs patients who have trouble in a dental environment will get the care they need.

Questions? Contact Dr. Margolis at kidzdr@comcast.net