Archives for October 2022

Whitening or Filling First?

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I have amalgam fillings and I want to get rid of them and replace them with the nice mercury-free fillings. I’m excited to finally have white fillings, but I’d also like to whiten my teeth. Is there a particular order to getting this done? Do I get the fillings first and then whiten my teeth or the other way around?

Milo

Dear Milo,

Before and after mercury-free fillings

Sanitary Amalgam Removal

There are actually two things to consider here. The first is who will replace your amalgam fillings. It requires a special procedure in order to be done safely. You will need to go to a dentist who has the equipment and understands the procedure. This is because the mercury will liquify during the procedure unless handled properly. As it is a known neurotoxin you don’t want to swallow or even inhale the mercury vapors.  I would look for a mercury-free dentist. They only do white fillings and will be much more likely to know how to do a sanitary amalgam removal.

Matching Your Composite Fillings

As for the whitening versus the fillings. I would do the teeth whitening procedure first, especially if you have visible fillings. You can’t quite predict a perfect match with teeth whitening, but a dentist with some cosmetic skill can match the composite fillings to the color of your teeth.

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Did Pediatric Dentist Do Unnecessary Work on My Son?

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I took my five year old to the dentist, which is the first time my dentist said that a child needs to go in for a checkup. My son had a bit of trouble being still for him and they were not able to get x-rays. The dentist thought he saw a cavity but because my son was so wiggly they could not do anything about it. I took him to a pediatric dentist in the hopes my son would respond better. He did. The pediatric dentist confirmed the cavity. We scheduled his procedure and used sedation, which ended up going very well and my son doesn’t even remember the procedure. However, when the procedure was over the staff told me that the decay was worse than they first thought and that they had to do a pulpotomy. I don’t understand how they wouldn’t have known this ahead of time. Do they have the right to do treatment on my son without my permission?

Rita

Dear Rita,

Child in a dental chair being treated.

There are several things going on here. I’m going to start with your last one. Let’s assume your child did need the procedure. Even then, they should have come to consult you. He was under sedation and therefore quite calm. There was no emergency. They should have sent someone out to tell you what they’d discovered and talked you through it and get your permission.

Should they have known ahead of time? It depends. Your first dentist had limited information. While this dentist had more, it could have been that between the evaluation and the scheduled treatment that the decay took a deep dive into the pulp. I am assuming that this was a back molar that they did the pulpotomy on because that is the only type of baby tooth that needs to be saved until your child is twelve years old.

I wanted to also address the statment your dentist made that children do not need to see the dentist until they are 5. That actually is not true. In general, if you wait that long, your child is more likely to have decay and end up afraid of the dentist. Taking your child to the dentist young, at about one to two years of age, is your child’s best chance of enjoying the dentist and having great oral health. Your dentist just didn’t want to see children until five, which tells me he is not good with children. That was played out in his inability to get cooperation from your son.

If you are comfortable staying with your new pediatric dentist, that is fine. But, if you are looking for a dentist you can both go see, look for a dentist who wants to see children early. That will tell you they are good at working with them.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.