Preparation of the child for local analgesia
Figure 1 : The child should be positioned comfortably for both child and operator. A simple explanation of the procedure should be given and, contrary to popular belief, it is often advantageous to show the child the assembled syringe, with guard in place, at this stage. This is in keeping with the ‘tell-show-do’ approach of behaviour management, and can be accompanied by a ‘childrenese’ explanation: ‘Here is the jungle juice machine. In this bottle is the jungle juice and when I press this button it comes down the bottle, down a tiny tube and dribbles into your gum.’ This approach will usually result in the child relaxing and accepting the administration of local without protest.
Figure 2 : If the sight of the syringe produces anxiety in the child then this identifies a pre-existing problem, which must be appropriately managed prior to local analgesic administration. Attempts to ‘hide’ syringes from anxious children will frequently result in the child attempting to see what is being concealed and a heightened anxiety in both child and dentist. Any trust already established between the two may be breached.
Figure 3 : Once the explanation is complete, the needle guard can be removed, out of the child’s field of vision, the soft tissues retracted and the injection carried out.