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Pain Control in Children

The Use of Anaesthetics in Children’s Dentistry
  1. When is an injection necessary?
  2. What are the side-effects or after-effects of the injection?
  3. What pain control can be used for a very anxious child?
  4. Is general anaesthesia used in treating children?

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.

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2. What are the side-effects or after-effects of the injection?

  • 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.

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3. What pain control can be used for a very anxious child?

  • 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.

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4. Is general anaesthesia ever used in treating children?

  • 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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