Fillings are used to restore teeth to their normal shape, appearance and function by filling in holes caused by decay. Retaining primary teeth is important to maintain the development of the dental arches and to keep space for the new permanent teeth when they erupt.
There are a variety of filling materials used today to repair primary teeth. Types of filling material used by your dentist or therapist may include:
Stainless steel crowns
Composite resin (tooth-coloured fillings)
Glass ionomer (tooth-coloured fillings)
The success of any treatment for children is ultimately dependent on the child’s cooperation and their ability to cope with the procedures that are required.
Stainless Steel Crowns
Stainless steel crowns are the best fillings available for back (posterior) primary teeth and they are used by dental practitioners all over the world. They cover and seal the entire tooth and are hard to lose or damage. Most of all, they last longer than any other filling material and because they are made of stainless steel, they are inert and do not interact with the body. The crowns being part of the tooth, fall out as the primary tooth is lost usually around 10 - 12 years of age.
No other filling will last as long or be as durable as a stainless steel crown.
Crowns are simple and quicker to place than other plastic materials, usually do not require local anaesthetic, and with new techniques require little drilling.
While some parents may not like the look of these crowns, most children do like the shiny appearance and they are special “princess” or “Transformer” teeth and they are very proud of them.
New porcelain crowns have become available recently, however, these are difficult to place, require extensive tooth preparation and have questionable longevity.
Composite resin and Glass Ionomers (white fillings)
These are plastic fillings. They rely on the material sticking to the tooth and unfortunately, while they may look better initially, they often fail within 2 years, with more decay underneath.
Tooth preparation (drilling) is more extensive and they are very susceptible to moisture contamination failure - making things difficult in a young child. They are perfect for smaller fillings, but where decay occurs between the teeth, then the stainless steel crowns are superior.
Pulpotomy (Nerve treatment)
When decay is deep and involves the “nerve” (called the pulp), then the pulp becomes inflamed. In these circumstances, a portion of the nerve can be removed and medicine placed over the infected part to preserve the tooth.
This procedure requires local anaesthesia and the placement of a stainless steel crown. If an abscess has formed and the tooth is dead, then, unfortunately, it usually needs to be removed. Root canal therapy (complete removal of the pulp, that is done on permanent teeth) is rarely performed in baby teeth.