Suggestions for consequences? Stubborn behavior!

[wolverine2]

DH (a SAHD) took DS1 to the dentist 2 weeks ago. He had been successfully twice before, but this time refused to open his mouth. DH told him that if he didn't open his mouth, he wouldn't be able to eat anything sweet. DS said "ok, I understand," refused to open his mouth, and we made an appointment for today. In the meantime, DS has completely been completely accepting of the consequence- not even a whimper about wanting a cookie or ice cream, even when I had one in front of him (he doesn't get that many sweets, but loves them).

Fast forward to today. DH took him back, and he had a complete and total meltdown. Kicking, hitting DH, yelling... not typical behavior for him at all. The dentist was great, had DH wait outside the door and got DS calmed down enough to do the exam.

I don't think this was a anxiety/fear thing... I think he was being stubborn. So now I still want a consequence for the inappropriate behavior, but want to praise him for cooperating eventually. I have a hard time thinking of a logical consequence, other than the no sweet thing. I was thinking of not letting him eat any Halloween candy, but letting him have birthday cake (he turns 4 next week). I want a serious consequence, because his behavior was ridiculous.

Any suggestions?

[Momof3Labs]

Rather than coming up with a consequence, can you come up with a super-enticing reward for his cooperation (trip to the museum, zoo, new book, movie in the theater, etc)? Or, why not wait 6 months and try again (his teeth won't rot and fall out in that time). He has been successful in keeping the dentist out of his mouth twice in a short period of time, and maybe needs to forget how well he's managed to control the situation before the dentist tries again.

A third option I'd throw out is for you to take him. Yes, DH is the SAHD, and yes, you may have to take time off of work to do this, but he may behave completely differently for you than your DH. Or try a new dentist - maybe a pediatric dentist (or a different one, if that is what you already see) will have better tools in his arsenal for dealing with a stubborn 4yo.

ETA: Whoops, I missed the part where the dentist was able to get the exam done. Honestly, I'd drop the whole thing (including the sweet thing - several weeks is a horribly long time to punish a 4yo) and just be more proactive next time. Yes, his behavior was bad, but not atypical of a 4yo, and not worth weeks of stress for your family.

[sste]

OK, this is embarassing but my experience is with my dog, who has unfortunately had thousands of dollars with dental work and seen 3 of the 90 board-certified canine dentists that exist worldwide. I mean this in no way as an insult to your son but in my experience many four year olds I have met have some similarities in world view to our smart and pampered pooch!

What struck me about your post is that your DH went into the exam room with dentist and your son. Although this would seem like the loving thing to do, I think for some reason the child's view is either that the parent is there which means "this is really serious" or that there is a hope the parent will rescue the child and take them out of the dental office. This is all amplified by the parents' body language and demeanor which after one or two experiences such as you described inevitably communicates stress. If the parent isn't in the exam room and treats the whole thing casually I think the young mammal (be it four year old or dog) kicks up a fit as they are going into the exam room but then calms right down.

So, I would let things go on the punishment end and just be firm about dropping DS at the door of the exam room and then going back to the waiting room with a cheery good-bye I will see you in a little bit.

Though by all means take the advice of more experienced parents here if it contradicts this!

[Ceepa]

If his extreme reaction was out of character, maybe your DS is truly scared of having a dental exam. Rather than focus on punishment plan for the next appointment. He'll have to go back to the dentist a couple times a year for life. Start a few weeks before the next appt. by talking about the visit, checking out books, role playing, letting him do an exam on you and DH or his stuffed animals. Do you go to a pediatric dentist? They're geared to little patients with big apprehensions.

[egoldber]

I really don't think that this is a situation that calls for punishment or consequences. Before the next visit I would really talk up the dentist, how important it is for your health, how mom and dad go too, maybe have him come to your and DH's visits.

The dentist is very anxiety provoking for a LOT of kids. The special chair, the equipment, the noises, someone getting up close and in your mouth....I know a lot of adults with severe dentist anxiety (including my DH). So I would never force my child to get an exam.

[Melbel]

While I would be mad too about the behavior, I agree that this is probably an area where a reward for future good behavior may work better. We make a trip to the ice cream store any time one of the big kids get a shot. Our former pediatrician took her kids for ice cream following the dentist (sounds awful but whatever works)!

[wolverine2]

I don't really want to "punish" him. I think that came out wrong. But I feel like we need to have more (hopefully logical) consequences in general... perhaps this is not the right time though. We did do many of the above suggestions in terms of previewing the dentist visit and we had a reward all set up both times (plus, he'd really enjoyed the dentist the last 2 times). He was not forced at all the first time, which is why we made an appointment for later. It was a pediatric dentist who was great and was able to make the exam happen eventually. I do think that the advice about a parent not being in the room is probably a good idea. I stopped taking DS to the doctor a long time ago because he would melt down every time I was there, but was perfectly fine with DH. But I also hate for a 4 year old to have to do anything scary without the support of a parent (perhaps this is why he melts down when I'm there- so I can support him!)

I really don't think this was about anxiety as much as it was about control, but either way I guess it's not atypical behavior and I can try a bit harder to let it go! (I think what got to me is the comment DH reported that the dentist said to DS... "I don't know what you do at home, but this is my office and you cannot behave like this." Of course, I felt like he must think we're the most terrible parents ever and that we let him act like that at home, but DH didn't care at all about the comment, so I'm glad I wasn't there!)

Thanks for the perspective reminder...

[marit]

I agree with some PP who said to just let it go this time.

I think the key thing for next time (I got this from a parenting class. Tadaaa:) you have to make a "contract" with him. There should be a reward for good behavior and a consequence for bad one agreed upon BEFORE the appointment. So he knows what to expect. It's even better if you let him pick the reward/consequence in your conversation before the appointment so he feels he is involved and has some control of his life. Of course, they should be acceptable to you.

That to me is the difference between a consequence and punishment. If you just tell him now "no sweets for X days" after he has no way of changing his past behavior, I think that's punishment. If he knew in advance that making a riot would cause him to have no playdates for 2 weeks and still choose to cause one, than he made a choice and should suffer the consequences...

[wolverine2]

Marit,
I agree. Last time he did have a reward set up, and DH told him ahead of time about the no sweets till next visit (2 weeks) deal, and he definitely made the choice- which is also why he never complained a bit about it the next 2 weeks- he totally understood the deal he was getting.

[brittone2]

This may not be what you want to hear, but I'd drop it and hope it goes better next time. The problem IMO with rewards/punishments is this...each time you may find you need to up the ante, kwim? Let's say you agree on said reward in advance. Well, 6 months later it may need to be a bigger enticement, and perhaps 6 months later and even larger one.

I know you mentioned feeling like it wasn't about anxiety, but rather control. However, I think the two are often extremely interwoven. For a child feeling anxious, it seems to me that the child may be trying to "control" the situation in the only way they know how to.

If you agree to a said punishment/consequence, even in advance, it seems to me that you are also laying out an option to not cooperate anyway, kwim? So if the child is particularly worried or anxious about the dentist, he/she may prefer to take the "consequence" anyway.

DS had an early cavity at 15ish months and had it filled at 18 months. THat's a rough way to start your relationship with the dentist :( After that he had some anxiety, but we see a pedi dentist who is pretty good with kids. He does stuff like provide those viewfinder toys for them to look through during the exam (so they aren't seeing the dentist come at their mouth, kwim?). They put everything in kid-friendly language and are very patient. The dentist himself isn't as playful/kid friendly as I'd prefer, but IMO better than most adult dentists. They do all exams early on with the child in the parent's lap, and then we tip him back into the dentist's lap for the cleaning/checkup. Once he was 3.5-4 they started asking him if he would sit in the chair, and DS wasn't ready for that. However, if we were holding him, he was willing to be perfectly still and so the dentist didn't mind one bit. Now that the filling is a pretty distant memory, and DS is older, he is now willing to sit in the chair with a parent nearby. The dentist built trust in DS.

I think setting up rewards/consequences/punishments around this may make the dentist a bigger/scarier deal in the long run. You can't force him to cooperate, and you may be forced to keep upping the ante, or DS may realize that he can refuse and take the "consequence" (or punishment) later anyway. IMO, better to just do some practicing at home (let mom or dad count your teeth, read books about the dentist, etc.) and try again next time. Re-evaluate after that, kwim? Perhaps look for a pedi dentist if you can find one or try some other creative approaches before going to consequences/rewards?

[egoldber]

feeling like it wasn't about anxiety, but rather control. However, I think the two are often extremely interwoven

Exactly. As someone who tends to be anxious it is VERY much about being in control. Situations that are unfamiliar where you feel like you don't know what's coming next or you can't control it are extremely anxiety producing.

[wolverine2]

Thanks ladies. The need for control=anxiety makes total sense to me. I'm letting the whole thing go, and am glad he had the exam and we don't have to go back for 6 months! Now, his annual dr visit is next week... off to play doctor.

[hez]

Just wanted to send you a :hug:

DS has been going to my dentist appointments with me since before he had his own. They have a Gameboy (and about 3 games) available, and going to the dentist has turned into playing-with-the-Gameboy-time. We don't have a Gameboy at home, so it's a super-special treat for him. The first time he had his teeth cleaned without sitting on my lap, the hygienist half-laughed at him because he was completely focused on the Gameboy but would open his mouth when she asked him to.

We fell into having a 'treat' at the dentist's office kind of by accident, but I know I'll try to do something similar with DD when it's her turn.

Good luck at the doctor's office!