Fillings in children — in both primary and permanent teeth — can be metal or plastic. Metal fillings are also called amalgam. Plastic fillings include composite resins and glass ionomers. There’s also a combination type called a resin-modified glass ionomer.
Amalgam has been used as a filling material for more than 100 years. It still is used to fill children’s teeth. The advantages of amalgam are that it:
- Has a long history of successful use, especially in the back teeth (molars), which are exposed to extreme biting and chewing forces
- Generally takes less time to place than plastic fillings
- Is more reliable if the decay is between two back teeth or involves several tooth surfaces
- Some people are concerned about the mercury in dental amalgam. Still, no study has shown that it causes any ill health effects.
- More of the tooth has to be removed to place an amalgam filling. That’s because amalgam is not bonded chemically to the tooth. Instead, it is held in the tooth by the way the dentist shapes the tooth.
Plastic fillings have several advantages:
- They are tooth-colored. They blend in with the rest of the tooth and other teeth.
- They are bonded to the tooth. This helps seal the filling and prevent decay around it.
- Glass ionomer and resin/modified glass ionomer fillings release fluoride. This mineral helps strengthen the tooth and prevent more decay.
- Usually, the dentist can cut a smaller hole in the tooth for a plastic filling than for an amalgam filling. That’s because bonding holds the filling in place. By contrast, an amalgam filling is held in the tooth by the way the dentist shapes the tooth.
- Placing a plastic filling is more complicated. This means your child may spend more time in the dentist’s chair.
- The American Dental Association found no difference in how well plastic and amalgam fillings lasted over three years. Plastic fillings in the back teeth are less likely to wear down if they are small and not subject to heavy biting and chewing forces. These filling materials continue to improve.
- Some children are allergic to methyl methacrylate, an ingredient in plastic fillings. This is rare.
Sedative fillings are placed on a tooth to reduce pain. Irritated or inflamed pulp can be the source of this pain. The pulp is the center part of the tooth that contains the blood vessels and nerves. A sedative filling calms the pulp. This reduces the chance that saliva or bacteria will leak into the tooth and irritate the pulp in the future.
Sedative fillings often are placed directly into the tooth. One of the most common types of sedative filling is zinc oxide and eugenol. This contains oil of cloves. Glass ionomers or resin/modified glass ionomers also are used for this type of filling. These materials may be placed on the tooth without any drilling.
A sedative filling is considered a stopgap measure. It often is used in very young children who can’t stand to sit in a dentist’s chair long enough to receive a regular filling. A sedative filling also may be used for a child who has a tooth injury and needs immediate relief.
Sedative fillings can last for about three to six months. Your dentist should regularly examine the sedative filling to be certain it is still in place and is fulfilling its purpose.