Dentaltown December 2020 - 70

Parents who insist on being
present in the operatory
can be welcomed within
clear boundaries. "
preferences, stick to your decision. It will
not only be easier on your dental team but
also, more importantly, will be better for
your communication with the patient and
their family.
It's important to recognize that you
won't be everybody's dentist. The trade-off is
having a dental clinic that produces consistent
quality results with recognizable systems in
a methodical environment.

Managing expectations
Set expectations well before the treatment
appointment: Parents need to know these
expectations before scheduling with your
office. Be clear and authoritative, while also
maintaining kindness and honesty. There
is nothing worse than informing anxious
parents upon arrival at the office that they
can't hold their child's hand and comfort
them. Besides creating conflict, the child
may struggle with the separation more when
they see their parent's negative reaction.

Parents during a pandemic
COVID-19 has changed the landscape
of clinical dentistry, including how we think
about who's in our operatories when we're
trying to minimize the number of people
in the building at one time. In my practice,
parents can't remain in the operatory during
an aerosol-producing procedure; they are
asked to wait in the waiting room or in
their vehicles, depending on the type of
appointment and the age of the child.
Most parents have been understanding,
considering the pandemic. This has created
an opportunity for practitioners who normally practice with parents in the clinic to

70

try a different environment. Likewise, it has
allowed parents to navigate an alternative
approach to treatment, where they are
separated from their child or where fewer
adults are allowed in the clinic.
Although we aren't sure how temporary
these new guidelines are, I'm sure they
will leave some permanent changes in the
practice of pediatric dentistry. If you aren't
happy with your clinic flow or you want
to try something new, take this time as an
opportunity for change.

My preferences and protocols
After years of practice, I have identified
my preferences and defined a system in
my practice. I will share those preferences,
recognizing that there are many different
ways to practice pediatric dentistry.
Dental disease is often recognized at
the new patient exam, recall appointment
or during an emergency visit. I welcome
parents to accompany their children for these
types of appointments. I also found this to
be advantageous in perceiving the parents'
emotional and psychological role in our
dynamic and determining their placement
for the upcoming visit. At this time, I
formulate a treatment plan and discuss the
role of the parents during the next visit. We
plan ahead if a different parent will bring
the child to the appointment. Each parent
is given plenty of time to ask any questions
or address concerns. A well-informed parent
is more confident and trusting.
For parents who are hesitant about
separating from their child, having an open
door or a window into the operatory can be
a creative compromise. They can check in

periodically without interrupting the procedure. Parents who insist on being present
in the operatory, however, can be welcomed
within clear boundaries. Specifically, no
more than one parent can be present and,
in an effort to minimize disruption, parents
cannot tag-team or exchange places once the
appointment begins. No other children can
be present in the room besides the scheduled
child. There is a seat in the corner of the
operatory, well away from the dental chair,
where the parent can sit.
I make it clear that parents cannot
reposition or move the child during the
procedure, because this can be unsafe. I
encourage parents to be silent observers. The
dental team has to direct the child during
the procedure and the parents' guidance
can be a significant disruption to the child's
attention. Clearly, parents aren't trained to
explain the procedure or the steps in the
same way that a dental professional can, so
I worry about them using distressing terms
such as needle, drill or hurt.
I absolutely will not allow cellular phones
or electronics in the operatory. If parents have
work to do or want to browse the internet,
they are welcome to use the lounge chairs in
the waiting room and have a cup of coffee.

Conclusions
When it comes to the parental dynamic,
there's no single " right " or " wrong " way of
doing things. I encourage you to try different
approaches. But if you already know your
preferences, trust your gut and stick with it.
Remember that working in a positive
environment where you feel confident and
in control will create a happier and healthier
workplace for you and your team. Show
your patients and their parents that you
have their best interests at heart.
If you need education on certain topics,
sign up for continuing education-better yet,
reach out to pediatric dental colleagues in
your community, or on Dentaltown's message
boards! I'm a firm believer that knowledge
is power, and that sharing knowledge with
one another empowers us all. Collaboration
makes for a better community. n

DECEMBER 2020 // dentaltown.com

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Dentaltown December 2020

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