August 5, 2022 • 11 mins
Anxiety about dental visits is common among children. But sometimes worry turns to a deep-seated terror that leads to cancelled appointments. Dr. Saltz advises a listener whose son dreads the DDS, even for a tooth cleaning.
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:05):
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm Dr
Gail Salt. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. Children can have many
different fears depending on their age. They may have a
fear of strangers, monsters under their bed, or dogs, and
along with a fear of seeing the doctor, some fear
(00:48):
going to the dentist. In fact, dentophobia, or anxiety associated
with seeing the dentist, is fairly common. One out of
five children will have a real fear of the dentist.
The problem is that dental hygiene and care are very
(01:08):
important to health, and skipping it can be really harmful.
Over time, some children go out of this sphere, but
others maintain their anxiety into adulthood, causing them to avoid
dental care and eventually leading to real health problems. Given
(01:30):
that how a child's fear is managed can make a
lifetime of difference, So today I'm answering a question about
an older child whose terror of the dentist makes it
hard to go at all. Why do some kids fear
the dentist. Well, let's face it, to a child, a
(01:52):
stranger putting instruments or his or her hands into your
mouth does sound alarming. It feels invasive of as well.
That there are parts of your mouth that can break
or fallout is a disconcerting thought for a patient really,
of any age. What's more, the noises and the feelings
(02:14):
associated with undergoing dental care can make some children feel
very uneasy. Combine this with the fact that a dentist
can potentially cause discomfort or pain, and you have a
recipe for anticipatory anxiety. So parents should be thoughtful about
(02:36):
introducing children to dental care. Basically, the earlier you start
seeing the dentist, the better. Beginning with having an appointment
to just count and lightly clean some teeth instead of
precedent that dentist's office are not a scary place. Choose
(02:58):
a pediatric dentist who is comfortable with young children, as
a cheery office and knows how to speak with young
kids in a gentle and reassuring way so that they
feel calmer. Tell your child well in advance about the appointment.
Then explain honestly but without too much detail, that a
(03:23):
dentist is someone who will simply check and clean the
child's teeth. Do not talk about all the things that
could happen at the dentist's office, because discussing things like
getting billings, cavity root canals, and shots will scare them
with nothing being gained, especially as it is very unlikely
(03:44):
for a young child to need these things. Should your
child ever need any of that, you can prepare the
child for that ahead of time, but sharing scary details
unnecessarily will only contribute to dentiphobia. Similarly, do not discuss
(04:04):
your own or other family members negative experiences with a dentist. Again,
this can only serve to frighten kids, and children take
a lot of their cues from parents. If you show
them and tell them that the dentist's office is a
comfortable place, they will feel comforted. So with that, let's
(04:27):
get to my listener's question and ask how can I
help dear doctor Saltz. My son has become increasingly afraid
of the dentist's office. When he was little, he used
to cry, even though nothing really hurt. I kind of
thought he would grow out of it, to tell you
(04:49):
the truth, but he's now thirteen and he still has
a terrible fear of going to the dentist just for cleanings.
I'm really concerned that once he is old enough that
I just can't make him do it, which is what
I do now, he won't do it anymore and he
will just let his teeth fall into disrepair. Is there
(05:11):
anything I can do to help him with this fear?
Yes there is, and yes you should, because sadly, you
are correct that plenty of kids grow into adults who
never resolved this fear and don't go to the dentist
and as a result have big dental issues that affect
(05:32):
their quality of life. I would be quite straight with
your son that he seems to have a phobia of
the dentist, and this phobia, while not unusual in fact
among phobias, one of the more common ones, is a
problem that can affect his health later, and therefore it's
very important to treat it now. Treatment can be done
(05:57):
by a therapist who specializes in treating phobias via what's
called exposure therapy, which basically means starting small, perhaps in
the therapist office with just pictures of the dentist's office,
maybe the dental instruments, maybe even the dentist, and using
(06:17):
relaxation techniques that are taught in the sessions to keep
anxiety down while the kid is being exposed and thereby
desensitizing him to the dental cues. Then you continue to
escalate how much exposure, moving up to at some point
(06:40):
going to the actual office and using the same techniques.
Some therapists who specialize in phobias will actually go with
patients to do this. Most dentists are happy to help.
I mean, after all, they don't want their patients to
be afraid either, and they will let patients come to
the way an area during even a non appointment time
(07:03):
with a therapist to work on desensitization to the dentists,
for example, office smells and sounds which can be quite
distinct and therefore triggering two people with a phobia. The
point is to not overwhelm him, but to work up
bit by bit so that it feels tolerable until visits
(07:25):
feel safe and comfortable. Some dentists actually specialize in patients
who have fears, and they will work with you and
have a program that helps patients do effectively the same
type of treatment. But there are more therapists doing this
kind of work than there are dentists, so it may
be difficult to find a dentist who will do this.
(07:48):
Another thing a therapist can do is potentially give a
touch of medication to help the patient feel more relaxed
while they are having dental work done, or even a
cleaning so that they can see that it is tolerable
and remember the calm they experienced at the dentist, which
can help the phobia to recede either way. I do
(08:11):
recommend that you get some short term therapist who can
work with you and your son to treat this phobia
and move on so he can have an important lifelong
relationship with a dentist. I hope that was helpful. There
are things that you can do yourself to set your
(08:32):
child up to feel more comfortable at the dentist. You
can show the child how it's going to be. For example,
demonstrate on the child's doll or stuffed animal how the
dentist might count and clean his or her teeth. Do
this using your finger or a toothbrush, not an instrument,
(08:53):
and with no sound effects showing the child what the
encounter might look like. You can let your child count
your teeth or even flush them. The point is that
dress rehearsals that feel calm and reassuring can carry through
to the real thing. Once at the office, keep your
(09:15):
voice calm and reassuring. Distractions can be helpful while you
wait and even in the dentist's share, so bringing a
small toy to hold or play with, for example, can
really help. Some children might find it relaxing to listen
to music while they have their teeth cleaned and checked,
(09:36):
so bringing some music for them on your phone with
headphones so that they can be relaxed and make a
real difference. Do not speak to them about a big
reward afterwards. If there needs to be a big reward,
there must be something terrible that's about to happen. Right However,
(09:58):
after the appointment, do praise them for doing a good job,
and you can consider giving the child a small reward
like a sticker or a little toy, which gives them
positive reinforcement. Never hold down or force a child to
open their mouth. The point is really to help kids
(10:22):
to be less afraid, and doing this will make them
more afraid. You can hold their hand while the dentist works,
but only for support and comfort. It's really important to
help kids through this sphere so that they can master
it because of it worsens and it remains, it can
(10:43):
truly affect their well being as an adult. If all
of the above measures are still not working, seeking a
psychotherapist who is well versed in treating childhood anxiety disorders
can be very helpful in treating this vote. Do you
have a problem I can help with? If so, email
(11:05):
me yet? How can I help? At Seneca women dot Com.
All centers remain anonymous and listen every Friday too. How
can I help with me? Doctor Gale's Salts
Bees are challenging times, but you don't have to navigate
them alone. Welcome to how can I help? I'm Dr
Gail Salt. I'm a clinical Associate Professor of Psychiatry at
the New York Presbyterian Hospital, a psychoanalyst, and best selling author,
and I'm here every week to answer your most pressing questions,
(00:26):
hopefully with understanding, insight and advice. Children can have many
different fears depending on their age. They may have a
fear of strangers, monsters under their bed, or dogs, and
along with a fear of seeing the doctor, some fear
(00:48):
going to the dentist. In fact, dentophobia, or anxiety associated
with seeing the dentist, is fairly common. One out of
five children will have a real fear of the dentist.
The problem is that dental hygiene and care are very
(01:08):
important to health, and skipping it can be really harmful.
Over time, some children go out of this sphere, but
others maintain their anxiety into adulthood, causing them to avoid
dental care and eventually leading to real health problems. Given
(01:30):
that how a child's fear is managed can make a
lifetime of difference, So today I'm answering a question about
an older child whose terror of the dentist makes it
hard to go at all. Why do some kids fear
the dentist. Well, let's face it, to a child, a
(01:52):
stranger putting instruments or his or her hands into your
mouth does sound alarming. It feels invasive of as well.
That there are parts of your mouth that can break
or fallout is a disconcerting thought for a patient really,
of any age. What's more, the noises and the feelings
(02:14):
associated with undergoing dental care can make some children feel
very uneasy. Combine this with the fact that a dentist
can potentially cause discomfort or pain, and you have a
recipe for anticipatory anxiety. So parents should be thoughtful about
(02:36):
introducing children to dental care. Basically, the earlier you start
seeing the dentist, the better. Beginning with having an appointment
to just count and lightly clean some teeth instead of
precedent that dentist's office are not a scary place. Choose
(02:58):
a pediatric dentist who is comfortable with young children, as
a cheery office and knows how to speak with young
kids in a gentle and reassuring way so that they
feel calmer. Tell your child well in advance about the appointment.
Then explain honestly but without too much detail, that a
(03:23):
dentist is someone who will simply check and clean the
child's teeth. Do not talk about all the things that
could happen at the dentist's office, because discussing things like
getting billings, cavity root canals, and shots will scare them
with nothing being gained, especially as it is very unlikely
(03:44):
for a young child to need these things. Should your
child ever need any of that, you can prepare the
child for that ahead of time, but sharing scary details
unnecessarily will only contribute to dentiphobia. Similarly, do not discuss
(04:04):
your own or other family members negative experiences with a dentist. Again,
this can only serve to frighten kids, and children take
a lot of their cues from parents. If you show
them and tell them that the dentist's office is a
comfortable place, they will feel comforted. So with that, let's
(04:27):
get to my listener's question and ask how can I
help dear doctor Saltz. My son has become increasingly afraid
of the dentist's office. When he was little, he used
to cry, even though nothing really hurt. I kind of
thought he would grow out of it, to tell you
(04:49):
the truth, but he's now thirteen and he still has
a terrible fear of going to the dentist just for cleanings.
I'm really concerned that once he is old enough that
I just can't make him do it, which is what
I do now, he won't do it anymore and he
will just let his teeth fall into disrepair. Is there
(05:11):
anything I can do to help him with this fear?
Yes there is, and yes you should, because sadly, you
are correct that plenty of kids grow into adults who
never resolved this fear and don't go to the dentist
and as a result have big dental issues that affect
(05:32):
their quality of life. I would be quite straight with
your son that he seems to have a phobia of
the dentist, and this phobia, while not unusual in fact
among phobias, one of the more common ones, is a
problem that can affect his health later, and therefore it's
very important to treat it now. Treatment can be done
(05:57):
by a therapist who specializes in treating phobias via what's
called exposure therapy, which basically means starting small, perhaps in
the therapist office with just pictures of the dentist's office,
maybe the dental instruments, maybe even the dentist, and using
(06:17):
relaxation techniques that are taught in the sessions to keep
anxiety down while the kid is being exposed and thereby
desensitizing him to the dental cues. Then you continue to
escalate how much exposure, moving up to at some point
(06:40):
going to the actual office and using the same techniques.
Some therapists who specialize in phobias will actually go with
patients to do this. Most dentists are happy to help.
I mean, after all, they don't want their patients to
be afraid either, and they will let patients come to
the way an area during even a non appointment time
(07:03):
with a therapist to work on desensitization to the dentists,
for example, office smells and sounds which can be quite
distinct and therefore triggering two people with a phobia. The
point is to not overwhelm him, but to work up
bit by bit so that it feels tolerable until visits
(07:25):
feel safe and comfortable. Some dentists actually specialize in patients
who have fears, and they will work with you and
have a program that helps patients do effectively the same
type of treatment. But there are more therapists doing this
kind of work than there are dentists, so it may
be difficult to find a dentist who will do this.
(07:48):
Another thing a therapist can do is potentially give a
touch of medication to help the patient feel more relaxed
while they are having dental work done, or even a
cleaning so that they can see that it is tolerable
and remember the calm they experienced at the dentist, which
can help the phobia to recede either way. I do
(08:11):
recommend that you get some short term therapist who can
work with you and your son to treat this phobia
and move on so he can have an important lifelong
relationship with a dentist. I hope that was helpful. There
are things that you can do yourself to set your
(08:32):
child up to feel more comfortable at the dentist. You
can show the child how it's going to be. For example,
demonstrate on the child's doll or stuffed animal how the
dentist might count and clean his or her teeth. Do
this using your finger or a toothbrush, not an instrument,
(08:53):
and with no sound effects showing the child what the
encounter might look like. You can let your child count
your teeth or even flush them. The point is that
dress rehearsals that feel calm and reassuring can carry through
to the real thing. Once at the office, keep your
(09:15):
voice calm and reassuring. Distractions can be helpful while you
wait and even in the dentist's share, so bringing a
small toy to hold or play with, for example, can
really help. Some children might find it relaxing to listen
to music while they have their teeth cleaned and checked,
(09:36):
so bringing some music for them on your phone with
headphones so that they can be relaxed and make a
real difference. Do not speak to them about a big
reward afterwards. If there needs to be a big reward,
there must be something terrible that's about to happen. Right However,
(09:58):
after the appointment, do praise them for doing a good job,
and you can consider giving the child a small reward
like a sticker or a little toy, which gives them
positive reinforcement. Never hold down or force a child to
open their mouth. The point is really to help kids
(10:22):
to be less afraid, and doing this will make them
more afraid. You can hold their hand while the dentist works,
but only for support and comfort. It's really important to
help kids through this sphere so that they can master
it because of it worsens and it remains, it can
(10:43):
truly affect their well being as an adult. If all
of the above measures are still not working, seeking a
psychotherapist who is well versed in treating childhood anxiety disorders
can be very helpful in treating this vote. Do you
have a problem I can help with? If so, email
(11:05):
me yet? How can I help? At Seneca women dot Com.
All centers remain anonymous and listen every Friday too. How
can I help with me? Doctor Gale's Salts
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.