Quartz 4

Childrenese choice of language in paediatric dentistry

9 min read

Learning Objectives

By the end of this article, the reader will have:

  • Access to a formulary of perceived effective word choices when treating children in a dental setting.
  • Increased awareness of specific words suggested to be avoided when describing dental treatments to children.
  • Greater consideration of the potential effects of a child’s age and gender when choosing dental terminology.

Keywords1

  • Dental communication
  • Paediatric
  • Language
  • Childrenese

Study Overview and Abstract

To ensure good communication with paediatric patients, members of the dental team typically avoid dental jargon by using appropriate substitution of words. This language of word replacement is sometimes termed ‘Childrenese’.

This survey was conducted to collect a formulary of perceived effective and ineffective word replacements from paediatric dental team members. It assesses the impact of factors such as age and gender on the respondents’ word choice. The resulting formulary aims to aid general dental practitioners in communicating with paediatric dental patients.

Introduction to Dental Communication with Children

Dentistry is a field in which highly specialised vocabulary is commonplace. However, to facilitate good communication with patients, dental team members typically avoid dental jargon, replacing it as appropriate with simpler words. In particular, within paediatric dentistry, the use of descriptive language or euphemisms is an important factor for explaining procedures to children in a simple way, which in turn can alleviate dental fear and anxiety.

Previous literature suggests that a child’s behaviour is dependent on the communication pattern of the treating dentist. Substitution of potentially fear-evoking words for milder, more inoffensive words has been recommended as an effective approach to behaviour management for younger patients. This is sometimes termed as speaking in ‘Childrenese’ or a ‘second language’.

Challenges for Dental Professionals

While ‘Childrenese’ may become second nature to those working closely with paediatric patients, certain groups may struggle with word choice and lack confidence when adapting their communication style, including:

  • Recently graduated dental professionals.
  • Practitioners who infrequently treat children.

Introduction2

Previous examinations of euphemisms have concluded that simpler word substitutes lead to better child behavior in clinical settings. While several textbooks provide examples of dental euphemisms, there is limited literature on the specific words currently used by dental teams. A 1980 study found a wide variety of word substitutions, describing them as limited only by the imagination of the dental health team.

Over the last 40 years, popular culture and child management have evolved. This survey aimed to improve communication skills and confidence for dental team members by collating a formulary of common words used by the NHS Lothian Oral Health Service. The study also evaluated if vocabulary choice was influenced by patient age or gender and identified ineffective terminology that may negatively affect communication.

Ethical Approval

Ethics opinion was sought from the NHS Lothian Research and Development team; it was determined that ethical approval was not required as participants were NHS employees. Approval was granted by the NHS Lothian Audit and Quality Improvement team.

Methods

Questionnaire Content

A voluntary, anonymous online questionnaire was distributed to staff in the NHS Lothian Public Dental Service (PDS) and Paediatric Dental Department. The survey was open from 5 August to 21 September 2020.

  • Part One: Assessed gender, professional role, and years qualified.
  • Part Two: Asked for common words used for specific dental terms, including:
    • Fissure sealant, fluoride varnish, composite restoration, stainless steel crown, extraction, local anaesthetic, inhalation sedation, general anaesthetic, aspirator, rubber dam, and drill.
  • Analysis: Respondents were asked if demographics influenced word choice and to identify ineffective terms.

To calculate the response rate, duplicate or bounced email addresses were excluded, as were staff members who confirmed they do not regularly treat children.

Results345

A total of 185 eligible staff members were contacted, with 36 responding (19.5% response rate). The mean years post-qualification was 14.9 years, and 83% of respondents were female.

Job Roles of Respondents

  • Dental Nurse: 30%
  • Trainee (StR, DCT, post graduate): 25%
  • Paediatric Consultant/Specialist: 17%
  • Other Dental Care Professional (Hygiene therapist, hygienist): 17%
  • PDS Dentist: 8%
  • Consultant (other): 3%

Common Euphemisms Used

Fissure Sealant (n=48)

  1. Plastic or protective coating/covering/shield (56.3%)
  2. Nail varnish or gel nails (22.9%)
  3. Paint/painting/special paint (12.5%)
  4. Other: Varnish, sealant, raincoat, protection cape (8.3%)

Fluoride Varnish (n=46)

  1. Special/high strength/fruity/sticky toothpaste (34.8%)
  2. Banana/fruit/caramel paste, varnish, or gel (32.6%)
  3. Fluoride/high fluoride paste, varnish, or paint (13.1%)
  4. Paint, special paint, tooth paint, fruity paint (13.0%)
  5. Special/tooth varnish (4.3%)
  6. Other: Magic medicine (2.2%)

Composite Restoration (n=40)

  1. White/tooth-coloured filling (57.5%)
  2. Bandage/plaster, tooth-coloured plaster (17.5%)
  3. Filling, filling hole (7.5%)
  4. Other: Cream, paint, sandcastle, white seal, covering, patch, white plastic (17.5%)

Stainless Steel Crown (n=68)

  1. Princess crown/tooth (29.4%)
  2. Superhero tooth (Ironman/Superman) (22.1%)
  3. Hat: Silver/shiny/metal hat or cap (22.1%)
  4. Silver/metal crown (7.3%)
  5. Pirate tooth (5.9%)
  6. Bionic/robot tooth (4.4%)
  7. Silver/sparkly coat/cover/jacket (2.9%)
  8. Other: Darth Vader mask, tooth jewellery, metal protector (5.9%)

Extraction (n=51)

  1. Wobble/wiggle tooth out, special fingers, hug and a wiggle (39.2%)
  2. Remove/take out/pop out tooth (23.5%)
  3. Remove tooth for the tooth fairy (11.8%)
  4. Say goodbye to the tooth (5.9%)
  5. Dancing tooth out (5.9%)

Common Euphemisms Used (Continued)

Extraction (Continued) 6. Extraction (5.9%) 7. Funny/weird feeling or pushing (3.9%) 8. Other: Lifting out (3.9%)

Local Anaesthetic (n=54)

  1. Sleepy juice/spray/medicine (44.4%)
  2. Numb up, numbing medicine/liquid (13.0%)
  3. Medicine to make tooth go to sleep (5.6%)
  4. Putting tooth to sleep (5.6%)
  5. Water/special water (3.7%)
  6. Freeze/freezing liquid (3.7%)
  7. Local anaesthetic (3.7%)
  8. Elsa’s magic power/juice (3.7%)
  9. Magic juice/freeze/cream (3.7%)
  10. Cold juice to wash tooth (3.7%)
  11. Other: Injection, jungle juice, magic wand, sleepy drips (9.2%)

Inhalation Sedation (n=45)

  1. Happy air/gas/wind (46.7%)
  2. Laughing gas (13.3%)
  3. Magic air/gas (11.1%)
  4. Relaxing air/gas (8.9%)
  5. Special air through nose (6.7%)
  6. Other: Floaty air, sleepy wind, giggle gas, funny smelling mask (13.3%)

General Anaesthetic (n=39)

  1. Sleeping/asleep/snoozing, go for a sleep (53.9%)
  2. Put you to sleep (15.4%)
  3. General anaesthesia (7.7%)
  4. Special/magic sleep (5.1%)
  5. Medicine to put you to sleep for a nap (5.1%)
  6. Other: Special air/gas, funny smelling mask (12.8%)

Aspirator (n=47)

  1. Hoover/vacuum (special, wee, mouth, water, or Harry hoover) (63.8%)
  2. Straw, sucky straw, thirsty straw (19.2%)
  3. Sucker/saliva sucker (8.5%)
  4. Suction (6.4%)

Aspirator (Continued)

  • Other: Billy the wind (2.1%)

Rubber Dam (n=37)

  1. Raincoat/coat for tooth (35.2%)
  2. Rubber sheet/cover, stretchy sheet (21.6%)
  3. Umbrella/rain cover (13.5%)
  4. Blanket/cover (10.8%)
  5. Trampoline (8.1%)
  6. Other: Rubber shield, safety curtain, tent (10.8%)

Dental Drill (n=50)

  1. Electric toothbrush/cleaner (32.0%)
  2. Buzzy/buzzing brush, buzzy bee (28.0%)
  3. Washing machine/cleaning machine/shower (12.0%)
  4. Mr Bumpy, Mr Buzzy, Mr Rumbles (10.0%)
  5. Polisher/tooth polisher (4.0%)
  6. Other: Drill, handpiece, dentist’s rumbling stomach, race car, vibrating machine (14.0%)

The age of the patient influenced word choice for 55% of dental team members on average. Gender had a significantly lower impact.

Influence of Demographics by Role:

  • PDS Dentist: Age (60.6%), Gender (6.1%)
  • Trainee: Age (60.6%), Gender (10.1%)
  • Nurse: Age (49.6%), Gender (9.9%)
  • Consultant/Specialist: Age (51.9%), Gender (11.7%)
  • Hygienist/Therapist: Age (57.6%), Gender (3.0%)

Influence Of Age And Gender On Word Choice6

Ineffective or Poorly-Received Terminology

  • Local Anaesthetic (66.7%): Jag/jab, injection, needle, numbing juice, freeze, sore/hurt, sharp scratch, numb sensation.
  • Dental Drill (44.4%): Drill.
  • Fluoride Varnish (36.1%): Sticky, banana paste/flavours, varnish, fluoride.
  • General Anaesthetic (33.3%): Nap lasting over 10 minutes, going to/put to sleep, operation, the gas, risk of death, being knocked out, injection in the hand.
  • Extraction (33.3%): Extract/extraction, pulling/pull out, removing, taking away.
  • Inhalation Sedation (19.4%): Gas/gas and air, mask, relaxing gas, “won’t remember.”
  • Stainless Steel Crown (16.7%): Metal, silver, crown, tooth.
  • Composite Restoration (11.1%): Composite restoration, cream.
  • Fissure Sealant (5.6%): Nail varnish, fissure sealants.

Ineffective or Poorly-Received Terminology (Continued)

  • Aspirator (13.9%): Suction, aspirator.
  • Rubber Dam (11.1%): Clamp, clip, rubber dam.

Ineffective Dental Terminology7

Reasons for Ineffectiveness:

  • Anticipated negative sensory change or loss of control.
  • Terms requiring further explanation to be understood.
  • Terms parents use that may confuse the child.
  • Fear of sleeping forever or associations with the death of a pet (specifically regarding “put to sleep”).

Discussion8

A consistent finding is that paediatric patients prefer word substitutions over dental jargon. Most dental terms were noted as ineffective or negatively received. For example, “extraction” can be poorly received during the procedure, highlighting the need for appropriate substitutions. Simple wording benefits both the child and the parent.

Some terms produced mixed results. While many use sleep analogies for general anaesthesia, others find them ineffective because children may associate “put to sleep” with the death of a pet or fear not waking up. Suggested alternatives include “snoozing” or “nap in a hospital,” or using the technical term with an explanation for older children.

Study Limitations

  • Response Rate: Difficulty in identifying the exact number of staff regularly treating children likely led to an underestimated response rate.
  • Accessibility: The survey platform was inaccessible on some NHS computers, potentially lowering participation.
  • Scope: The study was restricted to NHS Lothian; a wider UK or Ireland distribution would increase sample size and reveal regional variations.
  • Recall Bias: Responses were based on recall rather than real-time clinical observation.
  • Content: Only eleven dental terms were investigated to avoid survey fatigue.

Conclusion

This survey identified popular word choices and ineffective terminology used by paediatric dental teams. While many traditional substitutions remain popular, new terms have emerged. Age frequently influences language choice, whereas gender plays a minimal role except for stainless steel crowns. This pilot study provides a foundation for future large-scale research in the UK.

Footnotes

  1. Original PDF page 1: Childrenese choice of language in paediatric dentistry, p.1 ↩

  2. Original PDF page 2: Childrenese choice of language in paediatric dentistry, p.2 ↩

  3. Original PDF page 3: Childrenese choice of language in paediatric dentistry, p.3 ↩

  4. Original PDF page 4: Childrenese choice of language in paediatric dentistry, p.4 ↩

  5. Original PDF page 5: Childrenese choice of language in paediatric dentistry, p.5 ↩

  6. Original PDF page 6: Childrenese choice of language in paediatric dentistry, p.6 ↩

  7. Original PDF page 7: Childrenese choice of language in paediatric dentistry, p.7 ↩

  8. Original PDF page 8: Childrenese choice of language in paediatric dentistry, p.8 ↩

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