Banana paste, princess crown, sleepy juice – what’s in a name?

Effective and ineffective terminology when treating paediatric patients has been identified.

24 October, 2024 / infocus
 Will Peakin  

Effective – and ineffective – terminology used by dental team members in Scotland when treating paediatric patients has been identified in a study.

The study by researchers at Glasgow Dental Hospital, Dundee Dental Hospital and Research School and the Edinburgh Dental Institute set out to:

  • Determine the words and phrases that dental team members perceive to be effective for describing treatments to children.
  • Establish if there are any perceived ineffective words, or words that are received negatively, when describing procedures to children.
  • Assess if the choice of words is influenced by the age and the gender of the child.

A survey form was shared with NHS dental team members who routinely treat paediatric patients in the community public dental service (PDS) and hospital dental services (HDS) throughout Scotland.

For each treatment and instrument there is certainly not one ‘correct’ way to describe each dental term.

Researchers at Glasgow Dental Hospital, Dundee Dental Hospital and Research School and the Edinburgh Dental Institute

The n=209 respondents were asked a series of questions on words they perceived to be effective and ineffective for describing eight dental procedures and three dental instruments and whether their word choice was affected by the gender and/or the age of the patient:

  • Fluoride varnish
  • Fissure sealant
  • Composite restoration
  • Preformed metal crown
  • Extraction
  • Local anaesthetic
  • Inhalation sedation
  • General anaesthetic
  • Drill
  • Aspirator
  • Rubber dam

The top three responses for each word were:

  • Fluoride varnish: Special toothpaste/varnish (n = 81) Special paint (n = 80) Banana paste (n = 77)
  • Fissure sealant: Protective coating (n = 163) Plastic coating (n = 89) Fissure Sealant (n = 80)
  • Composite restoration: White/tooth coloured filling (n = 198) Bandage/plaster (n = 64) Composite filling/restoration (n = 29)
  • Preform metal crown: Silver/metal cap (n = 117) Silver/metal hat (n = 108) Princess crown (n = 108)
  • Extraction: Wiggle/wobble (n = 173) Take tooth out (n = 121) Tooth fairy reference (n = 108)
  • Local anaesthetic: Put to sleep (n = 136) Sleepy juice (n = 118) Numbing medicine (n = 82)
  • Inhalation sedation: Happy gas (n = 119) Laughing gas (n = 103) Special air through the nose (n = 75)
  • General anaesthetic: Go for a sleep (n = 121) Put to sleep (n = 98) General anaesthetic (n = 51)
  • Rubber dam: Rubber cover/sheet (n = 87) Stretchy cover/sheet (n = 84) Coat/jacket/raincoat (n = 67)
  • Drill: Electric toothbrush (n = 145) Buzzing/buzzer (n = 118) Tooth polisher (n=88)
  • Aspirator: Hoover/vacuum (n=201) Straw (n=90) Sucker (n=64)

“There is clearly a wide variety of replacement terms in use in paediatric dentistry in Scotland,” said the researchers. “While options are limited only by the imagination of dental team members, some favourite words are evident; the top word choice in each of the dental terms was selected by between 39% (fluoride varnish) and 96% (aspirator) of respondents.”

The word choices were unaffected by the gender, years of experience and job role of the dental team members and were generally not affected by the health board region. When compared with a large-scale US survey more than 40 years ago – the last time such a study has been attempted – the four overlapping studied terms (drill, rubber dam, extraction and local anaesthetic) shared at least some of the same top three word replacements, despite the differences in time and location.

“Individual creativity is still certainly evident today, however, with respondents using unique choices such as ‘squirt gun’ for local anaesthetic or ‘roller coaster rumbles’ for drill,” said the researchers. “While often humorous, this friendly terminology has the additional benefit of being tailored to the child. Person-centred care, of which good communication is integral, has been shown to improve patient outcomes.”

The researchers concluded that:

  • There is a wide range and variety of words and phrases used to describe dental terms, treatments and dental instruments
  • The child’s age commonly influences the choice of language. The chosen terminology is not generally influenced by the child’s gender, except in the case of pre-formed metal crowns
  • The three preferred replacement terms for each of the 11 dental terms have been identified through this study. These could be used as a guide to direct staff and unify terminology across the Scottish health boards
  • ‘Local anaesthesia’, ‘fluoride varnish’ and ‘extraction’ had the highest reported proportion of negatively received terminology.

“For each treatment and dental instrument included in the questionnaire, there is a wide scope for creativity and there is certainly not one ‘correct’ way to describe each dental term,” said the researchers.

“This is reflected in the many different alternative words and phrases suggested by the participants. It is hoped that this study provides insight into words that are thought to be effective and ineffective by dental team members who have experience working with children.”

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