Fighting decay is important for even the youngest teeth

  • Published
  • By Senior Airman Kristina Hailey
  • 66th Medical Operations Squadron
HANSCOM AIR FORCE BASE, Mass. --  Tooth decay is an infection that can affect your child's general health.

Restoring children's primary, or baby, teeth is considered necessary, even though the permanent teeth will eventually take their place. Primary teeth are essential for chewing, speech development, space maintenance, and guiding the eruption of the permanent teeth.
 
The two most common dental materials used in restorations for children's teeth are amalgam and composite.

Dental amalgam, also known as "silver fillings," is the most common and least expensive material used by the dentists. Dental amalgam is composed of a mixture of metals including mercury, silver, tin, copper, and zinc. Amalgam has proven to be strong and long-lasting. For these reasons, it is commonly used in the molar teeth due to its ability to withstand the forces of daily chewing and grinding.

There has been some controversy surrounding the use of amalgam because a small amount of mercury vapor is released as the filling material is being packed into the tooth. A much smaller amount of mercury vapor is also released as people chew with these fillings, although this amount decreases dramatically over time. Numerous studies have shown that the amount of mercury vapor released is well below that associated with adverse health effects.

The Food and Drug Administration has issued several endorsements over the years, declaring dental amalgam a safe and effective medical device, based on extensive, independent research. Last July, the FDA reinforced the safety of dental amalgam and placed it in the same classification as other dental filling materials, such as gold and composite.

Another option for restorative materials is the tooth colored composite, consisting of various compounds, including fillers and modifiers to achieve the desired properties for a dental filling. Chemically, they are most closely related to modern plastics, and are often called "plastic fillings." This material has the ability to bond to the tooth, so in some cases, less tooth structure needs to be removed before the filling is placed.

Additionally, some composite restorative materials release fluoride that can help strengthen the teeth and prevent cavities. However, plastic restorative material is more costly to use than amalgam and has less resistance to the heavy biting and chewing forces seen in the molar teeth.

Composite restorations are also considered to be technique sensitive, meaning there is a greater margin for error when placing these restorations. As a result, composite restorations have a higher failure rate than amalgam, which is usually seen as re-decay that develops under an existing composite filling.

To date, there is no evidence that silver fillings containing mercury pose any sort of health risk. A very small number of dental providers will recommend replacing silver fillings with composite fillings in order to achieve better health or relieve vague generalized symptoms such as headaches, fatigue or joint pain. There is no sound scientific basis for this and you should seek a second opinion in such cases.

Maintaining children's teeth and good oral health is a crucial step in achieving overall wellness. Brushing and flossing are still the first line of defense when it comes to preventing the development of oral diseases. Work with your children to help them develop good oral hygiene habits so their teeth will last a lifetime.

Editor's note: February is National Children's Dental Health Month. The above information comes from the American Dental Association and Federal Drug Administration.