MEDICAL-DENTAL RELATIONSHIP TO THE

CHILD PATIENT

  C. Everett Koop. J. Den. Children 22:197
  Fourth quarter 1956.
A child is not a small adult and when he is
treated as such, his response to surgery does
not come up to expectations. The child differs
from the adult in the character and variety of
lesions presented for care and correction. His
physiologic response to trauma, blood loss and
so forth is different from the adult response to
the same insult. If these differences are real
for the normal child, they are much more so
for the handicapped child.

A hospital experience for elective dental
surgery in a handicapped child need not be
an unpleasant one for a child. The child who
enters a hospital properly prepared for that
which he will encounter is almost invariably a
happy one. The child who has not been told
what to expect or who has been told a false-
hood concerning his admission is suspicious
of his parents, the doctors and nurses. It is
almost impossible in a short hospital stay to
win the confidence of such a child. The child
should be told the truth about those things
,which will happen to him, although it is USU-
ally not necessary to go into great detail.

When a child is approached in honesty, his
confidence is gained and his cooperation be-
comes a matter of course. For example, if a
painful procedure, such as a needle puncture
for a blood specimen, must be performed, it
is prong to tell a child: "This will not hurt."
Rather, he should be told something like this:
"We have to do a test on your blood and
must take the blood from your arm with this
needle. It will hurt, but just for a minute.
As soon as it is over, you will realize that
many things that happened to you yesterday
hurt much more than that, and you never
even cried." Usually, when some completely
painless procedure must then be undertaken,
such as a roentgenogram, the child can be

747

748 o THE JOURNAL OF THE AMERICAN DENTAL ASSOCIATION

told, "This will not hurt," and the child will
believe the practitioner.

Parents should begin several days in ad-
vance to prepare the child to come into the
hospital. He should be told something of the
duration of his stay, and whether he will be
staying with his mother or with other children.
Promises should not be made which cannot be
kept by the hospital staff.

Fear of hospitalization is largely fear of the
unknown or the unexpected. One of the best
ways to overcome apprehension on the parr
of the family is to discuss with the parents
exactly what they may expect so that they in
turn can inform the child. The child depends
on his parents for support in meeting any new
situation, and they can be of great service to
him and to the dentist by lending him the
confidence which they have learned by facing
the new situation squarely as it is presented
to them by the dentist.

The postanesthetic recovery time is one of
confusion for the child. Unlike adults, chil-
dren rarely have prolonged nausea postopera-
tively and if they do not expect nausea, they
frequently do not experience `it. A child who
has been properly instructed regarding the
operation itself accepts the postoperative care
without hesitation.