Treatment | Evergreen CO | All Kids Dental

Tooth-Colored Bonded Fillings | Baby Tooth Pulp Treatment
Stainless Steel Crowns | Esthetic Veneered Crowns| Space Maintainers

Tooth-Colored Bonded Fillings

The doctors at All Kids Dental utilize state-of-the-art technologies and techniques when restoring tooth decay. Research shows that bonded (composite resin) restorations, particularly in baby teeth, are much stronger and last more predictably than the old silver amalgam (mercury) fillings that most people are familiar with. The research has shown that over 30% of silver/mercury amalgam fillings on baby teeth fail within 18-20 months. Treating the same tooth twice is both expensive for the parent and unpleasant for the patient.

Composite resin (white filling material) actually bonds to enamel and dentin and strengthens the tooth while restoring it to its original shape. A more conservative tooth preparation is used during decay removal so that less healthy tooth structure is lost as compared to offices that still use silver/mercury amalgam fillings. This also allows us to restore small cavities earlier, before large restorations are needed. Bonded restorations are also more comfortable postoperatively and less sensitive to temperature changes.

Baby Tooth Pulp Treatment

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. Large deep dental caries (cavities) are the main reason a tooth would require pulp therapy. Decay progresses much more quickly in baby teeth and can enter the pulp before your child complains of a toothache. When this happens a "nerve treatment", "baby root canal", "pulpectomy" or "pulpotomy" is required in order to save the tooth. The two common forms of pulp therapy in children's teeth are pulpotomy and pulpectomy. The purpose is to treat the tooth so that it will be comfortably maintained until normal exfoliation time, typically age eleven to twelve.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown). A pulpectomy is required when the entire pulp is involved (into the root canal of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material so that the roots resorb and the baby tooth falls out at its natural time. Then, a final restoration is placed.

Stainless Steel Crowns

Baby teeth are not just small permanent teeth. They have thinner enamel, relatively larger pulp chambers and decay at a much faster rate than permanent teeth. In addition, baby teeth do not hold large fillings very well. Over 30% of large fillings placed on baby teeth fail, regardless of the type of filling material, within 18-20 months after placement. That is why stainless steel crowns are often recommended for baby molar teeth with significant decay. This is particularly important for younger children whose molar teeth are needed for a number of years. This one appointment technique offers a predictably strong restoration that will protect the tooth until its normal exfoliation at age eleven or twelve.

Crown restoration should be considered based on the extent of the decay and length of time the tooth is scheduled to stay in the mouth. Generally, in the long run, this is the most economical and most compassionate approach for your child. No one wants to treat the same tooth twice because not only does the parent have to pay for things twice, the child has to go through the procedure a second time.

Esthetic Veneered Crowns

Esthetic stainless steel crowns are available for both anterior teeth, and molars. This technology has been successfully utilized for a number of years for the front teeth of infants and toddlers. If your child has large cavities on the front teeth, we need to restore them to achieve good oral health and speech development, but we also want to maintain esthetics for proper psychological and emotional development. For this reason, we are happy to offer esthetic veneered stainless steel crowns to achieve the needed strength of a full coverage crown restoration, and while maintaining excellent esthetics.

We are now able to offer parents an esthetic option for molar baby teeth in situations where visibility of the stainless steel is of concern. Although there are strength limitations associated with the veneer due to the heavy biting forces placed on molar teeth, All Kids Dental has a favorable experience with the manufacturer should this option be of interest.

Space Maintainers

Your child’s primary molars (baby molars) will not be lost until age eleven or twelve. Until then they serve many important functions such as: promoting normal craniofacial growth, preserving space for the eruption of permanent teeth and guiding the permanent successors into their proper orthodontic positions.

If your child loses a baby molar due to injury or decay, Dr. Pyszka or Dr. Henry may recommend placement of a space maintainer. New technology allows for easy placement with a customized fit that is comfortable in your child’s mouth and is easy to brush and does not interfere with eating. The spacer is also easy to remove when the new permanent tooth is erupting. This example shows a space maintainer that will be in place until age eleven or twelve when the permanent premolar is scheduled to erupt.