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16th September 2016

Under 5 Year Olds Are a Very Special Group of Patients

Close up of boy having his teethIn May 2016 Public Health England announced that ‘The number of 5 year olds with tooth decay has dropped to its lowest level in almost a decade’. This is welcoming news and is a positive reflection on dental teams, parents and carers having an impact on the dental care of this pre-school group. However across many parts of the country, the highest number of general anaesthetic procedures for under five year olds is due to dental decay. As caries is a wholly preventable disease and the risks of general anaesthesia are high this statistic is unacceptable and clearly more needs to be done in terms of prevention and education in this vulnerable group.

Members play a Vital Role in Dental Care

The debate on ‘sugar-tax’ and better labelling will carry on, but the role of dental team members is vital. The dental practice environment should reflect and promote a preventive message as a priority. Expectant and nursing mothers should especially be targeted with appropriate verbal and written advice. Every interaction with young patients should be seen as an opportunity to encourage, educate and reward.

Building Trust

In order to communicate effectively, the dental team needs to gain trust and confidence from anxious children and worried carers. The first visit can be a turning point and create a lasting impression in either direction! Well-rehearsed ‘icebreaker’ techniques will be very useful in allaying anxiety and building trust. Always put the child at the centre of the conversation and focus on their expectations. Most importantly do allow time for this all important first contact!

Helpful Techniques

Subsequent visits may involve invasive procedure, and again, appropriate communication will be the key to maintaining confidence. Tell, Show, Do is a well-accepted behavioural management technique where touch and interaction are central in providing a sense of control which cannot be obtained by simply observing.

Relaxation and distraction techniques including breathing exercises will all help in the delivery of dental care, as will constant praise and reassurances. One of the most common dental fears is that of not being in control so it is very important to set the rules out clearly at the outset and have systems in place where patients can have a break and stop treatment if needed.

Also consider techniques where initial encounters involve ‘light’ invasive procedures such as placing mirrors and other instruments in the mouth and gradually moving to more intense procedures. A continuing message of praise, rewards and preventive banter will lead to success in the majority of patients.

Patients for Life

Not all dental team members are comfortable with this very important group, but they will be patients for life if we get it right. Our efforts will be rewarded by knowing that we have played a significant role in the management of this young and impressionable group.

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

Raj Majithia

Dental Specialist M.Clin.Dent, FFGDP, BDS, LDSRCS, MJDF (UK), DPDS

Raj is in General Dental Practice in London. His other current posts are Associate Dean of Postgraduate Dentistry at Health Education England – London where he is responsible for remediation of dentists in difficulty, quality assurance of Dental Foundation training practices and assessment of Dental Foundation equivalence for overseas qualified dentists. Raj has been the Crisis Management in Medical Emergencies Tutor and Postgraduate Dental Tutor at Northwick Park Dental Education Centre and West Middlesex Hospital.

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