Anxiety Management




Our mission is to help you and your child have the care desire, knowledge, and skill to give your child a healthy smile.  Mastering the dental experience is essential and easier the younger you start practicing.  Dental treatment is a valuable stressful experience that helps your child’s emotions to mature.  Each child has anxiety about dental care but responds differently to unknown, fearful and annoying sensations:  some cry, some are resistive and some are calm.  To achieve the goal of a healthy mouth, children need to manage their anxiety to accept dental treatment.  We love to see children grow to accept dental care calmly.  It takes years, but proceeding with purpose, persistence and patience has never failed in my experience.  Procrastination never succeeds.

Some children cry during part of the learning process.  Childhood emotions are intense and crying is a natural release since most children have not had to deal with anything similarly difficult.  Our response will be accepting, affirming and respectful of your child’s feelings but patient and firm to encourage success and improvement. Several approaches are combined for your child.

Anxiety Management

Anxiety management is encouraging your child to handle his worries with reasonable behavior.  There are three broad categories of behavior management:  HUG, TUG, and DRUG.  Each has its favorable and unfavorable effects, risks and costs.


TELL-SHOW-DO:  Your child is told what is to be done using simple words and then shown what is to be done on a model or finger.  Then the procedure is done exactly as told.  Praise is given to reinforce positive behavior.  Children have less anxiety when they know what to expect and trust your guidance.

ACTIVE LISTENING:  Your child’s behavior and statements are reflected back in order to maintain communication and help him through his feelings.  Children manage their worries better when they know someone has heard them and understands their concerns.

POSITIVE REINFORCEMENT:  (Praise and Compliment):  Your child is rewarded for any desirable behavior with praise or gentle physical contact.  Rewarded behavior tends to be repeated.

PARENTAL PRESENCE:  You can accompany your child for the dental visit.  Encourage your child and strive to comfort and instill confidence in your child.  Avoid explaining treatment or procedures.  Bring books to read aloud to your child.

Some children benefit from their parent’s presence.  There are some exceptions.  If you are anxious about the procedures, you child will pick up on your anxiety and become more anxious.  Some children do better with another adult other than parents.  In either case, your child may do better without you.  This is your choice.

PATIENT RESPECT (Core Value):  Regardless of your child’s behavior, we will be affirming, accepting and respectful, not angry, upset or demeaning.  Our joy is to help your child grow through fears and dislikes to help your child manage anxiety better at each step.  This requires improving your child’s confidence with appropriate encouragement, proceeding patiently with care, and not allowing the disruptive behavior to be rewarded.


MOUTH PROPS (Tooth Pillow):  A rest placed in your child’s mouth to prevent accidental closing and injury and to allow the jaw muscles to relax.

RUBBER DAM (Rain Coat):  A dam placed in your child’s mouth to prevent accidental swallowing of debris or instruments and to protect the mouth.  It also gives your child a sense of separation from the procedure.

HOLDING HANDS (Active Restraint):  You or our assistant can and should hold your child’s hands to assure your pressure and prevent interference with your child’s care or injury to your child.

PAPOOSE BOARD RESTRAINT (Passive Restraint, Special Seat Belt):  A last resort device to limit your child’s movement to permit treatment, protect your child, and prevent injury.  This is very helpful for some children, though trying to help, are unable to be still for treatment.

SUMMARY:  Risks of psychological or physical injury with the above techniques are unlikely.  There is probably a greater risk of injury when they are not used.


NITROUS OXIDE ANALGESIA (N20/02, Laughing Gas):  Analgesia is a reduction, not elimination, of pain and a sensation of well being.  Nitrous Oxide is very effective.  It smells good and the effects are completely gone three minutes after it is stopped.  It may causes nausea and vomiting.  N20/02 is best if your child is mature enough to breathe through the mask on their nose and not be annoyed with the mask.  Local anesthesia will still be needed.

CONSCIOUS SEDATION:  Conscious Sedation provides additional reduction of sensation and anxiety which for some children is essential.  Your child is not totally asleep and partially aware of treatment.  Sedation of children is somewhat unpredictable, effective in about seventy percent of selected patients.  Your child may still cry and be upset.

Local anesthesia is still needed.

GENERAL ANESTHESIA IN THE SURGI-CENTER:  The whole body is asleep so your child is totally unaware of the treatment.  This is the best method for children with extensive dental disease or children with other health problems.  This is done on an outpatient basis at the Medical or Surgi-Center where an anesthesia provider will be dedicated to provide this care for your child.

Which techniques is best?  The answer is different for each child.

COMPLICATIONS:  Complications include infection, swelling, irritability, nausea, vomiting, bad dreams, regressive behavior, allergic reaction, respiratory problems and shock.  Anesthesia is very safe.  These complications are extremely rare.

Our entire staff is certified by the American Heart Association for Basic Cardiac Life Support and PEARS (Pediatric Evaluation Assessment Recovery Support.  Dr. McCorkle is certified for Advanced Cardiac Life Support and Pediatric Advanced Life Support.

Pain Control – Local Anesthesia

Anesthesia is the elimination of painful sensation.  The cornerstone of learning good dental behavior is adequate anesthesia.  The areas of your child’s mouth requiring care are numbed.  Pleasant smelling topical anesthetic (numbs the gum) is applied before administering local anesthetic.  The level of anesthesia is verified without your child knowing.  After the visit, some children find the numb sensation annoying and may cry or bite their lip.  Engaging your child in a distracting activity while you discourage touching the numb areas will help your child deal with the annoyance.

Local anesthetic is essential for children’s dental care.

FOR BEST RESULTS AND SAFETY:  Talk with your child.  A well prepared child does better.

Tell your child that we will be very careful.  But even when we are careful, your child may not like some parts of the treatment or think it hurts and may want to cry.  This is normal and OK.  If your child can try to help and try to be as calm as possible, this will allow the treatment to be finished quicker and it will be easier for your child.

Your child will do better well rested.

Your child must be healthy.  Call well before the appointment if your child has a cold, nasal congestion, any kind of illness, or is taking medication of which we are not aware.

Dress your child in loose comfortable play clothing.  This also makes monitoring vital signs and administering medications easier.  One-piece outfits make monitoring difficult.

Preparation for Sedation or General Anesthesia

BEFORE THE APPOINTMENT:  An empty stomach is needed.  For morning appointments your child must not have any breakfast or drink not even water.  For afternoon appointments, no lunch or drink, but a good nutritious breakfast is helpful.

AFTER THE APPOINTMENT:  The effects of the medication will wear off slowly over the rest of the day.  Sedation and anesthesia are taxing so a nap is helpful.  Your child may play quietly with your supervision, but not outside running around or riding a bike.  Your child should not go to school.  Give nutritious drinks to your child to drink slowly as normal feeling returns.  Be prepared to watch him the rest of the day.  Please call us with your questions.


Treatment is planned based on your child’s behavior, age, weight, medical history, and dental treatment.  It is impossible to completely predict how your child will respond, so treatment may be altered to meet the needs of your child.

Children respond well to all of these methods.  However, some will not; at your request or our suggestion and if necessary and it is safe, we will stop and discuss alternatives with you.

Typically, within a few minutes of completing the treatment, your child will resume normal play and behavior.  Your child should be able to enjoy the rest of his day.

Let us know if anything remains unclear.  Your child can grow to have a healthy smile and a happy heart toward dental care.

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