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UI pediatric dentist links clinic misbehavior with parenting styles
IOWA CITY, Iowa -- The unruly child in the dentist's chair may resist treatment
not because of fear but rather out of trouble responding to requests from
adults. A University of Iowa College of Dentistry professor suggests that
parenting styles affect preschool children's willingness to comply with dental
Dr. Jimmy Pinkham, UI professor and head of pediatric dentistry, contrasts
contemporary children's feelings about dentistry with those held by previous
generations. Though today's children are less likely to associate dental care
with pain, misbehavior remains a problem in dental clinics. Pinkham attributes
part of the problem to the fact that some children simply don't learn the
give-and-take process of cooperation at an early age.
"The dental appointment is basically a conversation," he says,
involving the dentist's need to make reasonable requests and the patient's
need to respond accordingly. Pinkham describes this process in linguistic
terms as the exchange of requests and promises. It relies on essential knowledge
that, he argues, some children develop later today than in previous decades.
Pinkham proposes that these children mature more slowly because their parents
lack established models for childrearing and make fewer requests of their
children. Earlier generations, he continues, were more likely to have grown
up with expectations imposed by tradition, extended family, and, in some cases,
economic necessity. They grew accustomed to the exchange of requests and promises
while relatively young.
"I think the importance of requests and promises was easier to teach
when children were raised with a certain urgency and at least one parent in
the home," Pinkham says. Today's children may be less accustomed to acting
on requests than their predecessors were. Consequently, some of the behavior
management techniques pioneered by pediatric dentists generations ago may
not be as effective today.
Pinkham emphasizes that this relationship between parenting, linguistic maturity
and child patient behavior is only a theory. He described the idea in a paper
published in the September-October 1997 issue of the Journal of Dentistry
Pinkham does not fault today's parents, nor does he think their children
experience long-term harm from mild delays in linguistic maturity. Most children,
he says, learn their roles and responsibilities as they grow older, particularly
once they enter school. They gradually abandon misbehavior in the dental clinic.
Pinkham's interest in linguistic development and child behavior stems from
his role in teaching UI dental students the basics of behavior management.
Of various methods used by pediatric dentists to promote treatment compliance,
the most effective and accepted rely on communication. Students must understand
that successful communication requires commitment and skill, Pinkham says,
especially when dealing with preschool children.
"Much of pediatric dentistry involves behavioral science," Pinkham
says. He notes that becoming an effective pediatric dentist requires moving
beyond one's assumptions about children, especially the belief that they cannot
adapt to new situations and demands.
"Childhood is now portrayed as an extraordinarily fragile time,"
Pinkham says. He cites accounts of children from different eras and cultures
assuming responsibilities that would seem remarkable in many contexts today.
Children who face fewer expectations may take more time to acquire the skills
and knowledge that make them better patients, he says.