Helicopter parenting: does overprotectiveness worsen children’s oral health?

Hannah Walsh discusses a study linking overbearing ‘helicopter parenting’ to children’s behaviour in the dental chair and explains why the issue may be more complex than it first appears.

A Dutch cross-sectional study recently claimed that ‘helicopter parenting’ – or overprotectiveness – can lead to a risk of tooth decay in children. It explored how overprotective parenting styles may relate to children’s behaviour during dental treatment and their toothbrushing habits.

The study reports an association between higher levels of overprotective parenting and more disruptive child behaviour during dental treatment. Children whose caregivers scored higher on measures of overprotection were more likely to display uncooperative behaviours, such as anxiety, resistance, or distress, when undergoing dental procedures. In contrast, no significant association was identified between overprotective parenting and children’s toothbrushing frequency or the likelihood of skipping toothbrushing.

Can the study be trusted?

While this study suggests an association between overprotective parenting and children’s disruptive behaviour during dental treatment, I do not fully support these conclusions for a number of reasons:

Firstly, the study population was drawn from a referral paediatric dental practice, which limits the generalisation of the findings. Referral settings, both in the Netherlands and comparable paediatric referral services in the UK, typically treat children with more complex dental needs, higher levels of anxiety, or behavioural challenges. As a result, the sample is not representative of the general paediatric population, nor of the broader range of parenting styles which may be seen in primary care. This introduces selection bias, as children who already struggle with dental treatment are overrepresented in this study, making it difficult to confidently attribute behaviour solely to parenting style.

Secondly, the study design involved separating children from their caregivers during dental treatment. As a specialist paediatric dentist, I do not routinely use parental separation as a behaviour management technique, and its effectiveness remains debated. Observing children, particularly those as young as four years old as in this study, without their caregiver present may significantly alter their behaviour, potentially increasing anxiety or distress irrespective of parenting style.

Therefore, attributing disruptive behaviour to overprotective parenting alone may oversimplify a more complex interaction between the child, caregiver, and clinical environment.

Support versus judgement

It is important to recognise that parenting styles are diverse and influenced by cultural, social, and individual family factors. Categorising parenting as ‘overprotective’ may inadvertently lead to judgement. As clinicians, our role is not to label or critique parenting approaches, but rather to support caregivers in promoting their child’s oral health in a non-judgemental and inclusive manner.

The British Society of Paediatric Dentistry (BSPD), the UK’s leading charity advocating for children and young people’s oral health, has some excellent resources which you can use to signpost and help support children and their caregivers. A Practical Guide to Children’s Teeth emphasises the importance of supporting families with practical, evidence-based prevention advice to help children achieve optimal oral health, rather than focusing on parenting style itself.

In relation to behaviour management during dental treatment, it is widely recognised that a child’s response is influenced by multiple factors. As a clinician, I find creating a positive, supportive atmosphere is essential. Caregivers should be encouraged to model calm and confident behaviour, as children often take cues from their parents in unfamiliar situations. As professionals, we have a responsibility to help reduce anxiety and build trust. The BSPD resource Oral Health Advice for Parents and Carers of Autistic Children and Young People is a great resource for those children with additional needs, highlighting the importance of tailoring support to the individual, particularly for children who may find dental care more challenging.

Strategies for young patients’ caregivers

I find the optimal way for parents to support children’s engagement with oral health is through early involvement and building a consistent routine. Caregivers should be advised to begin toothbrushing as soon as the first tooth comes through and establish it as a twice-daily routine using fluoride toothpaste.

Early engagement with dental visits is also important – BSPD recommends a child is first seen by a dentist around the time the first tooth comes through or by the age of one. The purpose is to use these early visits for simple acclimatisation to the dental environment, giving the opportunity to reinforce prevention advice to prevent tooth decay and starting a habit of dental visits for life.

At the same time, caregivers can help children by creating calm, positive, and predictable environments for toothbrushing. Make toothbrushing fun. Sometimes playing music or using apps like Brush DJ or the BSPD Kids Vids can help make brushing fun and more engaging for children. For children who find oral care more challenging, especially those with additional needs, targeted support is essential, and resources such as www.autismtoothcare.com can provide practical strategies to help families improve oral health in a supportive and individualised way.

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