Restorative Care

Baby teeth serve the important function of eating, speech, and esthetics (self image). These teeth not only help form the developing jaws, but they hold space for the permanent teeth so that a normal bite occurs. The last baby tooth falls out at about twelve years of age. A decayed baby tooth can become so badly decayed that it can do damage to the permanent tooth. At times severe infections of the face, head, and neck can be caused by infected baby teeth. So it is important to restore baby teeth as soon as decay is first detected.

Teeth with dental decay can be restored either with tooth colored fillings or glass ionomer restorations reinforced with silver - it is a dark filling material but has no mercury in it. All of our pediatric fillings are fluoride releasing restorations to reduce the potential for recurrent decay. If the decay is extensive it may require the restoration with a stainless steel crown. That depends on how long it is anticipated that the "baby" (deciduous) tooth will remain in the mouth before being replaced by the permanent tooth.

Amalgam (silver fillings) Amalgam fillings have been in use as a filling material for well over 150 years. They have the longest track record after gold. It is an alloy of mercury with silver, tin, copper and zinc. The disadvantages of these fillings is that there are unaesthetic (dare one say downright ugly), require more tooth structure to be removed for placing them possibly weakening the tooth due to the extent of preparation. Once the metals are mixed with the mercury, it is a stable compound. The problem for the dental office is prior to it being mixed, the liquid mercury is volatile and poses a hazard for dental office personal especially should it be spilled. Clean up is costly and the vapors hang around even after proper cleanup. It is for that reason that this office discontinued its use in the late 1990's. I do not believe it is a hazard for any patient and do not recommend the removal of old "silver" fillings just because they contain a mercury compound. In my opinion most of these "silver" fillings are not as sound as they appear. They have however saved a lot of teeth over the years. This office uses alternate restorative materials for both adults and children.

Tooth Colored Fillings In the past; cavities could only be treated with unsightly metal fillings that are alloys for silver and mercury. These fillings, especially when close to the front of the mouth, are highly noticeable and unaesthetic. Sometimes, the filling is so large that it causes discoloration of the entire tooth. These fillings (or restorations) often weaken teeth due to the large amount of the original tooth that has to be removed. Modern dentistry has increasingly turned to Tooth colored or composite fillings as a strong, safe and more natural looking alternative. Composite fillings utilize a soft white plastic substance that is hardened with a blue light.

Restorative Visit

You can help us make this next visit a successful and positive experience for your child, by working with us to accomplish this goal. While taking to your child about this visit use positive words like fun, easy, tooth asleep, silver star, water spray etc. Do not use negative words like pain, hurt, needle, shot, tooth pulled etc.

The entire procedure will be explained to your child and you before the procedure is performed. Most of our kids don't even feel the process of having an anesthetic given, some cry because of conversations with siblings trying to scare them. We work with the child over several visits if needed to gain their confidence that what we do won't be painful. Gaining that confidence may take longer if they have had a poor experience previously. If because of an emergency (infection/spontaneous pain) we may have to proceed before the child is comfortable with our office, we may have to provide services with the child still anxious. We can give a preoperative sedative to help calm the child if overly fearful. Once the procedure is completed a piece of gauze referred to as tooth pillow is placed between the cheek and the teeth to prevent your child from accidentally biting into the numb cheek and lip. When the anesthesia is wearing off your child will feel tingling sensation which may be annoying to some children. Reaffirm to your child that the tooth is waking up.

After treatment is completed you can help us to continue the positive experience by praising your child and referring to the "fun" time they had. Please avoid negative comments such as: Did it hurt? That wasn't so bad! You were so brave! Did you get a shot? Were you afraid? These comments could persuade your child in thinking there was a reason to be afraid, even though they were cooperative, had a good time, and may make their future visits more difficult.