Ask a Paediatrician

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Paediatric Dentist

In discussion with paediatric dentist Phoebe Tsang  

Q) What led you to become a dentist for children with complex needs?

Dr. Tsang: I had first-hand experience of children with special needs because my cousin was diagnosed with autism and my grandma took care of another child living with autism. When I graduated from dental school, my first position was at BC Children’s Hospital. I vividly remember my first day—a patient with Sotos syndrome hid in the bathroom and I was dispatched to find him. Providing dental treatment for kids with disabilities can be tricky, but when I can open the door to a child’s heart, it’s rewarding. Many simple tasks, such as brushing their teeth, can be challenging so situations push me to be creative and think outside the box.

Q) Are there some key things you’ve learned?

Dr. Tsang: Families have many competing priorities, so I help them cross off at least one task from their perpetually long “to-do list”—by looking after their oral health.

Getting to know each child and their family is very important so that I can tailor my approach and treatment plan. I remembered there was a patient with trisomy 21 (Down’s syndrome) who was afraid of dentists but didn’t mind hair stylists. Because of this, I pretended I was styling her hair while I did the oral exam. Children can pick up my vibe. Approaching with kindness, confidence and not being afraid of their behaviours has helped me.

Q) What are the biggest dental-care challenges?

Dr. Tsang: Access to care is the main one. Many patients whose treatment can only be performed under general anesthesia have to endure long wait times. Those with medically complex needs suffer the longest, as there are only a limited number of tertiary-care hospitals (e.g., only BC Children’s Hospital in BC) that can safely look after them.

In terms of routine regular care, many individuals benefit from more frequent and repeated visits but, because of financial or time constraints, many families cannot afford this approach. Also, only a few dentists are comfortable with kids who have additional needs.

Q) What advice would you give to parents?

Dr. Tsang: Take baby steps and treasure small wins! Believe in your child. Be consistent and persistent even when behaviours are challenging. Repetition will prevail. For example, practise lying down in a recliner at home if a child is afraid of sitting on the dental chair. They will get used to this position and feel less out of control.

Q) What have you discovered through your research?

Dr. Tsang: That no one size fits all! The presentation varies depending on which end of the spectrum the child is at. Some are better at communicating using visual cues while others are not. Some may respond well to a social storyline. It is key for me to read each patient.

Dr. Phoebe Tsang is a pediatric dentist in Fraser Valley region, British Columbia. She combines her dedication to dentistry with her desire to enrich the lives of children and families.

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