Let’s Talk About Fillings

Dr. Shahnaz Ahmed of West County Pediatric Dentistry in Ballwin, MO talks about fillings.

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 dental office in Ballwin, MO and ask for your 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).  If your child is unable to handle treatment with nitrous oxide, Dr. Ahmed may speak to you about the use of general anesthesia. 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, your child will be escorted back to have a “clown nose” placed on his/her nose.  This is the nitrous hood, but we feel it critical to use child friendly words.   After the “clown nose” is placed over the child’s nose, they will begin breathing a mixture of oxygen and nitrous oxide.

The next step is to get the tooth numb. We say, “we are going to make your tooth sleepy”.  We shy away from scary words like “shot” and “needle” and ask that you please refrain from using them as well when talking about the appointment. A topical jelly with some anesthetic is placed near the tooth. We call this “sleepy jelly”.  This helps numb the mucosa before the injection is performed. We tell your child that we are going to “spray sleepy juice”.  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 “sparkly” or “like spiderman’s webs” or 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 using a rubber dam.  We call this a “rain coat”.  We “wash” the sugar bugs out of the tooth with our special toothbrushes and then we work on filling the tooth in. We tell your child that we are going to “use a special soap to clean the tooth” and put some “super glue” and then do a “princess filling” or a “superman filling.” We then shine a blue light on the tooth “magic wand” 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.

At this point, we turn off the nitrous oxide so that your child is just breathing oxygen and go over 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 you have any questions, feel free to call us anytime. 636.527.2779

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