Once a cavity has been cleaned out and the tooth prepared to accept the filling, now we have to decide what to fill it with. The two major choices are amalgam and composite. Amalgam is the material that has been used for over a century. It is an alloy of silver and mercury. Over the years, there has been a lot of negative media coverage on the use of mercury, however, once the silver and mercury are mixed together, the alloy becomes inert.
Amalgam vs. Composite
Since the material has been used since the 1800s and has been no population study that has shown any ill effects of using the mercury containing fillings, you need not worry if your dentist recommends using amalgam to fill your child’s teeth. In our office, we give the parent the choice of either the amalgam or tooth-colored filling material. The newer composite fillings have been shown to have a life span long enough to have the baby tooth come out naturally and are therefore a fine alternative.
Once a tooth is numb, the child should not experience any further discomfort. However, there are a lot of sights and sounds that can unnerve a child into thinking that what is happening is painful. Since a drill has to be used to clean out the decay and shape the inside of the tooth to hold a filling, the chatter of the drill’s bur, the water spray, and the high pitch sound can startle some children. At our office, we show the patient every step that we are about to take before we do it. For example, we take the high speed handpiece and hold their hand up to it and let them feel the water spray. We tell them that the water spray is going to clean out all the cavity bugs. With their fears allayed, most children will be still while the cavity is being drilled out. We tell them that the water spray will tickle their teeth, so the vibration of the drill is well tolerated. Taking the extra time to demonstrate what’s going to happen is well rewarded with a calm, cooperative child.