A child’s first cavity is a milestone no parent relishes. Yet, more than half of children will have a cavity by the age of six, so you’re not alone. We asked Dr. Scott Hamilton, a pediatric dentist at Children’s Hospital Colorado in Aurora, what parents should know if that first cavity pops during your child’s checkup.

Colorado Parent: Do baby teeth really need fillings?

Scott Hamilton: You need to treat cavities in both baby and permanent teeth. A common misperception—that’s been around for decades—is that you don’t need to worry about baby teeth. Cavities in baby teeth can be painful and lead to infection and swelling. It’s nice to catch them when they’re small so (the dentist) can use a smaller filling.

CP: What kind of fillings do kids get?

SH: You’ll find more white fillings (resin composite), and fewer silver fillings (amalgam) today. The materials in white fillings have gotten stronger and better. Your child may need a crown (a cap cemented on the tooth) if the cavity is big, on front teeth, or on baby teeth, which are more prone to breakage.

CP: Will it be painful for my child?

SH: For most fillings and crowns, a dentist will use a local anesthetic to numb the area. Kids don’t even know they’ve had an injection, most of the time. I use a cotton swab with a topical anesthetic jelly on the child’s cheek and gums, and then I’ll check to make sure the area is numb before the shot.

CP: How can I alleviate my child’s (or my own) fear?

SH: Be truthful. Tell your child: We’re going to the dentist and the dentist is going to fix your tooth. The dentist and hygienist will describe the procedure when we get there. Tell your child that the dentist is nice and is going to help.
It’s best if parents don’t talk a lot about the visit beforehand. Over-preparation can unintentionally stoke fears or anxiety. And sometimes a parent’s own fear of the dentist can transfer to their child.

CP: Should I bring something to distract my child during the visit?

SH: Distractors are really important. A lot of dental offices have TVs in the ceiling, where kids can watch movies during the procedure. I like to talk to the child, whether it’s telling a story or asking about their favorite food or classmate. If you’re a parent, consider bringing along something that the child enjoys (like headphones and music) and then talk to the dentist about how to incorporate it. Check with the dentist so it doesn’t get in the way of the procedure itself.

CP: What’s the best way to help prevent future cavities?

SH: A great start is to encourage kids to drink lots of water instead of sugary beverages and brush their teeth twice a day. Drink tap water because it has fluoride, instead of bottled water. Sealants—thin, plastic coatings applied to teeth to prevent tooth decay—are another important tool to discuss with your dentist.

This article was originally published in December 2024.
Kate Ruder

Kate Ruder is a freelance writer and editor based in Boulder.