Kid-Friendly Dentistry

Treating young children requires a unique skill set.

A few generations back, the general consensus was that children should be seen but not heard. Fortunately, by today’s standards, not only should children be seen and heard, they should be afforded the best possible healthcare, including oral care. Indeed, the recent drive to educate families on the importance of early oral care and the need to make treatment more accessible has paid off, both for pediatric patients and the pedodontists treating them. Overall, this is great news for dental professionals. At the same time, many dental owners are challenged with making their waiting rooms more child-friendly, investing in newer technology and providing their teams with more and better training.

Outreach and education
Rolando Mia, vice president of customer success at Zyris, has seen a definite rise in pediatric dental visits among the company’s pedodontist customers. “We believe the increasing population of children in the United States[1] is helping fuel growth among our pediatric customers, many who are expanding – adding operatories, personnel and even offices,” he says. “We also hear that more families are realizing the importance of bringing their children to the dentists’ office; This is reinforced by our pediatric and community health center customers via additional and ongoing educational programs, as well as dental education outreach in their local communities. For instance, many dentists today offer on-site visits to schools and provide free dental packs (e.g., toothbrushes, toothpaste, floss, etc.) for the children.

“It appears that more children and their families are taking advantage of insurance coverage, as well as special pediatric-focused dental outreach programs for preventative dental care, (e.g., the American Dental Foundation’s Give Kids a Smile, America’s Tooth Fairy, etc.),” he continues. “It’s been especially helpful as dental associations have come together to develop a successful ad council awareness campaign promoting the importance of managing children’s oral hygiene (e.g., 2 Min – 2X/Day, which involves brushing one’s teeth for 2 minutes, twice daily). As a result, more children are receiving higher quality oral healthcare today.”

Addressing the need
As more and more children are scheduled for dental visits, pedodontists and general dentists who perform basic pediatric care (e.g., checkups and cleaning, preventive care, caries treatment, sealants, education, etc.) are tasked with adopting new technology, remodeling their waiting rooms and offering reward programs to motivate their younger patients.

“We’ve observed that many of our customers recognize the need to make their offices an inviting, fun and safe place for children to visit,” Mia points out, noting it’s common for dentists to rely on themes to make their offices less intimidating. So, for instance, the office may feature a beach theme or a tropical, jungle, ocean or zoo theme. It’s also becoming more common to have digital or board games available in the waiting room, children’s programming playing on a television and interactive iPads available in waiting rooms, operatories and recovery rooms. Some practices have begun sponsoring special events, such as field trips to the dental office to give children the opportunity to use the instruments, see the operatories and learn about dentistry, he adds.

“We also see different engagement and reward systems for children who are successfully performing preventative oral care, such as the Brush DJ app, a no-cavity club or movie passes, awards or toys,” says Mia.

Not surprisingly, with an increase in patient visits comes a handful of administrative responsibilities, including recruiting qualified doctors and staff, managing the business and working with parents and caregivers – some who can be overbearing! “Pediatric dentists must be effective in consistently managing issues related to profitability, staffing, expense control, maintaining a high quality of care and managing the team,” says Mia. And, it’s not always easy to secure qualified or experienced dentists, he adds. Many dental school graduates are opting to join DSOs over solo practices. “In addition, we’ve learned from working with our pediatric customers there is a special patience and focus required to work with children,” he points out. “There is a level of communication and patience required to be effective with children, and not all doctors and clinicians have the capacity or talent to do so.

“Children are especially difficult to treat due to their decreased understanding of the procedure, short attention span and smaller mouth,” he continues. “Pediatric dentists have a small window of opportunity to treat a child before the patient becomes tired, distracted or simply upset during the procedure.” Sometimes, it’s a matter of working with a difficult parent or caregiver, he notes. “We continually hear that parents can make or break a dental procedure visit. When parents do not cooperate, or they feel compelled to question everything a clinician is doing, we’ve been told this can upset the child and compromise the clinician’s ability to effectively treat the patient. In addition, children key off their parents/caregivers during a procedure. If a parent is nervous, impatient, fearful, etc., the effect on the child can be negative.

“As technology and materials continue to improve, procedures are easier and quicker to perform,” says Mia. That said, incorporating and using new technology, equipment and materials can be challenging, he adds. “We’ve been told the proliferation of computer and digital systems is especially daunting. The challenge is to find clinicians, hygienists and dental assistants with the skills and ability to operate and use these systems once they are trained.” Examples of newer pediatric technology includes silver diamine fluoride (SDF) for caries prevention and treatment, digital X-rays, digital and laser cavity detection devices and aids, hard and soft tissue laser designed to painlessly treat cavities and decay, CAD/CAM impression technology, painless injection systems and improved isolation and retraction devices, such as the Isolite System. At the same time, pediatric dentists today must be comfortable with sedation dentistry, which is now used more routinely.

“We’ve heard a number of concerns from our dental customers regarding these newer technologies,” says Mia. For one, there’s an ongoing cost involved in adopting new technology, some of which may quickly become obsolete as next generation systems become available. “Our customers also tell us that new technology can be disruptive to clinicians,” he says. Naturally, there’s a learning curve involved and it takes time for clinicians to become comfortable using new technology. The dental team must also keep up with software updates and on-going training and support. “It requires a dedicated effort, and when technology is set aside and forgotten, it’s a wasted investment.”

Training and education
Even as dental care becomes more accessible to many children, some community health clinics continue to face a huge patient backlog, notes Mia. “According to one community health clinic we work with, some pediatric patients have wait times of one to two years to be seen by a clinician,” he says. “The majority of recent dental school graduates are trained to perform procedures primarily on adults,” he explains. “They often have limited education or expertise when it comes to working with younger children.

“Pedodontists must participate in a graduate education program that is focused specifically on treating and managing younger children,” says Mia, noting this requires a much different skill set from working with adult patients. “When a child is experiencing more complex oral health issues or severe conditions, it is imperative that he or she is treated by a specialist – one that is specifically educated and experienced in treating young children and special needs patients.”