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.”