Pain Control in Children

The Use of Anaesthetics in Children’s Dentistry

1. When is an injection necessary?

When a filling is needed and the amount of decay is very small, there is often no need for an injection. This applies particularly to fillings in baby teeth.
If a local injection is needed, a topical anaesthetic paste or gel can first be applied to the gum.
It is rubbed into the gum and left for about two minutes.
It numbs the gum to a depth of 3 millimetres, and makes the injection more comfortable for the child.
It is a routine procedure to inject a local anaesthetic into the gum near the affected tooth.
The treatment can then be pain-free.

There are a few side effects of a local injection:
- The lips, cheek and tongue may feel swollen, despite not being swollen.
- Because the area is numbed it is possible to bite the lip, tongue or cheek without feeling any pain.
  This can cause a minor injury which only becomes apparent when the injection wears off.

A child’s oral health will suffer if extreme fear of the dentist prevents dental treatment. Sedation may be an option.
- Sedation can be administered in the form of a nitrous oxide inhalation, also known as “happy gas” or “relative anaesthesia”.
- The gas is inhaled through a small rubber cover that fits over the nose.
- The inhalation helps the child to feel relaxed and accepting of the situation.
- It is a safe method of pain control.
- Sedation can be supplemented with a local anaesthetic if necessary.
- There are no unpleasant side effects or after-effects.
A paedodontist is a specialist in treating children.
- Anxious children can benefit by being treated by a paedodontist.
- Ask your general dentist to refer you to one if you have an anxious child.

General anaesthesia is used only as a last option. When a dentist is prevented from treating a child in the dental chair due to severe anxiety or any other reason, general anaesthesia can be resorted to.
This anaesthesia allows all the dental treatment to be completed in one session.
It has the advantage of leaving the child with no memory of the experience.
General anaesthesia must only be administered by a specialist anaesthetist in a hospital or clinic with the necessary facilities.

Also see Pain Control in the Adult section.

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