Filling cavities in baby teeth can be very important. Many people think that just because the baby teeth fall out eventually, you don’t need to be concerned about caring for them. Baby teeth are important to keep space open for the permanent teeth. If a baby tooth is lost too early, the teeth will crowd up making any subsequent orthodontics much more difficult. And if a cavity gets too deep, the tooth could abscess which can cause a lot of pain, not to mention the chance of serious infection. One of the worst parts of my job as a dentist is seeing a child writhing in pain with a toothache only to find out that this is their first trip to the dentist. It’s not too hard to imagine how much they will look forward their next trip to the dentist. It is also very hard to get profound numbness on an abscessed tooth which makes the experience that much worse. By pre-planning and catching things early, teeth can be filled painlessly on children.
When filling children’s teeth, I ALWAYS use local anesthetic on children. My practice includes a large segment of adult patients requiring sedation. The overwhelming reason for their extreme fear of the dentist is because their dentist didn’t use novocaine when they had their teeth filled as a kid. By numbing teeth ahead of time, a tooth can be drilled on without any pain whatsoever. Fear of the “shot” is a very common issue in children (not to mention many adults). We try to make that part of the visit as easy as possible for the patient. We start with a topical numbing gel that is placed on the gum at the injection site with a cotton swab. Once the gum is fully numb, the child is told that they will feel a little “pinch”. The anesthetic syringe is passed to the dentist out of sight of the patient. By quickly inserting the needle into the numbed gums and very slowly injecting the anesthetic solution, the child experiences little to no discomfort. It is such a heart-warming feeling to hear a child run out to the waiting room saying “Mommy, Mommy – I didn’t have to have a shot! He just pinched my gums.”