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Dental and Oral Health (Children)

Baby tooth cavity

05/07/2001

Question:

My 17 month old has a cavity on her front baby tooth. Our pediatric dentist recommends sedating her to fill the cavity. I am not comfortable with this and would prefer to simply have the tooth removed with novacaine. Are there any other options? And is an X-ray a must in this situation?

Answer:

Treating a 17 month old child is certainly challenging and sedation is very commonly used in these circumstances. It is appropriate for a parent to be concerned any time a child is to be sedated for a medical or dental treatment and you are urged to discuss your concerns with the care provider. The American Academy of Pediatric Dentistry publishes guidelines for sedation that seek to assure safety for the child and you should ask the pediatric dentist if she or he follows these guidelines. Another option is to treat the child under general anesthesia and this is most commonly performed in a hospital or ambulatory care facility with the assistance of an anesthesiologist. This option carries additional facility and anesthesia expenses which may or may not be covered by your major medical insurance. The final option is to complete the needed treatment by restraining the child and using local anesthesia only.

Extracting the tooth rather than restoring it is certainly a treatment option and you should again discuss the pros and cons of this choice with the dentist.

Taking an x-ray prior to treating the tooth is consistent with quality treatment. Use of modern shielding devices and high-speed film limits the radiation exposure to your child.

These are all excellent questions and you are encouraged to seek a second or even third opinion from other pediatric dentists until you are comfortable that they have been answered for your child.

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Response by:

Dennis J McTigue, DDS Dennis J McTigue, DDS
Professor of Pediatric Dentistry
College of Dentistry
The Ohio State University