Press and Media: Nursery World Articles

Surgery Hours: Going to the doctor and dentist

Visits to the doctor or dentist cannot be avoided, but the terror that they strike in some children can; with these tips from child psychologists at the Anna Freud Centre

Visiting the doctor and dentist is something that every child has to do. Many will take this in their stride, but children, like adults, can sometimes become fearful and anxious about these visits.

This fear can emanate from past bad experience, from a general fear of 'the unknown' or from fears transmitted by others. If a parent is terrified of the dentist, or is worried about the child, the child will often pick up on this and become afraid.

Good preparation, positive experiences and confident and supportive adults can help to prevent and overcome these fears.

The preparation need not just precede a specific visit but can be incorporated into everyday activities. Nursery staff can help by providing suitable toys and encouraging role play.

Situations can be acted out with soft toys or dolls. For example, 'Teddy is feeling poorly today - what shall we do? What if Teddy still feels poorly? Do you think he might need to go to the doctor?'

Observing the child's dramatisation of Teddy's trip to the doctor may give the child an opportunity to express any fears about what will happen. This gives nursery staff a chance to dispel any unfounded fears and to offer reassurance indirectly - that is, to Teddy.

Toys such as a doctor's case with stethoscope will give the child the chance to play the role of the doctor. 'Becoming' what is feared in role play can help to lessen or alleviate children's fears.

Encouraging such role play and providing resources for it will enable the child to cope more easily when the need arises for a visit to the doctor or dentist.

Books can also be a valuable resource. Most libraries have a section that contains books for adults to use with children to help them cope with particular situations.

This section, which is often near to the children's section, will usually include picture books that deal with visiting the doctor and dentist. Again, these can be used at any time as well as preceding a particular visit.

If a child has a tendency to anxiety, re-visiting these books from time to time can help build familiarity with situations, so that a real visit feels like less of a trauma.

Making books with children is another option. These can be very simple, with each page showing what is likely to happen, step by step, starting with the car or bus journey, and what might be seen on the way.

Talking to children is also very important. The child may have questions and these should be answered, if possible, in a way that will not frighten the child but is not dishonest either.

All this preparation will help children know what to expect and they will be far less likely to be worried. If early experiences with the doctor and dentist are positive, then the child will cope more readily with future visits and treatment as they grow older.

Every parent wants a visit to the doctor or dentist with their child to be a calm and reassuring experience. Thoughtful preparation will help to bring this about.

How can I prepare my child for a first visit to the dentist?
It may help if you first of all take your child along with you when you have an appointment yourself so that the child is familiar with the dentist's surgery.

Talk to your child about the visit but don't talk about it as if it is something to fear. It might be helpful to mention the visit the day before and then again an hour or so before leaving home.

Encourage your child by telling him how grown up he is, now that he is old enough to go to the dentist.

Explain about the dentist's chair and that the dentist has special tools to examine teeth. Find picture books in the library to read with your child. The more information you give your child, the less likely the child is to be frightened.

Role play using dolls can be helpful. You and your child can take turns to play the role of the dentist. If your child is very anxious, arrange to visit first and 'ride in the chair' without a dental examination. Perhaps take a soft toy or doll along for the dentist to examine.

Most dentists will be happy to oblige - they would rather take it slowly at first than spend years battling with a terrified child. There are also dentists who specialise in treating children so see if you can find one in your area.

What do I say if my child asks 'will it hurt?'
If you know that nothing painful is going to happen, it is obviously much easier to answer this question directly and honestly.

However, if you think or know that your child may have to go through a painful procedure at the doctor or dentist, it is not advisable to say 'it won't hurt at all.'

By lying you will lose the child's trust and this could affect your relationship. At the same time, you don't want to frighten him.

Saying 'it might hurt a tiny bit' but emphasising how quick it will be, and telling him how brave you know he is, is one way forward.

Another is to focus on what you will do afterwards. Reassurance that you will be right there with him and will hold his hand may also help.

What if we get to the waiting room and my child does start screaming?
First, try not to lose your temper! By getting angry with the child you are likely to exacerbate the problem rather than solving it.

If necessary, let the next patient go in first. Talk calmly and reassuringly and this may help to calm the child to the point where he can tell you what is worrying him.

Acknowledge your child's feelings and offer support and encouragement. He may feel safer if he knows that he can sit on your lap, for example. Distraction, such as focusing on what you will do afterwards, is another option.

You can also try giving your child a choice to make him feel more in control - for example, 'would you like to walk in by yourself or would you like me to carry you?'

This should be said kindly - not as a threat!

If this is a routine or first visit, it may well be enough to go into the surgery and just simply meet the doctor or dentist on this occasion.

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