Working with kids — and their parents — can be a nightmare. But it doesn't have to be! In this episode of Clinical Edge Fridays, ACT shares their Master Class with Dr. Carla Cohn, founder of Lit Smile Academy. She shares her proven techniques and strategies so you can manage the most difficult cases and effectively perform treatment. Start early, and turn difficult patients into easier, lifelong patients! To stop dreading and start enjoying the kids who come to your practice, listen to Episode 885 of The Best Practices Show!

Learn More About Dr. Cohn:

• Send Dr. Cohn an email: [email protected] 
• Follow Dr. Cohn on Instagram: https://www.instagram.com/kidsdentistcarla
• Follow Lit Smile Academy on Instagram: https://www.instagram.com/litsmileacademy
• Register for Dr. Cohn’s hands-on workshop (June 7, 2025): https://www.litsmileacademy.com/events/lit-smile-vancouver
• Register for Lit Smile Cancun (November 15-22, 2025): https://www.litsmileacademy.com/events/litsmilecancun

More Helpful Links for a Better Practice & a Better Life:

• Subscribe to The Best Practices Show: https://the-best-practices-show.captivate.fm/listen
• Join The Best Practices Association: https://www.actdental.com/bpa
• Download ACT’s BPA app on the Apple App Store: https://apps.apple.com/us/app/best-practices-association/id6738960360
• Download ACT’s BPA app on the Google Play Store: https://play.google.com/store/apps/details?id=com.actdental.join&hl=en_US
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt
• Get The Best Practices Magazine for free: https://www.actdental.com/magazine
• Please leave us a review on the podcast: https://podcasts.apple.com/us/podcast/the-best-practices-show-with-kirk-behrendt/id1223838218

Episode Resources:

• Watch the video version of Episode 885: https://www.youtube.com/@actdental/videos
• Read A Work on Operative Dentistry in Two Volumes by Greene Vardiman Black: https://www.google.com/books/edition/A_Work_on_Operative_Dentistry_in_Two_Vol/qr9AAQAAMAAJ?hl=en&gbpv=1
• Read Wright’s Behavior Management in Dentistry for Children, Third Edition: https://engage.ada.org/p/phys/wrights-behavior-management-in-dentistry-for-children-third-edition-729

Main Takeaways:

• Give yourself a time buffer when working with challenging children.
• Not all children are the same. Do a behavior risk assessment analysis.
• Don't take kids for granted. They are the key to a thriving adult practice.
• Ask questions and listen to assess a child’s anxiety level and coping ability.
• Know in advance whether you're working with a “dandelion” or “orchid” child.
• Learn to think outside the box with coping strategies for challenging children.
• Start behavior management early so difficult patients can become easy patients.
• Establishing a dental home as early as possible is part of behavior management.
• Fear is both objective and subjective. It can be passed on from parents and others.
• Understand the material choices that are appropriate for each child and their needs.
• Use age-appropriate language to explain your dental tools and how they will be used.
• Don't disregard children’s fears and reactions to pain. Address them and offer choices.
• Tell, show, and do. Children should know what will happen in advance, not right before.
• Manage expectations by communicating properly. Don't just talk at parents and children.

Snippets:

0:00 Introduction.

1:08 Dr. Cohn’s background.

3:30 Disclosures. 

4:45 Kids are the life of your practice. 

6:55 The parent/caregiver, child, and dental team triangle. 

8:26 Balancing challenging children, challenging parents, and challenging clinical situations. 

11:12 Behavior guidance and behavior management, explained. 

17:11 Do a behavior risk assessment analysis. 

18:50 Factors for a successful appointment: Patient age. 

20:01 Factors for a successful appointment: Developmental and functional age. 

20:46 Factors for a successful appointment: Temperament styles. 

23:07 Dandelion children and orchid children, explained. 

25:59 Signs of an orchid child.

26:53 Orchid children with sensory processing challenges. 

28:22 Establish a dental home for children as early as possible. 

29:59 Provide comfort in your dental office. 

30:33 Know the amount of treatment that is required. 

31:37 Be mindful of the pain scale. 

32:46 Challenges: Developmental delays. 

33:50 Challenges: Language delays. 

36:22 Challenges: Social insecurity. 

38:40 Challenges: Parental anxiety. 

41:03 Challenges: Previous bad experience. 

42:39 Fear and white coat syndrome, explained. 

44:53 Causes of dental fear and how to address them. 

47:57 Coping mechanisms for various sensitivities. 

52:22 Basic behavior guidance/management. 

53:02 Tell, show, do. 

54:16 Ask, tell, ask. 

55:02 Distraction. 

55:24 Desensitization. 

56:24 Treatment deferral. 

56:45 Local anesthetic. 

58:08 Understand pediatric behavior types. 

59:30 A structured approach to treatment planning. 

1:00:54 Restorations on children do not perform the same way on all children. 

1:02:20 Material choices for intra-coronal restorations for pediatric patients. 

1:08:03 Material choices for extra-coronal restorations for pediatric patients. 

1:09:13 Outliers: Silver fluoride and resin infiltration. 

1:11:16 Material choices for intra-coronal restorations: Clinical examples. 

1:30:18 About Dr. Cohn’s future courses and Lit Smile Academy. 

1:35:21 Q&A: How to manage dandelions and orchids in your schedule. 

1:38:04 Q&A: Dealing with pushback from parents. 

1:39:28 Q&A: Using child-friendly language and the slow speed handpiece. 

Dr. Carla Cohn Bio:

Dr. Carla Cohn is a general dentist devoted solely to the practice of dentistry for children. She maintains a private practice at Kids Sleep Dentistry Winnipeg at Western Surgery Centre in Winnipeg, Canada.

Dr. Cohn has published several articles and hundreds of webinars and live courses. She enjoys teaching all aspects of children's dentistry to the general practitioner and has had the pleasure of doing so both nationally and internationally. She teaches in the clinical undergraduate pediatric program at her alma mater, the University of Manitoba Dr. Gerald Niznick College of Dentistry. She is proud to be an active member of several dental organizations and societies and has served as president of the Manitoba Dental Association. She has been invited as a fellow to Pierre Fauchard Academy and International College of Dentists, and has been recognized as Dentistry Today's Leader in Continuing Education multiple years in a row as well as Top 100 Docs.