Many children go to the dentist because they have a cavity in a tooth. There is always the question of whether or not a child should be given local anaesthetic for restoring a cavity.
It is necessary to understand that decay can only be removed completely when proper pain management is used. This is because dentine, the second layer of teeth, is sensitive and painful.
To treat a significant cavity, the decay must be removed and then the tooth sealed completely. Incomplete removal of tooth decay will increase the risk of the filling leaking then failing as more bacteria is able to invade.
For this reason, it is very important that local anaesthetic is used for long lasting restorations. The only time it is appropriate to place a dressing (temporary filling) is when there is appropriate follow up treatment provided. This may occur when there are time limitations. An appointment in a few days should be made when time is available to give local anaesthetic and restore the tooth properly.
The other time it is appropriate to place a dressing is when the child is unable to cope with a local anaesthetic injection. In this case, the child should be referred for management where other behaviour management techniques are available. This could include sedation or even general anaesthetic for the very young or very frightened.
A temporary filling without local anaesthetic is likely to fail in a very short space of time.
Parents are often fearful of local anaesthetic injections themselves. However, if topical numbing cream is used and left in place for several minutes to give it time to work, it is possible to give an almost painless injection.
The dentist can then properly remove decay and the filling is likely to last. A small amount of discomfort with local anaesthesia is worth the alternative of repeated restoration failure, toothache and likely eventual need for extraction