Common Concerns during the School-Age Period


  1. Thumb sucking plays a little role in malocclusion as long as the habit does not persist past the time of eruption of the permanent front teeth at about 6 to 7 years.
  2. An orthodontist should evaluate children with malocclusion. The time to begin the correction varies with the extent of the malocclusion and the jaw size.
  3. Children with braces develop mild, shallow ulcerations on the buccal membrane from friction of metal wires. To manage this, an oral acetaminophen is administered or an agent such as Ora-Jel may be applied over the ulceration to provide relief.
  4. Dental floss should be used by children with orthondotic braces to remove the plaque around the wires.
  5. Retainers are worn when braces are removed to maintain the correction achieved.

Anxiety Related to Beginning School

Six year old children have a hard time adjusting to grade school. In grade school, the rules are firmer and it is difficult for a young child to imagine the time span that he or she will be going to the school. The following are important interventions in dealing with anxiety related to beginning school:

  1. A health assessment of all school-age children should include an inquiry about the progress in school. Information can be obtained by asking the parents and observing the child in the actual environment.
  2. To enhance the ability of a school-ager to read, parents should point to the words and pictures as they go along to help them realize sentence flow which is from the left to the right.
  3. Parent should spend more time with the child after school or in the evening. This is to make the child feel secure with his family and does not feel pushed out by being sent to school.
  4. For children who develop physical signs of illness such as vomiting, diarrhea, headache or abdominal pain during school days only, fear of attending school or school phobia is noted. With school phobia, the symptoms last after the school bus leaves the house or when the child is allowed to stay home. It is very important that parents should not let the child stay at home when their child shows signs of school phobia. Counseling may help the child manage the situation better.
  5. Parents should explore emotions and reasons why their child refuses to go to school. Attempting to transfer a child to another classroom or be excused from a disliked situation may stop the school resistance.
  6. The nurse should encourage the parents to allow their child to involve more in school activities. Some cases of school phobia results when the parents are overprotective or is the one having the most difficulty separating.
  7. The nurse should support the parents so they can treat the child’s illness symptoms so they can take their child firmly to the classroom.

Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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