Tooth-Colored Bonded Fillings
The doctors at All Kids Dental utilize state-of-the-art technologies and techniques to correct 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 more than 30% of silver/mercury amalgam fillings on baby teeth fail within 18 to 20 months. Treating the same tooth twice is both expensive for the parent and unpleasant for the child.
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 less healthy tooth structure is lost when compared to offices that still use silver/mercury amalgam fillings.
This also empowers us to fix small cavities earlier, before large restorations are needed. Bonded restorations are more comfortable post-operatively and less sensitive to temperature changes.
Baby Tooth Pulp Treatment
The pulp of a tooth is its inner, central core. 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 it will be comfortably maintained until normal exfoliation time, typically age 11 to 12.
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 and relatively larger pulp chambers, and they decay at a much faster rate than permanent teeth.
In addition, baby teeth do not hold large fillings very well. More than 30% of large fillings placed on baby teeth fail, regardless of the type of filling material, within 18 to 20 months after placement. That is why stainless steel crowns are often recommended for baby molar teeth with significant decay.
This is particularly worthwhile 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 11 or 12.
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, over 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 twice, but the child has to go through the procedure a second time.
For the last 60 years, large cavities in baby teeth have been treated with stainless-steel crowns. Although they are an excellent restoration and last without question, many parents have concerns over the stigma when their children have silver teeth.
One option is a Zirconia crown. Instead of having to use metal to place a strong layer of protection over the tooth, a beautiful, high-strength ceramic material is used. It can be used on either front or back teeth, and the child can avoid silver teeth. Cavities may keep happening, but at least we have an option to restore your son or daughter’s sparkling, brilliant smiles.
Aesthetic Veneered Crowns
Aesthetic stainless-steel crowns are available for both anterior teeth and molars. This technology has been used successfully 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 aesthetics for proper psychological and emotional development. For this reason, we are happy to offer aesthetic veneered stainless-steel crowns to achieve the needed strength of a full-coverage crown restoration, while maintaining an excellent appearance.
We are now able to offer parents an aesthetic option for molar baby teeth in situations where visibility of the stainless steel is of concern. Though 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.
Your child’s primary molars (baby molars) will not be lost until age 11 or 12. 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 little one loses a baby molar due to injury or decay, Dr. Brie or Dr. Bob 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, 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 11 or 12 when the permanent premolar is scheduled to erupt.
Another newer technology available in pediatric dentistry is the use of lasers. The best use for lasers in pediatric dentistry is for soft tissue procedures; for example, the tongue-tied three-year-old who is having speech difficulties.
Historically, this child would have required sedation by an oral surgeon, incision with a scalpel, and multiple stitches to close the wound. Lasers allow us to do the same procedure with little or no anesthesia, no stitches, and in a fraction of the recovery time.
Older children may benefit from lasers to snip heavy frenums in conjunction with braces, adjust gumline asymmetries, or expose blocked-out teeth. All kids appreciate having complex procedures done with lasers because it is quick, easy, and pain-free.