Let’s Talk Fillings with Dr. Adena Borodkin of Golden Valley Kids Pediatric Dentistry in Minneapolis, Minnesota

May 20, 2019

It happens to the best of us … you’ve been told your child has a cavity and that they need a filling. After recovering from the surprise, you may wonder how we go about doing a filling on a child. We thought it would be helpful to go through the basic steps of a white resin filling.

First, we’ll go over the treatment plan at our pediatric dental office in Golden Valley, MN and ask for your written consent. You should know which tooth the restoration will be performed on, and the surfaces of the tooth that will be restored. You should also know the fee up front. Because it can be difficult for a child to tolerate dental treatment, you may also see fees for nitrous oxide (laughing gas). For this blog post, we will talk about the steps of a white filling with the help of nitrous oxide.

After the consent has been signed and your questions have been answered, you should be asked if there have been any changes in your child’s medical history. Your child will be then brought back into our operatory (treatment room) and be given a choice from our menu of scented nose hoods. At this point, if your child is 3 and older, we’d recommend allowing them the chance to be in the treatment room independently. This allows us more opportunities to establish rapport and really get to know your child. Finally, the scented nitrous hood will be placed over the child’s nose and they will begin breathing a mixture of oxygen and nitrous oxide.

The next step is to get the tooth numb. I don’t require anesthesia for every restoration, but sometimes, it is necessary. We shy away from scary words like “shot” and “needle” and ask that you refrain from using them as well when talking about the appointment. A topical jelly with some anesthetic is placed near the tooth. This helps numb the mucosa before the injection is performed. We work really hard to distract our patients while we administer local anesthetic. Many of our patients don’t even realize that it has happened! I like to tell them that I just gave them some sleepy juice and that their face will start to feel a little funny.

After we have given the child time to achieve profound anesthesia, we isolate the tooth from the rest of the oral environment. We “brush” the sugar bugs out of the tooth with our special toothbrushes and then we work on filling the tooth in. We use a special shampoo to clean the tooth, add some bond, and fill the tooth with a white filling. We then shine a blue light on the tooth that polymerizes the white resin filling and makes it hard. Then we polish the tooth and check to make sure that the filling fits when they bite down and is easy to floss. Many of our white fillings are done using a material called resin modified glass ionomer. This is an esthetic material that also releases fluoride to the surrounding teeth. It serves to fill the cavity and prevent further decay around it.

At this point, we turn off the nitrous oxide so that your child is just breathing 100% oxygen.  We always review post-operative instructions and answer any questions that you or your child may have. Be cautious with that numb lip so that your child doesn’t pinch or bite it! The numbness will wear off in about two hours.

If your child does have a cavity, don’t worry, and don’t let them worry! We are always here to explain things step by step in a way they can understand.

If you have any questions, feel free to call us anytime. 763-222-1299.