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Traditional dental restorations, also known as fillings, are made of many materials. Amalgams, or "silver fillings," are the "gold standard" material that is used primarily in back teeth. Composite resin material has the appearance more like a natural tooth and is used for front teeth and permanent teeth. Both materials are used in our office and the doctor will recommend the best choice for your child and their specific treatment plan. There are many factors to consider before choosing which type of filling is best.
A pulpotomy is a procedure to save a very decayed primary or "baby" tooth. This treatment removes the affected pulp or "nerve" of the tooth to help prevent an abscess or infection, and also prevents the loss of the tooth. Once a cavity has gotten large enough to go through the enamel surface of the tooth and significantly into the next layer called the dentin, it may be too large for a traditional filling becasue of its close proximity to the pulp chamber, or "nerve" of the tooth. Primary or "baby" teeth are important to preserve the space for the permanent tooth to erupt in its place, so a pulpotomy would be the recommended treatment to save the tooth. After a tooth is treated with a pulpotomy, it will also require a dental restoration or stainless steel crown..
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so the doctor may recommend its removal. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your child's dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within the jawbone in a “tooth socket”, and the tooth is held in that socket by a ligament. In order to extract a tooth, the dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with the doctor any concerns or preferences for sedation.
If your child's tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when permanent teeth begin to come in. Without the use of a space maintainer, the teeth that surround the open space can shift, impeding the permanent tooth’s eruption. When that happens, the need for orthodontic treatment may become greater.