Faculty of Dental Medicine, Department of Paediatric and Preventive Dentistry, University St. Cyril and Methodius, Skopje, Republic of Macedonia
Received Date: October 09, 2017; Accepted Date: October 23, 2017; Published Date: October 31, 2017
Citation: Ambarkova V (2018) Acceptance of Children in Dental Ambulance. J Healthc Commun 3:4. doi: 10.4172/2472-1654.100115
Working with children is the most valuable work for a pediatric dentist. With my long experience of clinical work with children, I had the opportunity to understand the child's nature, all the developmental phases of the child from the psychological point of view and child’s entire developmental route from a small child, pre-school and school age, adolescence, to adulthood. The role of the pediatric dentist is therefore very responsible and specific.
In the course of his growth and development, the child’s personality started to shapes, starting to differentiate attitudes and relationships, and therefore our educational role in that process is very important. It is best for us as pediatric dentists to do our best to become best children’s friends. In this long process of mutual fellowship, the role of the dentist is to teach the child to take care of teeth and oral health.
Working with children requires great expertise from the dentist, great experience, quick perception and reaction, very great patience and good knowledge of the physical and psychological development and characteristics of the child. The pediatric dentist cannot expect that children will understand and accept the justification of an intervention, or cannot expect that child will cooperate, understand and help during the dental intervantion, especially for young children and children of pre-school age. In order to establish that communication, it is necessary between child and pediatric dentist a certain level of trust and understanding to exist. The success in working with the child will depend primarily on his age, his psychophysical development, his readiness for dental intervention, attitude of the pediatric dentist and dental team towards the child, and of course it also depends very much of the parents. Of course, we should not neglect the role of the environment in which the intervention takes place .
The behavior of the child is a manifestation of his mental maturity. In our first contact with the parents and the child, we point to the parents the great importance of their attitude towards our interventions and the importance of their willingness to cooperate with us. All of this is understandable when is well known the importance and attitude of parents in raising their child, seen from all aspects. Parents are idols for their children and, normally, if the child feels fear and insecurity with them, of course it will reflect on his attitude and behavior.
In the dental office come children of different age and different character, different habits and different behaviors. The pediatric dentist should understand the personality of the child, and treat children with a lot of love. It is necessary to keep in mind that the reactions of children are primarily emotional, spontaneous and abrupt, which significantly differ from adults. Children cannot control their emotions and reactions. So the pediatric dentist needs to think fast, his hands to be at any moment ready to move away from his mouth, his legs always ready to move away from the machine's slipper and to stop the intervention.
In the period of 0-14 years, the main phases of the development of the oropharyngeal system as development of jaws and teeth, eruption and removal of the primary with permanent dentition are generally completed. The first 14 years of the child's life are divided into 5 periods, periods of very dynamic development, which are characterized by special features that are important for the work of the dentist. These periods are period of a newborn, infant period, period of a small child, pre-school and school child.
The period of the newborn
Lasts from birth to the end of the first month of life. From dental aspect this period is not very characteristic, because the child is born with a swallowing reflex and receives the food immediately. In this period, very rarely, you can notice the presence of premature teeth in the lower jaw which lie on the ridge like caps and show an emphasized mobility. It is necessary to extract so swallowing and aspiration does not occur. During this period, congenital anomalies like clefts of the lips and palate, congenital tumors, etc. can be detected.
Period of infant
Lasts from the end of the first month to the end of the first year of the child's life. This is a period in which the child is totally dependent on the mother, for eating, warmth, comfort, love, creating eating habits. In the later life period, in the child’s life other people from his family are also included. It is important in this period a natural diet to be given to the child with breastfeeding (at least until the sixth month of life), because breast milk is the most up-to-date and richest source of food that the baby needs, and at the same time the act of sucking enables proper growth and development of orofacial muscles. This avoids the need for nutrition by using artificially prepared foods, especially those that are sweetened, thus avoiding the early habit of eating sweet foods. Often there is a need for additional nutrition, when the mother does not have enough milk, so mother have to take care for the food (milk formulas), which will be given to the baby, in the sense of being closer to the natural milk formulas. It is best to feed the baby with a spoon, but in the case of using a pacifier, mother have to keep an eye on the opening and size of the pacifier. Especially care mother should be take not to sweeten the food too much and to avoid meals in the night. During this period, also the child needs to drink water. In fact, the first year of life is very important for the formation of positive habits for maintaining the general and oral health. The parents need to be concentrate on the use of systemic fluoride prophylaxis with fluoride tablets at a strictly prescribed dose. In the middle of the first year the eruption of primary teeth begins. With the eruption of the first tooth, the maintenance of the oral hygiene should start. From a dental point of view, in addition to problems with the eruption of teeth, also poor habits may start, like fingers – finger and various objects sucking. Acquired bad habits during this period can cause damage of the teeth and soft tissue in the mouth. In this period, conditions for the development of early childhood caries can be created.
A period of little child
Lasts from the end of the first to the end of the third year of life. This is an interesting period in childhood, mostly because they are now more aware of the world, so they are interested in picture books, toys, small gifts, want to hear stories. However, they are still very much attached to their parents and usually when children are in the dental office, they are looking for the presence of parents, especially the mother. At their first meeting with the pediatric dentist, the children are shy and withdrawn and need adaptive period of time. For that reason, when we have a child of that age in our practice, we should not force anything unless it is an emergency. Sometimes it is necessary for the child to come to the dental office several times without intervening; dentists should leave time for the child to perceive the space, the overall dental ambience. Pediatric dentist also should allowed child to be drive in the dental chair, touch the dental instruments, and child will more easily accept dental intervention.
At the first visit of the dental office by the child, it is best for both of parents and child to get acquainted with the whole dental environment. It is best for the child to visit the ambulance when there is no serious dental problem and there is no need for urgent intervention. In this way, the child will not experience the pediatric dentist as a person who causes pain and it will not be necessary to hold someone firmly until we apply the painkiller or we are trying to establish drainage from the affected tooth. For children of this age, the presence of parents in the practice is not necessary. Small and pre-school children are very impatient, so care should be taken children from this age group not to wait very long and the interventions to last shortly, no more than twenty minutes.
A school- period of children start with the first day of going to school and lasting until the end of primary education. The children from this group can be divided into young school children up to 10 years of age and elderly adolescents up to 14 years of age.
Young school children are increasingly independent. Their interests begin to change, the circle of people with which they communicate increases, there is a need for belonging, friendship and respect for the elderly, as well as a feeling of pride and power. Interesting is the moment of giving the greatest importance to the words of the greatest authority for them, and that is their teacher, much more than the importance they attach from the words of the parents. Something similar occurs in relation to the words they hear from us, and this is reflected in imitating the words and actions of the pediatric dentist, identifying with doctors in the children's games and in their actions. All this brings even greater responsibility for us, because we need to be careful about every word and procedure that will be addressed to the child. Children's fantasy in this period is very developed. Thus they create idols of famous singers, actors, sports aces and begin to attach great importance to their aesthetic appearance. They are more tolerant, more patient, accept the cooperation with dentists and already understand the meaning of our advice on the issue of their oral health. The best period for children's education in terms of oral health is the age of 6-9 years [2-4]. During this period, it is necessary children to learn most intensely about the rules for maintaining of oral hygiene, children must adopt their skills for quality and proper brushing of teeth, dentists point out the need for reduced sugars, and also sealing of dental fissures are perform in this period. The children of this age are much easier to bear our interventions and have more patience in terms of duration of dental interventions.
In the early adolescence, in the years when puberty period begins, there are significant physical and psychological changes in the adolescent’s body. There is a rapid growth, gender differentiation, children growth from small to large person, starting to become aware of their personality, becoming rebellious, dissatisfied with themselves and with their appearance (especially girls) and therefore need a lot of support and understanding. In this adolescence period, they accept cooperation well with the dentists. Sometimes this age group may have difficulty in maintaining oral hygiene, consumption of inadequate foods and lots of sweets, using of fast food. Some children begin with the bad habits such as smoking and drinking of alcohol. During this period, from the dental point of view, the risk of dental caries is increased also due to the hormonal imbalances that make the oral medium more vulnerable.
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