Tag Archives: white fillings for children

Pediatric Dentistry, Uncategorized

Does my child’s baby tooth need a filling?

My daughter is seven years old. One of her baby teeth has a cavity and her pediatric dentist says it needs filled. I’m struggling with this prognosis. If the tooth is going to eventually fall out, does it really need filled? Or, is the dentist just wanting the money?

Thank you,
Ann

Dear Ann,

If the tooth with the cavity on it happens to be one of your daughter’s eight front teeth, there is no reason to have it filled. However, if the tooth in question is in the back, there are several reasons to fill it, as it could be a few years before the tooth falls out since some baby teeth stay in a child’s mouth until age 12 or more. In fact, there are some adults who still have baby teeth due to no permanent teeth growing in under them. An x-ray is the only way to know this or not. Needless to say, if the tooth with the cavity is a back tooth, she needs to have it filled in order to keep the tooth and hold the space for the adult teeth to come in correctly.  Letting things go and not filling the tooth will cause further decay to build up and she will eventually have to have the tooth extracted, which can be a traumatic experience for a child. If the tooth is pulled, a space maintainer will be needed, in order to keep the space for the adult tooth. If the tooth is removed or comes out too soon, and nothing is put in its place, the other teeth takeover the space and will prevent the eruption of the permanent tooth. This would cause a definite need for orthodontics in her future. Another point to consider, if the tooth in question is her last baby tooth, is is likely it is her six-year molar. This is a permanent tooth and would most definitely require a filling.

This post was written by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

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.

Pediatric Dentistry

Pediatric Dentist Insists on Amalgam Fillings- What Should I Do?

My 6 year old was recently at the pediatric dentist and it was discovered that he has two cavities. Even though my son is cooperative, the dentist says she has to use amalgam fillings because she won’t be able to keep my son’s mouth dry enough to use the tooth-colored ones. I told her that I’m not comfortable with putting mercury in my child’s mouth, but she insists it’s safe and that since these are baby teeth, they will fall out soon anyway. I don’t know what to do. Do I need to find a new pediatric dentist, can I take my son to my regular dentist or do I need to find some sort of specialty dentist?

Thank you,

Emilia- Ft. Worth, TX

 

Dear Emilia,

There’s a growing movement in dentistry to end the use of amalgam fillings and many people share the same concerns as you. However, both the FDA and the ADA agree that amalgam fillings pose no risk to your health and they are still a viable solution in situations like your son’s.

As your pediatric dentist explained, in order for composite fillings (the tooth-colored ones) to adhere properly, the tooth needs to stay dry. Even the most well behaved child can become fidgety during a procedure. Something as simple as your son slightly moving his tongue can contaminate the filling preparation and will require that the dentist start over or, if it goes unnoticed, will weaken the bond. This means that a composite filling may not be a long-term solution, as the filling may fall out and the child will have to continually return to have it replaced. For this reason, some dentists feel that providing a composite filling is a substandard treatment and will not do them in these situations.

That being said, you are the child’s mother. You must do what you feel is best for your son. If you are still uncomfortable with amalgam fillings and your pediatric dentist will not consider doing composites, your only real option is to find a dentist who will. This is truly a matter of the dentist’s preference. I wouldn’t insist your dentist do the procedure, because she probably can’t and will not say that to you. That will put your son’s treatment at risk. You may find success in another pediatric dental practice, in a general office or in a holistic office. Go wherever you feel most comfortable.  Best of luck to you and your son.

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