Good child, bad tooth: Management of the fear of tooth extraction in children

Abstract

1. 1. The circumstances under which children arrive for dental extractions have been described, and some of the psychological responses of mothers and children have been outlined. 2. 2. Psychological reactions of regression, anxiety, and the concept of trauma are discussed in relation to dental procedures specifically and to personality development in general. 3. 3. Problems of separation of mother and child and of the child's inability to understand what is being done, as well as the tendency to misperceive treatment as punishment, are pointed out. 4. 4. Several cases are presented to show the responses of different normal children, especially some who became unresponsive and tended to withdraw under the experience of dental extraction. The evolution of the emotional aspects and the manner in which the reactions were handled are presented. 5. 5. The management of these problems in a clinically practical manner is discussed. We have stressed the importance of firm friendliness and honesty with the child, emphasizing clear communication and supportive behavior from the staff and parents. The need to avoid misinformation, haste, and angry criticism or judgmental attitudes is presented.