Should You Stay or Should You Go?

The Truth About Parental Presence During Your Child's Dental Visit In Croydon

Dr O Dadashian

One of the most common questions parents ask when bringing their child to the dentist is whether they should stay in the treatment room or wait outside. It's a decision that can feel overwhelming, especially when your child is already anxious about the appointment. The answer, according to recent research, might surprise you.

The Great Debate - In or Out?

For decades, dental professionals have debated whether parental presence helps or hinders paediatric dental treatment. Some practitioners believe parents provide comfort and security, while others worry that parental anxiety might transfer to the child or that parents might inadvertently interfere with treatment.

Recent comprehensive research involving thousands of children has shed new light on this debate. The findings suggest that the impact of parental presence isn't as straightforward as many people assume, and the decision should be based on several important factors rather than a one-size-fits-all approach.

What the Research Really Shows

A systematic review of 62 studies examining behavioural management techniques in paediatric dentistry found some interesting patterns regarding parental presence. The research revealed that simply having a parent in the room doesn't automatically reduce a child's anxiety or improve their cooperation during dental treatment.

In fact, three major studies comparing parental presence to parental absence found that the technique had no significant impact on children's anxiety levels or cooperation during dental procedures. This might seem counterintuitive to many parents who assume their presence would naturally comfort their child.

However, the story becomes more nuanced when we look at different types of parental involvement. One particularly revealing study found that 74.7% of preschool children showed positive behavior when treated with "active" parental presence, compared to only 46.7% when parents were present but passive.

Active vs Passive Parental Presence - The Key Difference

Understanding the difference between active and passive parental presence is crucial for making the right decision for your child's dental visit:

Active Parental Presence involves:

• Engaging with your child through encouraging words
• Following the dental team's guidance on how to help
• Participating in distraction techniques when appropriate
• Maintaining a calm, positive demeanour

Passive Parental Presence typically means:

• Simply sitting quietly in the corner of the room
• Observing without interaction
• Potentially displaying your own anxiety through body language
• Not actively participating in your child's care

The research suggests that when parents are actively involved in a positive way, children respond much better to treatment. This makes sense when you consider that children often look to their parents for cues about how to react in unfamiliar situations.

Age and Individual Factors Matter

The decision about parental presence should also consider your child's age and individual temperament. Younger children, particularly preschoolers, often benefit more from parental presence than older children who may feel more independent.

Some children naturally feel more secure with a parent nearby, while others might actually feel more grown-up and confident when they handle the appointment on their own. Understanding your child's personality is key to making the right choice.

Additionally, children with special needs or those with significant dental anxiety may require different approaches. The research shows that individualised behavioural management is more effective than applying the same technique to every child.

The Parent's Role in Success

If you do stay in the treatment room, your role becomes crucial to your child's success. Here's how you can be most helpful:

Before the appointment: 

• Discuss the upcoming dentistry in positive, age-appropriate terms
• Avoid sharing your own dental fears or negative experiences
• Let the dental team know about any specific concerns or triggers

During treatment: 

• Follow the dental team's lead on when and how to interact
• Keep your own anxiety in check – children are remarkably good at picking up on parental stress
• Use encouraging words rather than phrases like "it won't hurt" which can actually plant the idea of pain

When Staying Might Not Be Best

There are situations where parental presence might actually hinder treatment:

• If you have significant dental anxiety yourself that you struggle to hide
• When your child tends to perform better independently
• If previous visits went more smoothly without parental presence
• When the dental team recommends you step out based on their professional assessment

Remember, stepping out doesn't mean abandoning your child. It might actually be the most supportive thing you can do in some situations.

Modern Alternatives to Consider

Today's paediatric dental practices offer many alternatives to traditional parental presence that can be equally effective:

• Video monitoring systems that let you watch from another room
• Two-way communication systems
• Audiovisual distraction techniques that engage children independently
• Specially trained dental assistants who excel at child communication

These options can provide the benefits of parental involvement without some of the potential drawbacks.

Making the Right Decision for Your Family

The key takeaway from current research is that there's no universal right answer about parental presence. The decision should be individualised based on:

• Your child's age and maturity level
• Their previous dental experiences
• Your own comfort level and anxiety management
• The dental team's professional recommendation
• The specific procedure being performed

Working with Your Dental Team

The most important factor in your child's dental success isn't necessarily whether you're in the room, but rather having a dental team that's skilled in paediatric behavioural management. Look for practices that:

• Assess each child individually
• Offer multiple behavioural management techniques
• Communicate clearly with both parents and children
• Are flexible in their approach based on what works best

Remember, the goal isn't just to get through one appointment, but to help your child develop positive associations with dental care that will serve them throughout their life. Sometimes that means staying by their side, and sometimes it means giving them space to grow and gain confidence independently.

The research shows us that successful paediatric dental care is about much more than just parental presence – it's about creating individualised approaches that help each child feel safe, comfortable, and empowered during their dental visits.

References:

1. Gizani S, Seremidi K, Katsouli K, Markouli A, Kloukos D. Basic behavioral management techniques in paediatric dentistry: A systematic review and meta-analysis. [Journal details from original paper]
2. AlDhelai TA, Khalil AM, Elhamouly Y, Dowidar KML. Influence of active versus passive parental presence on the behavior of preschoolers with different intelligence levels in the dental operatory: a randomized controlled clinical trial. BMC Oral Health. 2021;21:420.
3. Boka V, Arapostathis K, Charitoudis G, Veerkamp J, van Loveren C, Kotsanos N. A study of parental presence/absence technique for child dental behavior management. Eur Arch Paediatr Dent. 2017;18:405-409.
4. Afshar H, BaradaranNakhjavani Y, Mahmoudi-Gharaei J, Paryab M, Zadhoosh S. The Effect of Parental Presence on the 5 year-Old Children's Anxiety and Cooperative Behavior in the First and Second Dental Visit. Iran J Pediatr. 2011;21:193-200.
5. Shindova MP, Belcheva A. The effect of parental presence on the dental anxiety during clinical examination in children aged 6 – 12 years. Journal of IMAB. 2013;19.