Pediatric Dentist Visit Disasters

Hi Amy,

I thought that nail clipping was the most dreadful task I had to deal with as a parent, but now that I’ve taken my 3 year old to the dentist, I realize how very, very wrong I was.

I took my 3.3 year old daughter last weekend and, after 2 weeks of prepping, and reminding, and unbridled enthusiasm on her part, when we got there she totally shut down. She loves to brush her teeth and has been pretty great at other doctor’s offices. I found a pediatric dentist other parents recommended, so I figured that she’d have a decent bedside manner, but she, and her assistant, got right into my daughter’s face and just kept asking her questions (e.g., do you want this toothbrush or this one? do you want these sunglasses or these ones? can I count your teeth? can you count your teeth? do you want to brush your teeth for me? do you want to brush the bear’s teeth?) and I think it really overwhelmed my daughter.

She didn’t open her mouth once. There was no teeth counting. It was pretty awful. I got into the chair and had my teeth counted. I brushed the bear’s teeth. I finally told the dentist we’d ignore my daughter for a bit so she could warm up, and we had a 10 minute conversation. In that time, my daughter came over and got onto my lap, but then the questions immediately resumed and my daughter started squirming. I got impatient and started tough love/bribing (“I am going to get a treat because I cooperated, but if you don’t cooperate you won’t get a treat and won’t that be sad,” etc). When I caught myself trying to pin her arms down so the dentist could try to pry her mouth open I realized things were going very badly and we needed to just leave. I gave her one more chance to cooperate, got nothing, and out we went (I took my prize for cooperation, because consequences!). I think I’ve really screwed this up and I am worried I fostered a lifelong fear of the dentist. Plus, I still don’t know if her teeth are healthy, so we have to go back.

Advice? Should her father take her back to the same dentist in a month? Should we find a new dentist and go in 6 months? My husband wants to bring her along to one of our dental appointments, which I think is a terrible idea. But I have no idea what to do.

Thank you!

Oh, I have been there. HAVE I EVER BEEN THERE.

Here’s the thing about preschoolers (and toddlers, and school-age children, and probably some teens and adults as well), every visit to the dentist is different. You just never, ever know. I’ve had some TERRIBLE visits, almost exactly as you described (sans the in-your-face technician and dentist, so more on that in a bit). I’ve indeed had to hold a child on my lap tightly, my legs wrapped around theirs, while they refused to cooperate in the slightest and the dentist basically forced their mouth open for a cursory, half-assed cleaning.

In fact, our appointment seven months ago with Ezra went down pretty much exactly like that. Even though he’d been FINE at this same dentist six months before. It. Was. A. Nightmare.

(And for some reason our pediatric dentist’s office is a fan of joint appointments for siblings, so I also had Noah running around with HIS anxiety amped up to 11. And then the dentist was all, “Noah needs X-rays today too.” AND THEN I RAN AWAY AND LEFT THEM THERE FOREVER, THE END.)

I took Ezra (solo, no more joint appointments EVER) back for a cleaning this month. There were no words for how much I was dreading that appointment. I was in such deep denial that it was even happening that I did NONE of the pre-visit prep and endless pep talks we’ve done in the past. I basically woke him up, put him in the car and told him we were going to the dentist. I asked him if he would be brave and let them brush and count his teeth so he could get a prize and he said yes. I secretly called him a liar in my head.

And then: He did fine. He did amazing. There was absolutely no trace of the horror and thrashing and the forcible tooth-counting that had gone down before. He was apprehensive at times but unfailingly cooperative. He sat still for X-rays and was delighted out of his mind with the box of 5-cent prizes. He now says he loves the dentist and is promising Noah (who goes back [SOLO] [ALSO WITH HIS FATHER] this week) that going to the dentist doesn’t hurt and isn’t scary. I think it might have helped that his last doctor’s appointment involved some shots, so as soon as he was assured that the dentist doesn’t give shots, he relaxed considerably.

We’ve had similar ebb-and-flow with Noah as well — one nightmare visit followed by one easy one, and then back again. I will say that all of the worst dentist visits we’ve had were in the three-to-four-year-old range, even if we’d started regular visits earlier than that.

So back to you, and your experience: What you saw was probably pretty normal for her age, and no, you didn’t just instill a lifelong phobia of the dentist. In six months she’ll probably have forgotten about it completely. In fact, you’re probably a nicer mom than me for even agreeing to leave — we might not always have gotten the BEST cleanings during our “bad” appointments, but dagnabbit child, we drove here and I’m paying for this visit so you are getting SOMETHING done, hold still.

Going back in a month would be more challenging, since she won’t have the six-month buffer to forget about the whole thing and maybe mature a bit more. But three years and nine months would admittedly be a bit on the old side to have never had even a cursory check-up. (I am obligated to point out that the official recommendation from the American Academy of Pediatric Dentistry is that children begin lap exams by their first birthday at the latest, and get their first “full” cleaning between two and three, depending on the dentist and your child’s [HAHAHAHAAAA] cooperation level.)

It’s your call, but if you DO go back to the same dentist, request that they ease into things a bit (okay, a LOT) more. Arrive to your appointment early and remind them that this is do-over and they might want to try a different approach this time. I definitely don’t like the sound of the in-your-face first appointment and you’d think a highly-recommended pediatric dentist would know better than to tag-team a first-time patient with a million questions. Going to a new dentist might help because of the change of scenery…but possibly only at first, once she realizes it’s still the same basic place trying to do the same basic thing. Maybe an office that advertises an expertise with special needs children (like ours) would be more calm and patient around typical children than the office you went to. Maybe ask those other parents that recommended that dentist if they have a favorite hygienist as well. Maybe make her father take her next time, just to see. YOUJUSTNEVERKNOW.

(I agree with you that having her accompany you to a grown-up visit might be more trouble than it’s worth. Will she really sit there and pay attention? What if there’s like, SURPRISE CAVITY or SURPRISE EMERGENCY ROOT CANAL? What if there are no good prizes? My dentist sucks at fun and prizes.)

Some kids like all those initial questions because it gives them a sense of control, but some kids (especially younger ones) can get overwhelmed by them. It can help if a parent just answers for them so the “pressure” is off and the weird strangers stop asking them things that they don’t really understand or care about. (At Ezra’s last visit, they asked about toothpaste and flouride flavors twice before I answered for him, once I saw that a reply wasn’t forthcoming and he was starting to clam up and get shy about it.) If your daughter seems interested in something — ANYTHING — in the room, go with that instead of constantly trying to get her to go along with a “script” about “LOOK AT MR. THIRSTY. LOOK AT MR. BEAR.” If she’s staring at a fish tank or TV or whatever, talk about that and give the dentist the signal to just get in there and DO something. If she needs to sit on your lap and be held tightly, it’s not the end of the world and doesn’t mean she’ll need that for all dental visits until the end of time. Tell her you’ll give her big hugs in the chair and keep talking to her about other things. Remember that sometimes the things that we HAVE to do for our children’s health and benefit (shots, medicine, saying no to candy or toys, etc.) will make them temporarily sad, afraid or angry. Remember that children are pretty darn resilient, though.

I think the most important thing for your daughter is to just get through a visit, even if it’s not a great visit. First, because she obviously needs to get an examination done at this point, but also so she can leave feeling like there was some small success — a cool prize and lots of praise from you, etc. I’m sure that while she felt like she “won” last time when you bailed, she also sensed that the grown-ups weren’t happy and Mommy was stressed out and feeling that wonderful blend of embarrassment/guilt/anger that we mothers all know so well.

I also wonder if we all sometimes over-prep our kids for stuff like the dentist. It definitely can help to read a book or social story, or let a child touch your own electric toothbrush, but two weeks of prepping and reminding and YAY THIS IS GONNA BE AWESOME might have upped the ante a little too far for her. Maybe she shut down once she realized that the dentist like, wasn’t a real-life Dora cartoon and was actually kind of scary to her. Because let’s be honest: A lot of people hate going to the dentist for a lot reasons. It’s not ever “fun” when I go and yet I’ve totally downplayed the less-than-enjoyable parts of the dentist for my kids ahead of time and paid for it. I will never forget one cleaning where Noah finally submitted to the tooth-polishing thing that I had repeatedly told him would just “tickle” his teeth. He pushed it away, sat straight up in the chair and looked me right in the eye: THAT. DOESN’T. TICKLE. MOM. WHY DID YOU SAY THAT IT WOULD?

(j’accuse!)

If you do want to try some additional prep, however, we’ve been really into old episodes of Mister Rogers’ Neighborhood around here lately. At first my older two were like, this is so boring, when do things start exploding, but wouldn’t you know it, the topics he covers STICK with them in a really comforting, down-to-earth way. They bring up the things he says later in perfect context, every time. There’s an episode where Mister Rogers goes to the dentist for a checkup and it’s really pretty great. You can stream the whole episode for free if you have Amazon Prime (or buy it for $1.99 if you don’t).

In the meantime, while you wait for the next appointment, wherever and whenever you decide to do it, don’t ask constant questions or remind her of “last time.” A three year old can’t articulate exactly what scared her or WHY she wouldn’t open her mouth, so don’t ask or pressure her to help you figure out how to make it “different” this time. It might not be any different. It might completely suck and you might have to hold her again. You might have to bribe. You might feel like coming home and immediately cracking open a bottle of wine. (Note: ACCEPTABLE.)

But it might be completely different the NEXT time. And the time after that. Fingers crossed, along with the rest of us who have check-ups and cleanings on the horizon. You just. Never. Ever. Know.