Bringing an Anxious Child to the Dentist

by Linda M. Manning, RN, LPC-S, RPT-S
Registered Nurse
Licensed Professional Counselor-Supervisor
Registered Play Therapist-Supervisor


Fear is a gripping emotion and renders us unable to take action no matter what the age. If your child is generally anxious or just afraid of going to the dentist’s office, you can help the situation by acknowledging the fear and making it a normal part of human existence. Parents are often under the mistaken belief that acknowledging a child’ emotion will make it worse. Many times an empathic response will help the child regulate the feeling. Each human being is born with what is needed to grow and develop physically and psychologically to maturation. It is important to trust that your child will learn to self-regulate his emotions and will mature.
Begin by looking at your feelings about going to the dentist. Do you dislike it? Does it make you feel anxious? Is it routine for you and not anxiety producing so you don’t understand why your child reacts fearfully? You can transmit those feelings and attitudes to your child without being aware you are doing so. Just be aware of it. It’s not wrong or right – just what is.
Now, accept the fearful feelings your child has. Accepting them does NOT mean that you agree or that you are endorsing the anxiety. Just accept your child where she is with the knowledge that she is able to learn to regulate those feelings. This allows your child to own her own feelings and experience your trust that she can learn self-control. Think about how you feel when you have an emotional response to something and someone listens and accepts your feelings. You feel relieved that someone understands. This helps you think more clearly, emotions generally subside and you feel you are not alone.
Next, state that it is ok and normal to sometimes be afraid. Making a general statement that sometimes things are scary will normalize the reaction. Accepting a child’s fear is not going to work if you think you can manipulate them to not feel that way. Kids are very astute in reading sincerity in adults. They are great at sensing tense, uncomfortable feelings. They are not good at interpreting what the tension is about so usually think that it’s their fault. Again, acknowledge the fear in a calm, normal tone of voice and make a statement that says “sometimes it’s scary to go to the dentist”, “you wish you didn’t have to go to the dentist today” or “you don’t like going to the dentist”. Stating that you understand the child’s feelings does not mean that the child won’t have to go to the appointment. Accepting feelings does not change what has to be done.
Once the child knows that you understand, accept the child’s feeling and with your calm attitude you let the child know that you will be supportive and all is going to be fine. Accepting how the child feels will help the child be able to hear what you have to say. Isn’t it difficult for you to listen to someone else’s opinion when you are in the grip of emotion! Here’s how an exchange could go between a parent and anxious, uncooperative child:
“No! I don’t want to go! I want to stay to play with Susie!“ (child refusing – could be because having fun playing or could be because is afraid)
“You wish you didn’t have to go. You’re having fun here.” (parent responds by stating the child’s point of view – understands)
“I don’t want to go!”
“You’re so upset. You want me to know how much you don’t want to go.” The child may go on crying and saying doesn’t want to go. This is where the parent needs to stay calm. You will be in a battle if you think you can make the child feel differently.
The child may show more fear than objection. You need to go with what the child exhibits. Such as, the child begins to cry and look fearful, your response could be any of the following: “You don’t like going to the dentist”; “You’re worried about going to your appointment”; “Going to the dentist is scary for you”.
If you know your child is anxious and doesn’t like to go to the dentist, give yourself a few extra minutes to go through this exchange. Be patient but not too involved with trying to “fix” the child’s feelings. Too much focus on feelings can also make it all worse. Once you’ve acknowledged and accepted how the child feels, tell the child that you know she’s “afraid” or “scared” or “doesn’t want to go” but it’s time to go to the dentist’s office. It’s never a good idea to ask the child if he or she is ready to go. Why would you ask a “yes” or “no” question when the “no” is not an acceptable response? It is not the child who decides that he needs to go to the dentist, it is you. “I know you’d rather not go, but it’s time to leave now.”
By this point you may have a more cooperative child who knows that you understand and yet is relieved that you are taking charge or you could still have a combative child. Either way, this is where you take the child to the appointment regardless of the emotional response. Your actions at this point are more important than giving in to the child’s or your feelings. Parents have emotional responses to their children and can also have difficulty in controlling their reactions. You set the tone and you decide the actions. Whether your child is anxious or is in a power struggle with you, reflecting the child’s feelings and desires but following through with the actions to go to the appointment will set the stage for all future situations.
Here’s what you should never do, but exasperated parents do all the time. Do not offer to buy something for your child if he goes quietly to the appointment. Offering to buy toys, gum, happy meals, etc. will ONLY get you MORE of the SAME behavior! Parent’s mistakenly go for what is easier at the moment and suffer the results later by reinforcing behavior they really do not want. We teach our children how to manipulate us! Temper tantrums will fall away if they do not get rewarded. Behavior that is not reinforced does not get repeated. Anxious behavior can be just as manipulating as temper tantrums.
In summary, respond to your child’s emotions knowing that YOU cannot fix the fear or anxiety. You can understand and ACCEPT it as a normal human emotion (yes, even irrational fear is common). KNOW that your child CAN learn to self-regulate his or her feelings and will be OK. ACKNOWLEDGE your child’s feelings by stating what he is showing you. Accept the emotions but DO NOT CHANGE the outcome based on feelings. FOLLOW through calmly and confidently. You will transmit your confidence in the child’s ability to overcome his fears. He will learn that feelings can be handled and there are things we have to do even when we don’t feel like it.

Tell Me Again Why My Child Has A Cavity!?

It's disturbing to hear that your child has developed a cavity when you know he or she brushes morning and night. And flosses once a day! How can that be possible? You've always been told that brushing and flossing prevents cavities. It does, however, unfortunately there is more to it than that.

Besides the usual cavity causing villians: diet, poor brushing and oral hygiene practices, there are other factors involved in the occurrence of the dreaded cavity. First of all, let's look at the tooth itself. What is the quality of the enamel? How thick is it? Are there deep pits and fissures in the shape and surface of the tooth? How much fluoride is the tooth exposed to? Many bottled waters do not contain fluoride. Then there is the saliva. What is the mineral content of the saliva? How effective is the buffering capacity of the saliva against cavity producing bacteria? Is the saliva supersaturated with calcium and phosphorus? Is the principle buffer, bicarbonate, present in sufficient quantities and functioning in a healthy manner? Other factors that can reduce the body's resistance to cavity development are medication, disease, dehydration, radiation and age. Still other factors involved are racial ethnicity, socioeconomic status, behavioral education, general health and stress. Then there are those pesky genetic markers that predispose an individual to cavities. There is a significant association between markers on genes for ameloginin and tuftelin, which are the proteins found in developing enamel in teeth and are involved in the strength of the tooth development.

Phew! As you can see, many of these factors neither you, the dental team, nor the child have direct control over. What you and your child do have control over is how often and how well your child flosses and brushes and how often you make it to your dental checkup. Yet, as we have just seen, even with regular flossing and brushing there are many variables involved in developing cavities. The chance of getting a cavity is greatly reduced with good oral hygiene, a healthy diet, drinking lots of water, plenty of rest, exercise and regular visits to the pediatric dentist. Those factors are under your control. Regular visits to the pediatric dentist are very important, but nothing replaces a focused and concerted effort to clean your child's teeth - front, back and in between!

Now that you know some of what contributes to cavities, consider all that you do not have control over. Brushing and flossing are important components of daily oral hygiene and if only it were that simple! Unfortunately, what you do have control over doesn't give you a guarantee that your child will never develop a cavity. Your pediatric dental team is here to help you catch those cavities early if they develop and help your child stay healthy.

Posted by Linda M. Manning, MEd, RN, LPC-S, RPT-S
October 15, 2009

Early Dental Care for Children

Fort Worth Texas Dentist Gordon Strole Jr. encourages parents to schedule their childs first dental appointment around the child's first birthday. Dr. Strole Jr. explains important information about teething, primary teeth, good diet and healthy teeth, infant tooth eruption and preventing baby bottle tooth decay at www.stroledds.com/early.asp.