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Kidspeak: Bridging the communication gap with toddlers, tweens, and teens

Aug. 4, 2011
Good communication is essential with every dental patient but particularly so with toddlers, tweens, and teens. Cathy Hester Seckman, RDH, discusses some methods to successfully connect with patients in these age groups.
By Cathy Hester Seckman, RDH
At the end of a long, tough day at a general office where I worked years ago, my beautiful little three-year-old patient backed herself under a countertop, waved her arms wildly, and screamed, “NO! NOOOOOOO! I can’t do it, NOOOOOOO!” I handed her mother a referral card for the local pediatric office and walked them back to the waiting room.
It’s every hygienist’s nightmare, isn’t it? If your first impulse would be the same as mine, consider this: I now work in a pediatric office. Difficult children are now my responsibility, and if I can learn to handle them, so can you. Effective communication is an essential component of child management. Not only fussy toddlers, but shy tweens and monosyllabic teens in your practice will benefit. Think about the cycle of communication. For completion, a message must be said, heard, responded to, and received.
Suppose you have Little Jacky Jump-up in your chair. We all know Jacky. He’s the boy who pops up like a Jack in the Box every time you let go of him. That used to frustrate me, make me dislike Jacky, and rush through the appointment just to get rid of him. The problem was never Jacky; it was my lack of effective communication. All I had to do was learn to deliver a complete message:• Say it: “Jacky, I need to get something. Keep your head on the pillow.”• Know that he hears it: Swing your stool around to face him, make eye contact, and begin with his name.• Get him to respond: Be unequivocal. Instead of asking a question by adding “Okay?”, elicit a response by lifting your eyebrows and saying, “Understand?”• Know the message was received. Wait for a sign of agreement from Jacky before you let go, and don’t forget to reinforce the message throughout the treatment: “Remember, Jacky, stay put,” or “Don’t go anywhere, we have more to do.”
There are many aspects to successful communication with toddlers. Remember that they’re beginning to need social interaction, and they always want validation and praise. Make friends before you get down to business. Accept their fears and concerns, and find ways to deal with them. “Ryla, I will not hurt you today, but the toothbrush might tickle, and the toothpaste might be crunchy. Do you think you’ll giggle when I tickle your teeth? Let’s find out.” Use age-appropriate language. At my office we call saliva ejectors straws, and we describe an exam by saying the dentist will count and measure their teeth.By the time a child is in the tween years, their needs have changed. Hopefully, they’ve learned to be good dental patients but trying to have a conversation with them can be like pulling teeth. To effectively communicate with tweens, says researcher Lawrence Kutner, “Listen between the lines.” If shy, silent Morgan comes in holding a book, ask about it. If she has a feather or beads in her hair, ask if she got them on vacation. Admire her nail polish and shoes. Ask for assistance in holding a fluoride varnish tray, or evaluating different prophy paste flavors. If you can help her to feel praiseworthy and empowered, you’re more likely to communicate effectively. Let her see that you are not just an anonymous health care provider, but a person with whom she can easily and safely connect. The secret to talking with teens, I’ve discovered, is respect. They’ve moved beyond social needs to esteem needs, and they’re beginning the process of self-actualization. If you validate their process, they’re more likely to respect you and listen to your recommendations. Has Tyler gotten a lip piercing? Instead of grimacing and lecturing him, be interested. Let him explain it to you, ask his motivations, and find out what he knows about caring for the piercing. If Tyler can see that you respect his choices and are willing to deal with them, he’s more likely to listen to your suggestions on caring for his oral health.Good communication is essential with every dental patient in order to get our messages across. If we want Jacky to be a better brusher; and Morgan to have a beautiful, confident smile, and Tyler to have healthy teeth, we must first find ways to successfully connect with them.References
1. Cherry, K. Cherry, K.
Cathy Hester Seckman, RDH, has written on dental topics for 26 years. She works in the pediatric office of Jay Reznik, DMD, MS.