We have received a great deal of resistance for our parent policies and would like to offer some education for those who want to understand the science, practicality and politics of defining boundaries and setting expectations.
Science:
A child does not have the ability to reason and think rationally as an adult does. (adults possess a fully developed dopaminergic prefrontal cortex which supports their ability to make rational decisions while children do not) In other words, the way a child interprets its environment is based on emotion (limbic system) and their need to trust others for their well-being. An infant relies heavily on their mother for comfort and truly needs them to be completely present with them in a state of emotional regulation in order for them to be able to regulate themselves through their autonomic nervous system.
Simply said, the child needs to associate the parent with the calm and comfort of recovery, not the challenges and uncertainty of the procedure. If a child identifies the parent with the procedure, there is the possibility of the creation of a "trauma bond". The child does not have the rational capacity to think like an adult and might associate the parent as allowing them to be "hurt". We are literally begging our parents to allow the child to have any association of trauma with us as providers. They will need the unconditional love of a parent to comfort them and be fully present to love them thorough their recovery.
To review some extensive literature references on this subject, please see below...
Practicality:
Let's face it. Children (especially those 5 and older) behave differently when their parents are in the same space as a healthcare provider. They are smarter than their parents give them credit for and can sense if a parent does not trust their provider. If the parent makes a big deal about not trusting the provider to care for their child without them being present in the room, the child automatically will distrust the provider. This can be a game changer for the doctor patient relationship that is built on trust.
In addition, dental offices are not built with observation areas. Treatment rooms are for treatment. Waiting rooms are for waiting. Surgical areas are controlled, sterile environments with instrumentation and personnel dedicated to caring for a patient, not entertaining a parent. Maintaining a controlled environment with laser plumes and aerosols requiring additional ventilation is important at all times...and especially in a pandemic. Having parents present in the surgical suite or dental treatment area is an additional risk that might prevent ideal outcomes for the delicate procedures that are performed in a dental surgical or restorative setting.
Politics:
The pressure that is placed on providers to meet the realistic (or unrealistic) needs of the parent is often a factor in making treatment decisions on how a provider earns a living. It is the decision of each provider to make decisions on how to manage their offices.
In our office, our decision to place the needs of the child receiving treatment before the needs of the parent paying for the treatment is based on science and not on finances. The parents who are willing to understand the science behind the decisions to create and enforce policies will educate themselves before making a decision based on feelings instead of facts.
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