The Next Generation of Smiles

Crystal Spring, RDH, executive director of Smiles Across Montana, a non-profit mobile preventive and restorative dental program that brings access to exceptional dental care to underserved populations, underscores this idea. "Prevention is everything," Spring says. "Keeping kids out of the operating room starts with using minimally invasive techniques like silver diamine fluoride and glass ionomer sealants to stop decay before it gets serious. It also means teaching parents and caregivers how daily habits, nutrition, and early intervention can make all the difference."

One of the primary challenges in pediatric dental hygiene care is making the visit a positive experience. Both Do and Spring share the belief that this goal goes hand-in-hand with providing excellent care. Creating an environment that makes children feel safe and comfortable is essential. Do explains, "For me, it's all about creating a safe and supportive environment for children and their parents. Being flexible and patient is important because you never know a child's background or if this is their first dental experience."

Spring emphasizes that meeting children "where they are, both physically and emotionally," is vital in fostering trust and easing anxiety.

When treating pediatric patients, it is helpful for hygienists to adapt their approach depending on the age and developmental stage of each child. Children under the age of 8 typically have limited dexterity and need help with brushing and flossing. Do highlights this developmental milestone: "Children typically need help with their oral hygiene until around age 8, and that's because their dexterity to do a good job is not quite developed," she says. Because of this, it's crucial to educate parents on the importance of their involvement in their child's daily oral care. As Do points out, "I make sure parents understand their role in that."

Hygienists should also be aware that a child's level of cooperation may vary based on age and temperament. Do recommends that for younger patients, the focus should be on making the visit positive and on creating a trust-based relationship. "Sometimes, that means taking breaks or needing a longer appointment," Do says. "The main goal of the visit matters. In some cases, the focus is simply on creating a positive experience and taking things one step at a time."

For children over the age of 8, treatment may progress with more autonomy, but dental hygienists should continue to be patient, flexible, and supportive, ensuring a positive dental experience, the experts say. Spring, who works with a diverse pediatric population that includes children from underserved communities, says children can benefit from being more involved in their care. "I let them check out the tools I use," Spring says. "They love the cordless polisher. I let them choose a toothbrush. Taking small steps at their own pace gives them a sense of control." Giving older children the opportunity to make small decisions about their care helps to foster a sense of ownership over their dental health, Spring says.

The ‘Tell-Show-Do' Approach

Both experts agree on the importance of the "tell-show-do" technique in easing children's anxiety during dental visits. This method involves explaining each step of the procedure, demonstrating the tools and techniques, and then performing the procedure while checking in with the child throughout. Do explains the technique as follows: "If I sense they are nervous, I address it. Generally, I will tell them what I am using with child-friendly descriptions and how it will sound if there is a noise. Then, I will show them the item and use it. I pause after each step to allow the information to register with the patient."

Do provides a concrete example of how she uses this technique before using a saliva ejector with children for the first time. "This is my ‘crazy straw,' and it bends and wiggles," she says to her young patients. "It will sound like the ocean." Then she pauses and turns on the saliva ejector, allowing the children to feel it if they would like. "It will help take out the water. Let's practice," she tells them. Then she pauses again before using it in children's mouths. By taking the time to describe tools in relatable terms, show them to the child, and let them feel them, Do is able to reduce fear and build familiarity.

Spring also implements the "tell-show-do" approach to establish trust. "The biggest game-changer is consistency and kindness," Spring says. "When kids see the same friendly faces and have positive experiences, that fear starts to fade." By consistently using the same approach in a gentle, non-threatening manner, hygienists can help children feel more comfortable and secure in future visits, Spring says.

The Role of Education in Pediatric Dental Care

Education is a cornerstone of pediatric dental hygiene. Both experts agree that educating children and their parents is essential for building a foundation of healthy habits that can prevent oral health problems in the future. For children, making education fun and engaging is crucial. Spring simplifies the concept of cavities for young patients by describing them as "sugar bugs," a playful yet effective way to explain the impact of sugary foods on dental health. Spring recommends resources like the book Where the Sugar Bugs Live by Carrie Wucinich, RDH, to help instill good oral hygiene habits at an early age. She adds, "Meeting families where they are and giving them practical, real-life advice makes all the difference."

Do likes to show children the plaque buildup on their teeth, which helps them understand its role in cavities and gum disease.

Parents, too, must be educated on how to care for their children's teeth and gums by assisting their young children with brushing. "My biggest advice for parents is to stay involved in their children's oral care, especially if their children are under 8," Do says. "Kids still need help or guidance with brushing, flossing, and tongue brushing, especially at night when it's most important."

The Impact of Early Dental Visits

Early dental visits are critical for laying the foundation of lifelong oral health. "Early dental visits are incredibly important because they help set the foundation for a lifetime of good oral health," Do says. "The American Academy of Pediatric Dentistry recommends that a child's first dental visit happen by their first birthday or within 6 months of their first tooth coming in. It's not just about checking for cavities-it's about building healthy habits early, supporting parents, and making sure everything is on track with growth and development."

"Understandably, parents and patients often worry about cavities, but I sometimes notice a lack of concern for gingival health," Do says. "I've had patients who are excited to be cavity free but have severe gingivitis. While avoiding cavities is important, gum health should be just as much of a priority. I explain to them what happens if they do not take action to improve their gingival health."

For hygienists, the first dental visit is an opportunity to educate parents, make the child comfortable in the dental office, and start building a positive association with dental care. Do says, "The role of the dental hygienist in these first visits is to help parents feel confident in caring for their child's teeth. I go over brushing techniques, recommendations, and any concerns they might have."

"It can also help to find ways to make brushing fun and motivating for children," Do says. "Whether it's a sticker chart, a fun app to track brushing, or a special reward system, finding what works for them can make a big difference. I tell parents that when they help them brush, try to think of it as a bonding time rather than just another chore. Also, don't forget to have them replace their toothbrush every 3 months, or sooner if the bristles look worn out."

"Diet plays a huge role in oral health, too, so try to limit drinks other than water between meals and cut down on frequent snacking. This helps keep the oral microbiome balanced and maintains a healthy pH in the mouth. And, of course, I tell parents to bring their children in if there are any concerns," Do adds.

"For me, it's not just about fixing cavities but changing how dental care is delivered," Spring says. "By integrating oral health with medical care, innovation, and community partnerships, we can reach more kids and keep them healthier from the start. Every child deserves high-quality, compassionate care, no matter where they live, their background, or their family's financial situation."

Providing pediatric dental care requires a combination of clinical skill, patience, and a thorough understanding of child development. By using strategies such as the "tell-show-do" approach, focusing on prevention, and tailoring care to the individual needs of each child, dental hygienists can make a lasting impact on the oral health of their young patients.