Every once in a while, a child presents with multiple cavities. The patient can be 3-5 years old and can have as many as 4-6 cavities. The cause: usually a diet high in sugar and most likely some poor habits (such as sleeping with a bottle containing milk or juice and/or an unwillingness to brush and floss). Obviously these cavities need to treated. Back baby teeth (primary molars) can last as long as 12 years of age and play a vital role in the proper development of the adult dentition. So the question becomes: How do we handle a young patient with multiple cavities? I am a firm believer in not creating a fear of the dentist. If a child has one or two small cavities and freezing is most likely not necessary, a general dentist can easily provide the appropriate care. If, however, multiple visits would be required and injections a must, it is my opinion that a general anaesthetic should be considered. There are risks involved with general anaethesia but they must be weighed against the benefits of completing all the treatment in one go if possible, the child having no memory of the treatment and the avoidance of a fear that may last into adulthood.
– Dr. Jay Rabinovich