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.”

"Happy Gas"

Getting a child comfortable and relaxed once seated in the dental chair is paramount in having a good experience with a filling appointment.  We have TVs in the ceiling that can show cartoons or children’s programming which can get most kids at ease.  For those who continue to have reservations, many times just taking the time to explain what is going to happen can be enough to allay their fears.  If a child continues to be unruly, the next step is nitrous oxide (laughing gas).  This “Happy Gas” can be the final calming factor for many children.  Every once in a blue moon, we will come across a child who is so fearful that they cannot be safely controlled.  We do not use papoose restraints in our office, so sedation is the only alternative in those cases.  Sedation of children is best handled by pedodontists.  They have special training in sedating children who have a very variable response to many of the medications that are used.  About once in every five years, I refer a child to specialist care.

With patience and a gentle demeanor of the dentist, most children can have cavities filled with minimal fear and discomfort.  As a patient in preparation for the visit, don’t use phrases like “Oh, it won’t hurt”, or “It will only hurt a little bit”.  Use positive statements, like “Remember how you got your teeth cleaned? Well, Dr. G is going to clean out all of the cavities bugs”.  The question of “Am I going to get a shot?” frequently comes up.  The best answer to that is “Dr. G has a special pincher that will put your tooth to sleep so that you won’t feel it when he cleans out the cavity bugs”.  When the day comes, we allow the parents to bring the child back into the treatment room, but when the time comes to start the treatment, we ask the family to go relax in the waiting room.  We have found that 99% of pediatric patients are much more comfortable and much less fearful without a parent to get attention from.  I have had screaming children clutching mom’s or dad’s arms, holding on for dear life, only to turn into placid little angels within 15 seconds of the parent’s departure.