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Pediatric Cavity Treatment - Boy holding skateboard.

Cavity Treatment Procedures

At Smile Out Loud Pediatric Dentistry in Gramercy Park, NYC, we love prevention. However,  cavities may still happen, even with impeccable brushing and flossing. Dr. Dikansky always prioritizes a minimally invasive approach. However, operative treatment is sometimes needed. This may include composite resin fillings, pulpotomies, stainless steel crowns, or extractions.

Composite Resin Fillings

At Smile Out Loud, we use tooth-colored, or white, fillings and match them precisely to the color of your child’s teeth so no one can see them, not even your child!  We use a bioactive dental composite material called Activa, which actively strengthens and protects the tooth. This highest-quality, durable filling material usually outlasts baby teeth. Patients forget they’re there all the time! We love Activa fillings for the following reasons:

  • The bioactive composite releases ions that strengthen the tooth and protect it from future decay.
  • Because the composite material can bond directly to the tooth, we’re able to be more conservative than if we were using amalgam (silver) fillings.
  • Composite fillings contain no metal or mercury.
  • They can last long term
  • Tooth-colored fillings are virtually invisible (Activa is the most seamless filling material yet)
  • Ease of placement makes for shorter procedure times, which is extra helpful when treating little ones with shorter attention spans. 

Pulpotomy (Root Canal)

Pulpotomy, nerve treatment, and baby-tooth root canal are terms that are used interchangeably. This treatment is needed when a cavity gets so large that it affects the nerve of the tooth. We know it can feel scary if you’ve been told your little one needs a root canal. However, you can rest assured that you’re in good hands with Dr. Dikansky. She performs pulpotomies for children referred to her from all over the city. 

Also, it’s helpful to remember that a tooth that needs a pulpotomy is still savable–this is good news. If a tooth that needs a pulpotomy is not treated for too long, the cavity will get worse and eventually lead to the tooth needing to be extracted. We always strive to avoid extractions when possible! 

Dental Crowns

A tooth needs a crown when a cavity is too large to be fixed with a filling. Said differently, teeth with very large cavities are not healthy enough to hold fillings inside of them, so crowns need to be placed over and around them. At Smile Out Loud, we have two different kinds of conventional crowns available: 

  • stainless steel, or silver colored crowns
  • zirconia, or tooth colored (white) crowns 

Dr. Dikansky will discuss the pros and cons of each option pertaining to your child’s unique situation and help you choose the crown that’s right for you.  

Hall Crowns

Children requiring a dental crown for a cavity may be able to receive this no-needle, no-drill type of crown. It’s fast, easy, and can be placed in a single visit. Here’s what to expect if your child is getting a Hall crown:

  1. We clean the area of decay thoroughly.
  2. Dr. Dikansky places a preformed stainless steel crown over the tooth.
  3. Finally, she crimps the crown into place.

The crown covering the tooth halts decay by starving the bacteria. In most cases, a Hall crown can prevent further intervention for a baby tooth until the day it falls out naturally.

Like SDF, Hall crowns aren’t appropriate for every situation. For example, since they’re stainless steel, we wouldn’t use one on a front tooth. That said, this technique is revolutionary, because it can prevent your child from having to undergo a more invasive procedure. 


Unfortunately, a tooth extraction is necessary sometimes. Reasons include large cavities and broken teeth. Although it may be intimidating news to learn that your child needs a tooth pulled, rest assured that Dr. Dikansky will complete the procedure in as safe and painless a way as possible. Her favorite reaction is when a child asks her if the tooth is out yet after she’s already extracted it! 

Will it Hurt?

Fillings, root canals, crowns, and extractions may seem intimidating to children and their parents. After all, it’s often a new experience for the entire family. Or worse, you or your little one may have had a previous painful dental experience. Fortunately, Dr. Dikansky is as compassionate as they come, and she will help you and your child navigate their treatment painlessly.

You can learn more about our sedation and pain management options here, but here is a brief overview of how we keep treatments painless and positive:

  • Nitrous oxide (laughing gas) to help manage fear, anxiety, and behavioral issues. It helps a little one feel more relaxed and at ease
  • Local anesthesia to numb the area around the tooth/teeth so that the patient doesn’t feel pain in the area being worked on
  • “Sleep Dentistry,” including sedation and general anesthesia for situations where the imminence of a patient’s dental needs severely outweigh their ability to sit for them
  • Thorough instructions for pain management after the procedure (we set you up for success at home, too)

Thanks to anesthesia and nitrous oxide, your child should experience no pain at all during their procedure. And, although some mild soreness can sometimes occur after procedures–and is easily managed with over-the-counter children’s NSAIDs. Recovery is typically painless.

A Compassionate Pediatric Dentist Near Me

Dr. Dikansky cares deeply about keeping children’s dental experiences positive. So, for a pain-free filling, children’s root canal, or crown, choose Smile Out Loud in Gramercy Park, NYC. Call us today to set up an appointment or ask any questions you may have! 

Book your next visit with Dr. Jacqueline Dikansky and the Smile Out Loud Team!

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Get Ready to Smile Out Loud!

CALL 646-779-1419


9:00 AM - 6:00 PM
8:00 AM - 2:00 PM
201 E 21ST ST., UNIT 1H, NYC 10010