Tag Archives: silver versus composite fillings

Pediatric Dentistry

Why are silver fillings used with children?

I am a mom of three children under 10. Two of my three have had cavities in need of fillings. The pediatric dentist placed a silver filling for both children. I have also noticed that other children in our lives have silver fillings as well. As an adult, I know I would prefer a filling that matches the natural color of my teeth. I’m just wondering if there is some medical reason that the dentist uses the silver fillings on children?

Thank you,

Stacey

Dear Stacey,

Thank you for writing. There are several reasons pediatric dentists place silver fillings on children.

  1. Cost: Stainless steel or amalgam fillings cost less than the natural tooth-colored crowns, normally placed on adults. Because baby teeth are eventually replaced by permanent teeth, dentists typically use this option, because these fillings are premade in various shapes and can be placed less expensively.
  2. Decreases number of visits: Because most young children are feeling wiggly, dentists often use nitrous oxide or an anesthesia before a procedure. Therefore, limiting the number of visits is important. This is another advantage to using the premade fillings.
  3. Strength and effectiveness: When a significant portion of the tooth structure is damaged or lost, it needs the full coverage and strength that the stainless steel provides.
  4. The tooth is protected longer: the stainless steel helps to prevent sensitivity, future decay and the need for repairs.

Recommended: The American Academy of Pediatrics recommends the stainless steel crowns. Therefore, dentists who place these on children are following the recommendation.

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Pediatric Dentistry

Bummed My Son’s White Filling Keeps Falling Out

I don’t know what to do. I’ve been going to a pediatric dentist for my son. I wanted a white filling for him. The dentist understood that and gave him one. Or, at least he tried. He’s given him three and all of them have fallen out. I don’t know what to do. I don’t think it’s the pediatric dentist. He’s a respected dentist. He knows what he’s doing. Can you help me know what’s going on? I don’t want to give him a mercury filled filling.

Christina – New Jersey

Christina,

I understand your feelings about mercury-free fillings. Many patients are opting for them. Some patients even insist on them. With children it’s tricky. The process is completely different than with ye old silver amalgam fillings. Composite fillings work almost like a glue. The surface is etched and then the composite is bonded to it. As you can imagine, even a tiny bit of moisture missed in during this bonding process will destroy the bond, which is why a lot of dentists prefer to use amalgam when they’re working on back teeth or helping wiggly children. However, that doesn’t mean it’s impossible.

Without an examination it’s impossible to tell what the actual culprit is. But, moisture is the likely bad guy. With adults, you can usually work around this and take steps to keep the tooth dry during the procedure. Doctors generally use a mixture of cotton rolls, air, and dental dams to isolate the area they’re working on. Kids, especially little ones, have the tendency to fight this kind of stuff. They’ll move around in the chair, push their tongue into the preparation, and they aren’t typically fond of dental dams. So, when you get to the point where a parent really wants the white filling and the child can’t cooperate enough to keep it dry, sedation during the procedure becomes the next solution.

Dental sedation is not like surgical sedation. He will be conscious, but completely relaxed and very sleepy. It will help him stay still and cooperative during the procedure and is perfectly safe.

If you want to, you can get a second opinion from another pediatric dentist to determine if moisture is the actual issue. Then make a decision from there.

This blog is brought to you by Dr. Kevin Peck.