CORE principles
Setting the Stage: The Winning Ingredients!
Here are the core principles and winning ingredients, of a step-by-step approach that supports the principles of acclimating to dental care. To ensure success, it is recommended you follow these guidelines when using the exercises in this guide.
It Starts at Home
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Step by Step
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The ‘Sandwich’ Principle
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The Power of Counting: Structuring and Soothing
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The Clever Ruse of ‘False Choices’
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Reinforcement and Praise
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Progress With No Pressure: Respect Limits
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Communication = Control: Equip The Child
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1
IT STARTS AT HOME
Exercises implemented to the daily routine:
Implement these exercises in the daily routine for example, after breakfast or before going to school. Make it a fun part of the day.
Five minutes is enough.
Consistency is crucial to establish a routine and ensure that the progress made between each exercise is maintained.
A visual aid can also be used to provide the child with cues regarding the sequence of the exercise or tooth brushing. Here is an example.
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Aim for Gradual and Consistent Exposure: Introduce new steps little by little, just a bit at a time. Each new step may be slightly uncomfortable but always at a manageable level for the child.
Finish on a Positive Note: Each exercise should end with a reduction in stress to bring your child back to a state of calm and serenity. This ensures that the exercise remains a positive experience for them.
step by step
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THE ‘SANDWICH’ PRINCIPLE
Always keep it fun! Do the exercise between two short play periods.
Play
Exercise
Play
This ensures that the experience remains positive. The child will also be motivated to redo the exercise, knowing it is part of a playtime period.
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THE POWER OF COUNTING: STRUCTURING AND SOOTHING
Countdown: A predetermined and announced countdown should be associated with the activity done with the child (e.g., give the toothbrush a kiss for three seconds. The adult counts out loud 1-2-3 while the child touches the toothbrush with their lips). This strategy helps the child understand there is a predictable start and end to the exercise, which may sometimes be uncomfortable. This clear, consistent, and reassuring framework greatly helps reduce anxiety that may arise during these moments.
Counting also helps the child focus on the exercise.
Stay Still: It is important that the child does not move during the exercise to facilitate dental care, both at home and at the dentist. Instructions should include ‘we count for x seconds, without moving’. If the child moves during the countdown, simply stop the exercise. Reiterate the rules (countdown of x, without moving), and start again. If you notice that the child needs to move or to take a break, offer options while setting limits on the play period duration before returning to the exercise.
Increase Slowly: Start with a few seconds and gradually increase the duration, if things go well.
Other strategies can also be used to structure the exercise, such as performing the exercise for the duration of a song (always choose the same song to ensure predictability) or using a ‘time-timer’ (physical or via an app) to visually mark the duration.
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Offer ‘False Choices’: This is a technique to give children a sense of control while guiding their actions. For example, instead of asking if the child wants to brush their teeth, you could ask if they prefer to use the red or blue toothbrush, or if they want to start with the top or bottom teeth. This approach increases cooperation by allowing the child to make decisions within a predefined framework, reducing conflicts and facilitating exercises and daily routines.
THE CLEVER RUSE OF ‘FALSE CHOICES'
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Reinforce and praise
Always Recognize and Value the Child’s Efforts: Positive reinforcement is a crucial tool to motivate children, encourage them to persevere, and make them enjoy repeating activities.
At the beginning of the process a reward can be offered after each small success (e.g., sticker, short video clip, song, hug, etc.). For instance, touching the toothbrush is followed by a sticker. This creates a positive association with the toothbrush (avoid sugary treats!).
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PROGRESS WITH NO PRESSURE: RESPECT LIMITS
Easy at First: Ensure small successes at the beginning to build confidence.
Slow but Steady: If something seems difficult, no worries, take your time and go back if needed.
If the child indicates they want to stop and the discomfort is reasonable, offer one last try before ending the activity. This allows the child to gradually push their limits and the parent to maintain structure and control over the exercise.
Respect Each Child’s Limits: Avoid pushing them to a point of stress, or discomfort, that could negate progress. This helps maintain a steady and secure progression, where each step builds the child’s confidence and comfort.
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COMMUNICATION = CONTROL: EQUIP THE CHILD
Learning to Express the Need for a Break: Teach them to ask for a break or signal discomfort (whether through signs, words, or pictures, depending on their abilities). This gives them a sense of control over the situation, enhancing their autonomy and ability to influence what happens to them.
Stress Reduction: Knowing that they can communicate their needs, and that they will be heard, significantly reduces the child’s stress and anxiety, making them more confident and relaxed during potentially stressful activities.
Important :
Every child is special and unique. Listen to them and adapt activities to their pace and comfort. If you see they are a bit uncomfortable, it’s normal to take a break and give them more time.
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STEP
method - Step-by-Step Guide
Once you have reviewed and familiarized yourself with the core principles above, explore various exercises, tips for effective tooth brushing, and a guide to preparing for a visit to the dentist.