Dealing With Anxiety & Pain In The Dental Office

Recent research in the field of pain and anxiety reveals a close relationship between the two, particularly in young children. Indeed, your young child may have difficulty separating pain from fears. Dentistry is among the few instances in medicine that your child is awake during surgery, so your child, who has limited coping skills and experience with pain, may have a lower threshold of acceptance than that of an adult. Your child may also bring along fear acquired from a previous negative dental experience or from adults with their own substantial anxiety (a girl's anxiety is more directly linked to parent anxiety than a boy's).

If anxiety is present (in either boys or girls), your child likely will be more difficult to numb and will have a heightened sensitivity and response to pain. Anxiety decreases your child's ability to accurately report pain. Also, because of your young child's limited past experience with pain, something that you may view as mild discomfort may be perceived by your child as the worst pain ever felt. Thus, pain and anxiety need to be dealt with prior to any dental treatment.

Please start by calming (or concealing) your own fears and creating positive expectations for your child prior to the dental visit. Watch confidently as our trained team further calms the fears of your child and bolsters self-assurance and trust. If your child has severe dental pain from an abscessed tooth for example, then antibiotic medicine should be given and treatment deferred until the pain and infection are under control.

At the end of each treatment visit, your child subjectively evaluates the pain experienced by using a "Faces" pain rating scale to personally assess and custom tailor our efforts. Enjoy knowing your child is always provided the best possible experience.

Here is an example of the "FACES" pain rating scale you can use to practice with your child at home:

From Hockenberry MJ, Wilson D, Winkelstein ML: Wong's Essentials of Pediatric Nursing, ed. 7, St. Louis, 2005, p. 1259. Used with permission. Copyright, Mosby.

Reframing/Debriefing:
Sometimes even with everyone's best efforts, your young child still has a "negative" tearful experience depending upon his/her anxiety level and ability to cope with the unique experience of receiving in office dental care. In this case, research shows that a technique known as reframing is quite effective at reducing your child's fear and pain response at future dental visits.

Your young child's memories are malleable and can be swayed in a positive direction by you or a Silver Star Dental team member who was in the room at the time of the tearful treatment. Reframing is less effective when done by the dentist who elicited the tearful response. Discuss the previous visit in a positive manner with your child to bolster the sense of accomplishment and emphasize positive aspects of the appointment. For instance, "Johnny, you opened really wide for Dr. Hsu when he fixed your teeth." Your child may respond, "But I cried the whole time." Answer your child in return with, "Yes, but you stayed really still for him, your teeth look great and the sugar bugs are gone."

Look forward to the benefits of performing the reframing at some point after treatment (excluding the day of) and before the next dental visit. Watch as your child's outlook on dentistry improves and all pain and anxiety melts away.