Ask Dr. B | My Child Has a Cavity. Now What?

This post is sponsored and written by Dr. Michael Blen. We are huge fans of Dr. B’s and love that we get to share his knowledge with all of our readers!

Q: Do I really need to fix my child’s tooth? After all, it is just a baby tooth!

A: Yes, you do.

Children’s primary teeth get cavities just like adult teeth. And just like adult teeth, these primary teeth need to be fixed.

Primary, or “baby,” teeth are important to help children speak clearly and chew naturally, aid in forming a path that permanent teeth can follow when erupting, allow for proper growth and development and promote self-esteem. These primary teeth also react to decay the same as permanent teeth do and may eventually cause pain, swelling, infection and cellulitis. All of which can lead to serious health risks.

Q: Ok, Dr. B, you have convinced me to have my child’s tooth/teeth fixed. But, how exactly are you going to accomplish this?

Dental decay does not have to be the worst thing in the world (see my last blog post for more information), and treatment of dental decay does not and should not be a terribly negative experience. Believe it or not, I bet most of my patients would report positive experiences even with fillings, extractions, etc.

A: There are a number of behavior guidance techniques that Pediatric Dentists have been trained on including “tell, show, do”(TSD), distraction, “ask, tell, ask” (ATA), nonverbal communication, etc.

Some of the most common treatment options for children (along with the practitioner’s experience) for behavior guidance include the following:

1. Treatment with Basic Behavior Guidance. This includes these previous techniques with or without the use of Nitrous Oxide (laughing gas) in the office setting. Nitrous Oxide is considered basic behavior guidance and is a “safe and effective technique to reduce anxiety and enhance effective communication” (AAPD). This is used along with some local anesthesia (numbing) for comfort. The work is then completed.

2. Treatment with Advanced Behavior Guidance. This includes protective stabilization, conscious sedation or general anesthesia. Your dentist can discuss these with you in more detail, though generally speaking I will break this down in to 2 categories:

A. Treatment with a combination with oral conscious sedation medications (narcotics, hypnotics, antihistamines, etc) and Nitrous Oxide in the office setting. This treatment may include the use of a papoose board (protective stabilization) for patient safety. After numbing, the restorative work will be completed.

B. Treatment under general anesthesia in the hospital setting. This would most likely be outpatient same-day surgery. This would allow the anesthesiologists to care for the child’s sedation needs in order to allow the Pediatric Dentist to care for the teeth. The restorative treatment would be completed while the child is asleep under general anesthesia.

In order for proper treatment of children, the risks and benefits (pros and cons) of all treatment options should be explained by your dental provider, understood by you and weighed by each individual family. You can ask your pediatric dentist if they have any other treatment options.

You should have the opportunity to ask questions regarding this dental treatment and all answers should be clarified for you.

Your pediatric dentist can help you decide on which option will work best for your individual child’s needs.


My office mission statement is: We pride ourselves in providing high quality dental care in a safe and nurturing environment through individualized attention. Our goal is to create happy dental patients for life. Please visit my website at for more information on my practice.