Despite being almost entirely preventable, tooth decay is a common problem among American children. By the time they enter high school, half of all children have had tooth decay and for the first time in decades, there has been an increase in the number of young children with cavities in their baby teeth. The causes of tooth decay are subject to some speculation, but the effect of poor oral health can include a significantly reduced overall health throughout the person’s lifetime.
Poor oral health leads to gum disease and tooth loss which in turn causes negative dietary changes. Studies have linked poor oral health to increased risk of cardiovascular disease and reduced life expectancy. Now there is another reason to be concerned about tooth decay in children.
A recent report has linked composite tooth colored fillings to behavior problems in children. Most fillings are either amalgam (silver colored) or composite (tooth colored). Composite fillings have a number of advantages over amalgam and are popular with patients because they are the same color as natural teeth. Composite fillings contain BPA, a chemical that has come under some scrutiny by the FDA but so far has not been banned.
The report focused on children with composite dental fillings and found an increased level of behavior disorders in children with composite dental fillings. The researchers did not measure the levels of BPA in the children and have stated that that further study will be needed. In addition, current composite fillings may have lower levels of BPA than those in the study.
Talk to your child’s dentist if you have any concerns about composite fillings. Your dentist will have the most up to date information and be able to help you decide whether composite or amalgam fillings are best for your child. Better yet, you can avoid having to make that decision by ensuring your child follows good oral health habits. Twice daily brushing, flossing daily, and regular dental check ups will go a long way toward preventing cavities. Also, talk to your dentist about sealants and fluoride treatments if your water supply is not fluoridated.
There are a range of different types of restorations for restoring damaged or decayed teeth. These include fillings, inlays, onlays, and crowns. Which type of restoration is best depends on the extent of the damage, the health of the remaining tooth, and the chewing load the tooth is expected to bear.
Dental fillings are referred to as direct restorations because they are formed and placed by the dentist in the office during a single visit. Crowns, inlays, and onlays are called indirect restorations because they are made in a dental laboratory and require at least two visits to the dentist’s office. During the first visit the tooth will be prepared and a mold will be made and sent to the lab. During the second visit the dentist will cement the restoration in place.
Fillings are the restoration used for the most minor damage. The dentist removes the decay from the tooth and fills the cavity with amalgam (silver color) or composite (tooth colored) filling material. Fillings are only effective when there is sufficient healthy tooth to support the filling. A filling that is too large will leave the tooth weak which could cause it to break or crack.
For much more extensive damage to the tooth, the dentist removes the decay and damaged material and will also remove enough additional tooth material to allow a crown to be placed over the tooth. A crown (also called a cap) is made in a dental laboratory and cemented in place by your dentist. The crown completely encircles or “caps” the tooth and provides a strong restoration for a seriously damaged tooth.
Dental inlays and onlays are used to repair damage that is too much for a filling, but not enough for a crown. Inlays and onlays are indirect restorations similar to crowns, but cover less area of the tooth. An inlay fits in between the cusps or rounded edges of the tooth while an onlay covers one or more of the cusps or even the entire biting surface.
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