Examining the Spirited Child
Spirited children can pose a challenge to a successful preventive oral health visit. In this edition of the bOHP newsletter, we bring you an update and a short video on the "how to" perform a successful oral examination and varnish application on a spirited toddler.
Have a great summer,
The bOHP Team
THE SPIRITED TODDLER:
A SIMPLE AND SYSTEMATIC APPROACH TO EXAMINING YOUNG CHILDREN
Provider comfort and training have been identified as factors contributing to dentists taking care of infants and toddlers in clinical practice[1]. Nearly a decade ago, Seale and Casamassimo identified that 1 in 10 general dentists reported caring for children 6 months-3 years. Among the barriers identified were offices not geared for children (44%), access to a pediatric dentist (31%), and lack of training (13%)[2].
While there has been some improvement, a more recent study by McFarland et al., (2013) identified NC general dentists "Stage of Readiness" as it related to the care of infants and toddlers. Over half indicated delivering preventive oral health to this cohort, while 30% and 12% indicated not caring for young children or considering it, respectively[3]. The authors were interested in identifying what factors predicted whether dentists cared for young children. Of the multiple demographic, practice and provider level variables, PROVIDER COMFORT emerged as the only predictive factor. Providers in the action stage were 5.8 times more likely to report comfort when delivering preventive services to infants and toddlers when compared to those not doing it[3].
Unpublished data from the McFarland study provides some further insight regarding more specifics of COMFORT. Based on the 8 sub-questions asked of them, dentists reported being most uncomfortable when dealing with a “crying child” or what we refer to as “spirited” (See Figure 1).
Figure 1. Varying comfort levels of NC general dentists when dealing with a crying infant/toddler N=417
So how do we best promote your COMFORT when dealing with a spirited child?
A systematic approach to examining a spirited toddler is essential to performing a predictable and concise exam. The following video demonstrates a systematic, safe and efficient approach to positioning the child, dentist, and assistant/hygienist for a successful exam and fluoride application. The goal of the video: to improve your comfort level when providing care to spirited toddlers.
Video: Oral Examination on a Spirited Toddler
[Click on link below to view video]
