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Placing a Child's Filling

Young children may have some difficulty with dental treatment. But the visit can be a positive one if the dentist has training and experience with this age group. Here's how a filling is placed.

Anesthesia

If the filling will be placed using a standard dental drill, first an anesthetic gel or ointment will be applied directly to a small area of the gum or inner cheek. Once the area is numb, the dentist will inject a local anesthetic. This will numb the teeth and surrounding area during treatment.

If a dental laser is used, local anesthesia is usually not required.

Sometimes young children may not sit still for treatment. In this case, the dentist may decide to use nitrous oxide to help them relax. This is a gas that is delivered through a face mask. Other options for sedation include oral medicines, intravenous sedation or even general anesthesia.

Dental Dams

After giving the local anesthesia and any sedation, the dentist will put a dental dam on your child's teeth. This is a piece of latex or similar material that isolates the tooth your dentist is treating. A hole is punched in the dam so the tooth comes up through the hole. The dam protects the rest of the mouth.

Some dams are latex, but there are other materials for children with latex allergies. Some dental dams are scented or flavored.

The dental dam has several advantages:

  • It protects the cheeks, tongue and lips and keeps them out of the way of the procedure.
  • It keeps saliva away from the area being treated. Most of the materials that dentists work with are more effective if kept dry. In some cases, saliva can weaken a filling.
  • It prevents the child from accidentally swallowing or choking on anything during the procedure.
  • It makes many children feel safer to have a dental dam between them and the dentist.

Removing Decay and Placing the Filling

The dentist uses the standard dental drill (handpiece) or dental laser to remove the decayed part of the tooth and shape the tooth to receive the filling.

An amalgam filling will be placed in the prepared hole and pressed down with a special tool. If a plastic filling will be used, the hole the dentist makes is etched with a weak acid for 15 seconds. This prepares the tooth so the plastic filling will bond to it.

A plastic filling must be hardened with a special light. This is usually done in layers. This is one reason plastic fillings take longer than amalgam ones.

Once the filling is hardened, your dentist will smooth and polish it. He or she will remove the dental dam and ask your child to bite down gently on a piece of special marking paper. This will show whether the filling has affected the bite (the way the teeth come together). If the bite is not correct, the filling will be reshaped until the bite feels comfortable.

Special Issue: Braces

Before placing braces, the orthodontist should make sure your child has had a full dental exam. This should include X-rays, to ensure there are no cavities.

The bands should be removed once a year to allow the general dentist to check for cavities.

Braces make it more difficult to keep teeth clean. Your orthodontist needs to be aware of your child's brushing habits. Children who have a more difficult time cleaning food from brackets and wires may need to have more frequent dental exams.

After the Procedure

Your child should feel little to no discomfort after a filling is placed. Any discomfort usually is caused by irritation of the tooth's pulp or the soft tissue around the tooth. This typically goes away after the first 24 hours. If your child complains of pain after 24 hours, the filling may be too high. Contact your dentist's office. Over-the-counter pain medicines can help relieve discomfort.

After receiving a filling, a child sometimes may accidentally suck, chew or bite on a numbed lip because it feels swollen. This can cause significant injury. The dentist should warn your child not to do this. Don't feed your child until the anesthesia wears off.

Pay attention if your child complains that his or her teeth don't come together right, or that biting "feels funny." The filling may need to be reduced in height. Contact the office to see if the dentist should check the filling.

Potential Long-Term Problems

A filling can break or crack. This is more likely to happen if the bite is not correct and too much pressure is placed on the filling.

Fillings also can leak. This is more common in composite (plastic) fillings. Leaking can occur if the area is not dry when a composite filling is placed or if the composite is not hardened correctly. As a result, saliva and bacteria can seep under the filling. Leakage can cause sensitivity and further decay.

It's important for your child to visit a dentist regularly. The dentist will check to make sure fillings are still in place and are not leaking. The frequency of visits should be based upon your child's risk of getting cavities. The dentist will assess this risk based on several factors, including your child's:

  • Number of cavities
  • Brushing habits
  • Diet and snacking habits



Last updated May 8, 2014