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Started By
Message
OT Dentists: Question on Kids' Fillings
Posted on 4/18/14 at 9:15 am
Posted on 4/18/14 at 9:15 am
I appreciate the help...
My son needs a filling, and the dentist insists the only option is a silver cap (baby tooth). We went through this a few years ago with my daughter, and I felt sorry I didn't seek out a second opinion (so she wouldn't have a visible cap).
The dentist says that the tooth-colored ones don't last and that the child may break it. If this is true, then how do adults get non-silver fillings?
Don't give me any BS about keeping the kids' teeth clean, the dentist said they both have very clean teeth and that both cavities were oddities (daughter due to chip in tooth and son due to between teeth cavity that's barely there, just don't want to "spread").
Thanks in advance.
My son needs a filling, and the dentist insists the only option is a silver cap (baby tooth). We went through this a few years ago with my daughter, and I felt sorry I didn't seek out a second opinion (so she wouldn't have a visible cap).
The dentist says that the tooth-colored ones don't last and that the child may break it. If this is true, then how do adults get non-silver fillings?
Don't give me any BS about keeping the kids' teeth clean, the dentist said they both have very clean teeth and that both cavities were oddities (daughter due to chip in tooth and son due to between teeth cavity that's barely there, just don't want to "spread").
Thanks in advance.
11
Posted on 4/18/14 at 9:17 am to LSUfan20005
How old is your son?
Posted on 4/18/14 at 9:29 am to LSUfan20005
I was told that they use the silver because of insurance. Insurance won't pay for the more expensive fillings because the teeth are not permanent.
However, our new dentist used white on my 6 year old becuase he doesn't use silver at all.
However, our new dentist used white on my 6 year old becuase he doesn't use silver at all.
Posted on 4/18/14 at 9:38 am to LSUfan20005
For a kid the stainless steel crowns are used because the tooth doesn't have to be extensively prepped and the crown is fitted on right there. They are cheap and the kid will lose the tooth soon anyway. A pfm tooth colored crown like the ones adults get will cost you over a thousand dollars because insurance isn't going to cover it for a baby tooth.
There are options for tooth colored crowns if it is an anterior tooth. Called strip crowns. They aren't crowns that are sent off to a lab for fabrication. It's basically a shell of composite (tooth colored filling) that goes over the tooth. They do break much easier. I'm just a student so an actual dentist can chime in.
Also at 6 years old he is starting to get his permanent teeth. 1st molars and central incisors should be coming in soon if they haven't already.
There are options for tooth colored crowns if it is an anterior tooth. Called strip crowns. They aren't crowns that are sent off to a lab for fabrication. It's basically a shell of composite (tooth colored filling) that goes over the tooth. They do break much easier. I'm just a student so an actual dentist can chime in.
Also at 6 years old he is starting to get his permanent teeth. 1st molars and central incisors should be coming in soon if they haven't already.
This post was edited on 4/18/14 at 9:40 am
Posted on 4/18/14 at 11:27 am to LSUfan20005
when I have had to get fillings my denstist always does the tooth colored fillings even though my insurance only pays for the amalgam. I just have to make up the difference and its not a large amount.
Posted on 4/18/14 at 12:38 pm to LSUfan20005
Crowns placed on adult teeth are completely different from the pedo crowns you are asking about. You would not place an adult crown on a child's tooth.
The reason for placing a 'silver cap' is there may not be enough remaining tooth structure to sustain a filling long term. This could cause failure of the tooth, filling, or both. The solution for this is to cover the whole tooth with a 'cap' so the tooth structure does not come into play. If you absolutely opposed to a silver cap, I'd tell your dentist you understand the risks and would like a resin (tooth colored) filling placed. A tooth repaired with filling would be much better than no fix at all.
The reason for placing a 'silver cap' is there may not be enough remaining tooth structure to sustain a filling long term. This could cause failure of the tooth, filling, or both. The solution for this is to cover the whole tooth with a 'cap' so the tooth structure does not come into play. If you absolutely opposed to a silver cap, I'd tell your dentist you understand the risks and would like a resin (tooth colored) filling placed. A tooth repaired with filling would be much better than no fix at all.
Posted on 4/18/14 at 3:42 pm to LSUfan20005
quote:
The dentist says that the tooth-colored ones don't last and that the child may break it.
Is it for a front tooth or a molar? There are stainless steel crowns with a white 'shell' of material that can be used for front teeth. (Typically a different shade than the natural teeth) Another option would be a strip crown which was described above. Depending on the child, these can fracture often.
quote:
If this is true, then how do adults get non-silver fillings?
I assume you are asking about tooth colored/porcelain crowns. The porcelain needs to be 1.5mm - 2mm so that it doesn't fracture. It isn't possible to do an 'adult' crown on baby teeth (or young permanent tooth for that matter) because you would have to make a lot of reduction on the tooth (1.5mm - 2mm) which may cause a pulpal exposure requiring a root canal. This is because young teeth have large pulp chambers that are much closer to the surface than in mature older teeth. They also cost $800-1000.
When a baby tooth gets a crown, a small amount of tooth structure gets removed from the tooth to make room for the very thin stainless steel crown.
Posted on 4/18/14 at 10:50 pm to LSUfan20005
quote:
The dentist says that the tooth-colored ones don't last and that the child may break it. If this is true, then how do adults get non-silver fillings?
It is all about the SEAL. SEAL! Thanks Bob Sergent (2 E's) for that. It's not about the restoration "breaking", it's about it not leaking.
Bonded restorative materials simply don't bond and seal as well with primary enamel and dentin. A "cap" is often the best way to seal the tooth off from the bacteria and their energy sources in the mouth.
Then understand the fact that the distance of protection between the pulp chamber of a primary tooth and the Dr. Pepper you give your child is much smaller than the layers of protection that your permanent teeth have.
It's as simple as this, a dentist goal is to treat a primary tooth with active caries only ONCE. This is why a tooth with an absolutely minuscule area of decay should be treated with a "cap", if, for example, the tooth is of a 3 year old that needs 9 more years of service. In other situations, a silver filling may be appropriate to accomplish that goal. And I use tooth color covered caps on the upper anterior teeth, I couldn't put silver up there on my own children.
Regardless of your choice, just for kicks, let us know if the tooth naturally exfoliates without further treatment in coincidence with the other teeth that hopefully didn't need treatment that match it in the other side or other quadrants of their mouth. That is what defines successful treatment of a primary tooth.
eta: Picture of Bob (on left)
This post was edited on 4/18/14 at 11:10 pm
Posted on 4/18/14 at 11:12 pm to LSUfan20005
Very true about the silver lasting 10 times longer than the colored. I had a filling replaced 3 times in less than two years that was colored. Dentist recommended the silver since it tends to adhere more effectively. It's been there now for over 5 years and no problems.
Comment posted about insurance not covering colored filling is bullshite.
Comment posted about insurance not covering colored filling is bullshite.
This post was edited on 4/18/14 at 11:14 pm
Posted on 4/5/18 at 7:11 pm to LSUfan20005
(no message)
This post was edited on 10/1/20 at 11:43 am
Posted on 4/5/18 at 7:46 pm to LSUfan20005
Just pull the tooth, kids are like sharks. There's always another tooth to replace the one they lose
Posted on 4/5/18 at 8:14 pm to LSUfan20005
I treat my kids at home with DentalZoom.com. If it’s a tricky procedure, I watch some YouTube videos for extra training.
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