Fillings, Whoa, Whoa, Fillings

How dental professionals relate to pediatric patients, and the tools we choose to deliver care, can result in either a positive or negative dental experience for children.

How dental professionals relate to pediatric patients, and the tools we choose to deliver care, can result in either a positive or negative dental experience for children. When I was a child, my dentist asked the same trite questions and used the same archaic tools in the same old-fashioned manner every visit. “How old are you? What grade are you in? Now open wide, this won’t hurt.” This was the chairside verbiage he routinely used. I meekly replied with tears streaming down my cheek, and then followed his instructions. I fully realized, even as a child, that this casual conversation eventually led to a painful filling because I knew the drill. On the other hand, today we know than an honest and upbeat chairside manner that uses innovative tools can be comforting when a child fears the unexpected.

Thankfully, by combining today’s technology, operatories, and products, the dental visit can set the stage for a lifetime of dental care and education. Who would have dreamed we could do “drilless dentistry” with air abrasion and lasers? The handpieces of today have less vibration and are noticeably quieter throughout the dental office. The high pierced pitches have been replaced with electric micro-motor “happy-hums,” and ultra-small fissurotomy burs. Electric handpieces offer variable smooth cutting of tissue more effectively than the dated slow speed handpiece, which was equipped with a large round bur (without a water spray rinse) to dissipate uncomfortable heat buildup.

Another unforgettable memory from my early dental visits was the purposeful gouging from the Sheppard hook explorer to detect caries. A welcome device to the detection armamentarium is the DIAGNOdent by KaVo. This kid-friendly unit is a far cry from a dull and dated dental explorer. The glass tip glides over occlusal surfaces, never sticking or gouging at the enamel. Instead, it quantifies reflected light and gives a measured reading, in numeric form, from the decay. The accuracy of the repeatable readings allows the clinician to confidently gage the patient’s needs from visit to visit. Tooth conserving measures like fluorides or sealants can arise as a treatment method for low readings produced on the DIAGNOdent, before instituting tooth-cutting procedures.

Kid-friendly fillings take on a new esthetic appearance when utilizing colored composite. When I was young, I would have liked an ocean blue, wild berry purple, sunny yellow, or cool white sparkle filling material instead of the crunchy amalgam that filled the space. The shimmer-colored composite material, MagicFil by Zenith/DMG, is a dual-cure product. The filling self polymerizes in four minutes (if you can keep the child still that long) or quick light cures in about 40 seconds. It is delivered in a plunger type syringe to automix, and is easily extruded through a small curved tip to allow for accurate placement into a child’s tiny grooves. This type of filling material is a great choice for the primary tooth that will eventually shed. As an extra bonus, the material releases fluoride to help prevent recurring decay. As an added incentive, the company supplies fun stickers to give to children as a reward.

Dental visits for restorations need not be torture for pediatric patients. Through modernization of chairside protocol and product choices, we can break the cycle of anxiety for both patient and parent. Dental offices can be modern, painless, neighborhood practices that kids want to visit and tell their friends and family about.

Ms. Kaiser has been in the dental field since 1986. She graduated from St. Louis, Mo., Forest Park hygiene program in 1994 and practices in Illinois at the Center for Contemporary Dentistry. Ms. Kaiser authors articles, presents, and can be reached at At Your Fingertips: hygiene touch@yahoo.com.

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