White Fillings in Children

I have a question about white fillings. My son needs his first filling. I am really uncomfortable with the silver fillings because of the mercury in them. I asked my dentist about getting him a white filling but he said they don’t work well in children. Why is that? Will the silver ones be dangerous for him?


Dear Mallory,

Let’s start with your last question first. Are the silver fillings dangerous? The American Dental Association still says that silver amalgam fillings are safe. Understandably, though, many patients and parents are uncomfortable with the high mercury content.

While composite (white) fillings are a tad trickier with children, that doesn’t mean they are not able to have white fillings. The struggle is because the composite material has to stay completely dry while it is being placed. That can be tricky for wiggly little ones.

If having a composite filling is important to you, I have found that using some nitrous oxide allows the children to completely relax if their nerves are making them figity. Most of the time they end up sleeping through the procedure.

That being said, I wouldn’t push your current dentist into this. The technique for placing composite fillings is completely different from placing amalgam fillings. I have often found that dentists who try to steer you to a different procedure are actually doing that to keep from admitting they can’t do the one you want. If you pressure him into the other procedure, he will likely not do it correctly.

I suggest that you look for a dentist who advertises as a mercury-free dentist and then see if they are also a pediatric dentist. They don’t have to be a pediatric specialist. Instead, they can be a general dentist who enjoys treating children. They are qualified and do a pediatric rotation so your children will be in good hands.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Two Sets of Teeth in Youth

I have two sets of teeth for some of my teeth. I mean that I have both the baby teeth and the adult teeth in my mouth at the same time. How do I fix this? I’m 16 and want a pretty smile before I leave for college.


Dear Kaycie,

teenager smiling with braces

If you have been under the care of a dentist this whole time, you need a new dentist. This should have been addressed a long time ago. You don’t have to see a pediatric dentist. It can also be a general dentist, especially at your age. Though, I would look for a general dentist who also treats children. They tend to be more patient.

To get your mouth in proper alignment, the first thing you will need to do is have every baby tooth that has an adult tooth erupted also extracted. Make sure whoever you end up with does a full set of x-rays so you are sure which teeth have the adult teeth.

From there you have three possible scenarios.

Scenario 1: All Your Adult Teeth Have Erupted

In this situation, you have all of your adult teeth and they have all erupted. If that is the case, the solution is fairly simple and can be done in two steps. Step one is for you to have your baby teeth extracted.

Once that is completed, step two is to have your teeth straightened with orthodontics. You are not limited to metal wires and brackets and more. These days, Invisalign can handle most cases. If you’re unfamiliar with Invisalign, they use clear aligners to straighten your teeth.

Scenario 2: Not All Your Adult Teeth Have Erupted

If you have the adult teeth, but they still haven’t erupted, your dentist can open the area to make it a bit easier. In most cases, they’ll come in after that.

Then, once they are in, you can then get orthodontics done as suggested in the previous scenario.

Scenario 3: You Don’t Have All Your Adult Teeth

In some cases, a patient will have genetically missing teeth. That means there never was an adult tooth to replace the baby one. When this happens, you will still need orthodontics to open up the space where all the teeth are in their proper positions. Once that happens, you will start with a temporary tooth replacement, such as a dental flipper, in order to keep the opening in the right place.

When you are older and your jaw is fully developed, it will be time to get a more permanent replacement. The ideal tooth replacement is a dental implant, so that is what I’d recommend. Though, your dentist can give you all the options.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.