You know the drill? Types of restorations your dental provider may recommend

One of the most common questions I hear in the pediatric dental office is “why fill baby teeth when they’re just going to fall out?”. Baby teeth serve many purposes for your child! Baby teeth are important for your child’s 1) diet and nutritional status; 2) speech and oral motor development; 3) maintaining space for the developing permanent teeth; and 4) helps build confidence in their smile.

According to the American Academy of Pediatric Dentistry, by the age of 5, nearly 60% of children will have had dental cavities at some point; and about 40% of kindergarteners enter school with cavities. As the rise of “Early Childhood Caries” continues to increase in children, it is important to understand why your child’s dental provider may recommend certain types of procedures to restore their teeth to health. By understanding the rationale for these suggestions, the potential implications for not restoring the teeth to health, and the types of common treatment options, you are staying informed and educated around this topic! 

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What are the most common types of dental restorations for children?

  • Tooth-colored fillings 
  • Amalgam fillings
  • Stainless steel crowns
  • Tooth-colored crowns 
Let's go through each type one by one :)   
  • What is a tooth-colored filling?

A tooth-colored filling (resin composite or while filling) is made out of a resin and plastic compound. The cavity is removed and the portion of the tooth is then filled with this material to blend right in with the surrounding tooth structure. These types of fillings are less noticeable

  • What is an amalgam filling?

Amalgam fillings (or silver-colored fillings) are made from a mixture of metals that include silver, copper, tin, and mercury. These types of fillings have been recommended and used for over 100 years and have been proven safe world-wide.

  • What is a stainless steel crown?

A stainless steel crown (or cap) covers the tooth completely, protecting all visible surfaces. They are silver in color and have been used for 50+ years. 

  • What is a tooth-colored crown?

Tooth-colored crowns are similar to stainless steel crowns because they cover the entire visible tooth surface. But, they blend in with surrounding teeth either because they have a tooth colored resin coating, or are made entirely of composite or zirconia material. There are several options when it comes to tooth-colored crowns. 


Alright, now that you have a brief overview of each of these dental restoration options, let's review some of the other factors to consider when deciding which restoration is best for your child. Your dentist should take these into account when reviewing your child’s treatment plan in the office, but, if you are like me, it’s nice to do some of your own research to have a better understanding of your child’s needs. 


Factors to consider when deciding which restoration is best for your child:

  • Extent of the decay
  • Lifespan of the tooth and restorative material
  • Cost
  • Aesthetics

Tooth-colored fillings:

  • Extent of decay:
    • These types of fillings are for either primary (baby) or permanent (adult) teeth with small cavities in front or back teeth.
  • Lifespan of the tooth and restorative material:
    • This material bonds well to the tooth and is very flexible and flowable meaning less tooth structure is removed during the cavity prep.
    • There are some composite materials (glass ionomers) that release fluoride after they are placed which can help prevent future cavities from recurring in that site. 
  • *Cost:
    • These fillings are more costly than amalgam fillings because they are technique sensitive and require more time to place.
    • Tooth-colored fillings are less durable than amalgam fillings too, so it is common that they need replacing after 5-7 years. 
  • Aesthetics:
    • Because these materials are tooth colored, they may become stained from foods and drinks meaning they may need to be replaced more frequently. Plus, plastic is less durable than metal.
    • However, they are more aesthetically appealing because of how well they match surrounding teeth. 

Amalgam fillings:

  • Extent of decay:
    • These types of fillings are ideal for moderate to large cavities because of their durability.  They are often recommended for permanent (adult) teeth compared to primary (baby) teeth. 
  • Lifespan of the tooth and restorative materials:
    • Amalgam fillings can last a very long time. More tooth structure is necessary for removal when placing amalgam fillings in order to gain the necessary retention to the tooth. This means they place a little more stress on the tooth over time. 
  • *Cost:
    • Amalgam fillings are often cheaper than tooth-colored fillings because they are less technique sensitive and require less time when placing. Because they can last 10-15 years, they will not need to be replaced as often as composite material. 
  • Aesthetics:
    • Metal is visible because of the silver color when compared to tooth-colored material meaning amalgam fillings are aesthetically less appealing. For this reason, most of the time amalgams are recommended for back teeth or in areas that are less noticeable.  

Stainless steel crowns:

  • Extent of decay:
    • Stainless steel crowns are often the restoration of choice for severe cavities, teeth that are fractured, teeth that have some type of developmental defect occuring during their formation, or have a history of root canal treatment. These crowns are often recommended for baby teeth. 
  • Lifespan of the tooth and restorative materials:
    • Stainless steel crowns will last until the primary tooth is ready to fall out because of the permanent tooth erupting. These crowns are incredibly durable and come preformed meaning your dentist will select the size that fits your child’s tooth best and adjust its shape accordingly. 
  • *Cost:
    • Stainless steel crowns are more affordable than tooth-colored crowns but are often more expensive than amalgam and tooth-colored fillings. However, they will often last the entirety of the baby tooth’s lifespan and protect the entire tooth surface from developing another cavity. 
  • Aesthetics:
    • The silver color of the metal crown is much more obvious and one of the more concerning drawbacks from an aesthetic perspective. However, if the cavity is large, or the tooth has a pre-existing filling on part of it already, there is a good chance your provider will recommend a stainless steel crown to protect the entire tooth surface. 

Tooth-colored crowns:

  • Extent of decay:
    • Similar to stainless steel crowns, tooth-colored crowns are often to treat the same types of cavities or other tooth-related problems. 
  • Lifespan of the tooth and restorative materials:
    • Tooth-colored crowns are less durable than stainless steel crowns. 
  • *Cost:
    • Tooth-colored crowns are the most expensive restorative option among these discussed.
    • Some types of crowns, such as strip crowns, are made solely of composite material meaning they are very time and technique sensitive to place and require really good cooperation from your child. Oftentimes these crowns are used for front teeth that have cavities in younger children. Some dental providers will not place strip crowns unless the child is incredible cooperative or under some form of sedation. 
  • Aesthetics:
    • These crowns are natural looking and blend in with surrounding teeth.
    • Stainless steel crowns that have been covered to be tooth-colored are much bulkier than just a stainless steel crown. While they are more natural in color, their size may be more obvious, especially if used on a front tooth.
    • Zirconia crowns, another type of tooth-colored crown, are the most popular in terms of aesthetics and durability, however they can be very expensive. But, because of their material and design, they are stain resistant and very natural. 

While it is nice to have options for restoring your child’s dental health, your dental provider knows your child and their needs best. I encourage all parents to discuss their options and weigh the pros and cons for each. While aesthetics are nice and can help reduce potential self-insecurities for your child, these other factors in decision making are also important.  At the end of the day, your child’s dental health is priority!


And remember, good oral hygiene and a diet limited in sugar is critical to maintain your child’s dental health after restoring cavities. Cavities can occur around fillings, also known as recurrent decay. By using products like Grin Natural Kids Oral Care Bundle Pack and Grin Natural Adult Brush and Toothpaste Kit, you are helping prevent future dental problems! 

Grin Natural toothbrush and toothpaste bundle help protects children's teeth

Sources:

https://www.aapd.org/assets/1/7/FastFacts.pdf

https://www.deltadentalins.com/oral_health/amalgam.html 


*disclaimer: fees vary based on dental provider and insurance coverage


About the Author: 

Kristen Cockrell is a Registered Dental Hygienist with a passion for preventive pediatric dentistry and oral health education. Kristen recently completed a master’s degree in dental hygiene education at the University of North Carolina at Chapel Hill.


Social media account: 
Instagram: @kristenwcockrell