Composite Restorations (Fillings)
If a cavity is beyond the point where he can safely monitor it, Dr. Church may recommend a white composite filling. These vary widely in shape, size, and long-term prognosis but Dr. Church will help you know what expectations to have. If the cavity is small, Dr. Church may not need to use anesthetic for the procedure, especially if nitrous oxide (laughing gas) is used. This is often his approach for small cavities in primary teeth especially.
Book OnlinePorcelain and Stainless Steel Crowns
If a cavity is too large to be restored with a composite restoration, Dr. Church may recommend a crown. Porcelain crowns are utilized for the front teeth, including the canines. Stainless Steel Crowns are still the standard in pediatric dentistry for primary molars because of their durability and biocompatibility. These crowns cover the entire tooth which prevents further breakdown and new cavities from forming.
What are stainless steel crowns made of?
Stainless Steel Crowns contain the typical blend of metals that make up medical grade stainless steel: Iron, Chromium, Carbon, and Nickel. These are commonly used in earrings as well. Any allergies or adverse reactions to these materials are extremely rare. There is no mercury or lead or any other harmful metals in these crowns.
Pulpotomy
If the cavity has entered the nerve of a primary tooth, it will be necessary to clean out the compromised nerve. This is done by removing the diseased tissue mainly in the crown portion of the tooth (not all the way to the tip of the roots). After the nerve is cleaned out, a small amount of biocompatible material called MTA (Mineral Trioxide Aggregate) is placed over the root canals. This material helps stimulate a natural response to rebuild the hard tissue. Another material called Zinc Oxide Eugenol is placed to seal the MTA and fill the remainder of the space before a stainless steel crown is placed over the tooth. The goal is for the tooth to heal and remain in place so that an extraction is not necessary before the tooth comes out naturally.
Though it is less common, a pulpotomy may be completed on an adult tooth as well.
Frequently Asked Questions (FAQ)
Restorative Treatments (Fillings, Crowns, Pulpotomies)
Composite Restorations (Fillings)
When does Dr. Church recommend a filling?
A white composite filling is recommended when a cavity has progressed beyond the point where it can be safely monitored, meaning the decay requires active treatment to prevent it from getting larger.
Will my child need a shot (anesthetic) for a filling?
For small cavities, especially in primary (baby) teeth, Dr. Church may not need to use a local anesthetic, particularly if nitrous oxide (laughing gas) is used to help the child relax.
Crowns
What is the difference between a filling and a crown?
A filling (composite restoration) repairs a portion of the tooth, usually when the cavity is small to medium-sized. A crown is recommended when the cavity is too large for a filling; it covers the entire tooth to prevent further breakdown and protect the tooth from new cavities.
What types of crowns are used?
Porcelain crowns are used for front teeth (including canines) for their aesthetic appearance. Stainless Steel Crowns (SSCs) are the standard for primary molars due to their superior durability and biocompatibility.
Are stainless steel crowns safe? What are they made of?
Yes, SSCs are safe and considered the standard in pediatric dentistry. They are made from a medical-grade blend of metals: Iron, Chromium, Carbon, and Nickel. This is a common blend also used in medical tools and earrings. They do not contain mercury or lead.
Pulpotomy (Nerve Treatment)
What is a pulpotomy?
A pulpotomy is a procedure performed when a cavity has reached the nerve (pulp) of a primary tooth. It involves cleaning out the diseased nerve tissue, primarily in the crown portion of the tooth.
Is a pulpotomy the same as a root canal?
No, a pulpotomy is often referred to as a “partial” nerve treatment. We only remove the diseased tissue from the crown of the tooth (not all the way to the tip of the roots) and then place materials to promote healing. The goal is to save the tooth and keep it in place until it naturally falls out.
What materials are used after the nerve is cleaned out?
A biocompatible material called MTA (Mineral Trioxide Aggregate) is placed over the root canals to help stimulate natural hard tissue growth. This is then sealed with Zinc Oxide Eugenol before a stainless steel crown is placed over the tooth for final protection.