When I was in my orthodontic residency, I was lucky enough to spend a lot of time with my pediatric dentistry colleagues. One of the more capable residents (let’s call him “Dave”) used to tell me that he chose the profession because it reminded him a lot of poker; He enjoyed the opportunity to anticipate a child’s behavior, and use that knowledge to help them get over their fears of dentistry. I learned a lot from Dave during my 30 months in school, but it was a casual comment he made that has stayed with me to this day.
Dave mentioned that the faculty of the pediatric dentistry department didn’t let parents come back into the clinical areas for kids who were older than toddler age. And while most parents understood that the department had good reasons for the rules, there were some parents who insisted on being by their children’s sides during the appointment. Dave said that he allowed those parents to come back, but under one condition: They weren’t to speak or touch their child during the appointment. He made it clear to them that he was going to take exceptional care of their child and the parents’ presence was allowed for the parents’ sake, not the child’s. The appointments always went well (Dave was a great pediatric dentist), and after a few visits of watching this, those parents who insisted on being there generally decided that their time was best spent outside of the clinic.
Dave further explained that for a child to feel secure and safe, they needed to establish trust with the person who was treating them. There needed to be an emotional connection and he had to build the trust with the pediatric patient. His concern with parents being present is that they were rarely experts in child psychology and often interrupted his very methodical way of establishing rapport. They would answer questions when the child was supposed to answer. They would start touching and mollifying a child when it was unnecessary, drawing the child’s attention away from the very specific approach he was undertaking. Worse, they would often interject themselves and their parenting styles into his trained way of treating a child, by telling the child to “open up” , or saying “there’s nothing to be afraid of” or even asking if everything was OK when he clearly had the situation well under control.
In short, the parents were often (inadvertently, of course) undermining the relationship that the doctor was trying to develop with the patient. There were many parents who were sure that they knew their child better than any doctor ever could (which is true), but it wasn’t knowledge he was looking for; It was trust, and that only comes when an honest one-on-one relationship is built without outside interruptions.
While I have always allowed parents to come into the clinical area with their children, Dave’s comments got me observing the impact of parents’ on patient comfort levels. One thing became clear very quickly. The more involved a parent was in their child’s appointment, the more difficult the appointment seemed to be for the child. In hindsight it’s common sense that a child needs to build a rapport and trust with the doctor and there’s no way that can happen with a parent intervening, but I never realized to what extend this was happening in clinic until I purposely started looking at it.
Without exception, the more the parent hovered over the appointment, the more they talked to the child, the more they rubbed the child’s leg or held their hand, the more scared the child invariably was during the appointment. When a child would come back into the clinic, happily chatting with the assistant, the entire feel of the appointment changed when mom or dad asked: “Do you want me to come back there with you?” Suddenly the child was less open to talking and you could literally feel their anxiety level rise. Conversely, the parents who stayed in the reception area, or sat at the chair checking their Facebook feeds more often than not had kids who cruised through the appointment far easier and high-fived the doctor and team when it was over.
I’m a parent (our oldest is about to start college in the fall) and I know how hard it was for me to “let go” of my need to be a part of the action when went to the doctor/dentist. But I have allowed them to build their own relationships because the appointment is about them, not me. My control of the appointment was replaced with the joy of watching them develop an earnest, comfortable relationship with their healthcare provider. I trust my kids’ doctors 100% and moreover, they are never alone with my kids so I know all is well.
Keep in mind that a healthcare provider doesn’t ever want to offend a parent, so even if the parent’s presence and involvement is negatively impacting the delivery of care, the provider is likely to just “suck it up” and deal with it and allow it to continue. Most clinicians don’t have Dave’s straightforwardness or candor and it’s tough to tell a parent that their presence is impacting their child’s visits. (I can also tell you that 25 years in practice has taught me that the parents who need the conversation the most are also the ones least likely to react well to hearing it.)
If you feel the need to hover over your child during their orthodontic appointments, let it go. I promise that it’ll be better for everyone involved; The orthodontist, the assistants, your child and even yourself.
Best of all, you might even get some time to relax in the reception area because as we all know, being a parent isn’t easy.
The Dental Sherpa 
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