Let’s Talk About the Steps of a Filling
It happens to the best of us ... you’ve been told your child has a cavity and that he or she needs a filling. After recovering from the surprise, you may wonder how we go about doing a filling on a child. So we thought it would be helpful to go through the basic steps of a white resin filling.
The first thing that should always happen is going over the treatment plan and getting your consent. You should know what tooth the filling will be on, and what surfaces of the tooth will be restored. You should also know the fee upfront. Since it can be difficult for a child to tolerate dental treatment, you may also see fees for nitrous oxide (laughing gas), oral sedation, IV sedation, or general anesthesia. For this blog post, we will talk about the steps of a white filling with the behavior management 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. Then the 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. 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.
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 an hour or so.
If you have any questions, feel free to call us anytime!