Psychology in Dentistry for Children

Abstract

The attitudes and feelings of the patient toward the dentist and the dental procedures are as important to successful treatment as are the technical skills of the dentist. This is particularly true in the practice of dentistry for children, where the behavior of the child in the dental chair often determines what procedure the dentist can use—or even whether he can treat the child at all! It is imperative, therefore, for the pedodontist to understand the child's psychological and emotional development, as he now understands his physical growth and development, if he is to deal successfully with the child's dental problems. Children can be managed in various ways: forcefully and authoritatively (i.e., to subdue the child and force him to accept the demands of dental treatment), or by understanding his needs and leading him to accept dental procedures. The latter is an active learning process which promotes his emotional growth and development instead of blocking it. Generalizations in the management of children may be misleading because children vary greatly in their attitudes and feelings at different age periods. A child of two years differs from one at six years in his reactions and behavior in the home, in school, at play or in the dental operatory. A child of four differs considerably from a child of nine or eleven years. Although fear is a basic factor in most if not all dental situations, the reaction differs and behavior differs at each age level. In addition, the personality of the child, especially as it is influenced by the family constellation and by previous stressful experiences, will modify the child's reaction to the dentist and to the fearsome bur or needle. An attempt has therefore been made to characterize the general pattern of child behavior at different age periods in the dental office because when the dentist understands why children behave the way they do, he is more likely to understand why this particular child behaves the way he does. If the dentist then confers with the parent to seek reasons for unusual behavior patterns, he is much better prepared to cope with the individual situation. For this reason and many more, it is hoped that dental schools will teach as much about emotional growth, and thus make the student more aware of emotional problems in the dental patient, as they now pay attention to physical growth and deviations in occlusion. Until this is done, management of the child patient (and the adult) may remain at the empirical, often dogmatic level, determined by the dentist's personality instead of being based on and guided by an understanding of the patient's needs.