If a child sees a dentist on a regular basis, sometimes cavities can be detected before it penetrates the enamel (outer protective layer of the tooth) and does not require any local anesthesia. This is the easiest and quickest type of cavity to treat. However, once a cavity has penetrated the enamel, it usually requires local anesthesia so a child is comfortable during treatment. As a pediatric dentist, we are trained in the use of nitrous oxide and other behavior management techniques, which can distract your child and help them to relax during their visit safely.
On occasion, there can be decay that is extensive and deep and may require multiple visits, including root canals (for very deep decay impinging on the nerve) and crowns. Although it seems that a child may not be able to tolerate this, with nitrous oxide and our behavior management techniques, we are able to complete the treatment as comfortably and in the same amount of time as a simple filling. For those children that are unable to tolerate treatment in an office setting (e.g. very young or special needs), there are sedation options that can be discussed with your dentist.