Encourage parents to discuss with dental office staff how to best prepare CSHCN for a dental visit. For example, ask parents what time of day works best for their child. Typically dental office staff will have parents complete forms when they arrive for their first visit.

Download and complete the form Dental Office Considerations Checklist to help determine ways in which the office services and set-up can be adjusted or improved to accommodate CSHCN.

For example, noises may startle children with sensory impairments or those who have difficulty understanding procedures. Children may be fearful about unfamiliar procedures and equipment. Ask parents for their input on the best way to alleviate the child’s fears. Let the child know what you will be doing in terms they understand, for example, “I am going to count your teeth one at a time” (for the exam). Dental office staff can introduce instruments and equipment to the child before using them to help alleviate fears. Demonstrating equipment or techniques on the child’s, parents’, or oral health professional’s fingernail or on a doll can help familiarize the child with the procedure to be performed and help them feel more secure. Observing another compliant child in the chair can be reassuring. Using social stories (pictures of what will happen step by step) can also be helpful. This can work especially well for children with autism. Ask parents about what works best to make the child feel comfortable.

To accomplish procedures safely and effectively often requires two professionals working as a team (e.g., a dentist and a dental hygienist, a dental hygienist and a dental assistant) and projecting a positive, supportive, calm environment.

Involving parents in the child’s care while in the operatory requires good communication before, during, and after the provision of services. Decisions about appropriate ways to involve parents should be based on discussions before beginning the procedures and on observations of parent-child interactions. (See Module 5, Section 5.3, Behavior Guidance, Communication and Communicative Guidance—Parent Presence or Absence.)

Because every child’s needs are unique, individual home care and in-office care plans should be established in conjunction with the family and regularly re-assessed to determine progress and the need for changes.

Some children who use wheelchairs can transfer themselves into the dental chair without help or with help from parents, but others need additional assistance. The extent of the oral health professional’s involvement will depend on the child’s or parents’ ability to help. Most children can be transferred safely from wheelchair to dental chair and back by using the two-person method. The following steps describe a safe transfer that is most likely to work well for the child and the oral health professional. 4 Oral health professionals are encouraged to practice the steps before performing an actual transfer. (See Wheelchair Transfer: A Health Care Provider’s Guide for detailed information about each step.)

Six Steps for a Safe Wheelchair Transfer

Step 1: Determine the child’s needs
Step 2: Prepare the dental operatory
Step 3: Prepare the wheelchair
Step 4: Perform the two-person transfer
Step 5: Position the child after the transfer
Step 6: Transfer the child from the dental chair to the wheelchair