Restorative Care

There are many factors that may affect the onset of decay or disease, often despite the best efforts of both parents and kids. After examining a child’s oral health, we thoroughly discuss treatment procedures that promote long-term dental health.

A Range of Treatment Options

  1. Amalgam: Durability for large cavities
  2. Composite: Small or mid-size fillings (BPA-free)
  3. Crowns: For infected nerves or advanced decay


Amalgam, commonly referred to as "silver" filling material is made from a combination of metals that include mercury, silver, tin, and copper. Because of their durability, these fillings are often the best choice for large cavities or those that occur in the back teeth where a lot of force is needed to chew. Amalgam hardens quickly so it is preferred in areas that are difficult to keep dry, such as back teeth. Because it takes less time to place than composite restorations, amalgam is also an effective material for children and patients with special needs who may have a difficult time staying still during treatment.

It is important to know that amalgam is a safe and stable material. Once the material has hardened, mercury cannot leak from the filling, because the mercury has fused with other metals. The American Dental Association, U.S. Centers for Disease Control and Prevention, U. S. Food and Drug Administration and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer's Association, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society—all science-based organizations like the ADA also say that amalgam poses no health risk.

The Mayo Clinic recently stated that dental amalgam is a safe and durable choice for dental fillings. They also note that "there are several kinds of mercury. The mercury [methylmercury] found in water that can build up in fish and lead to health problems if you ingest too much is not the same type of mercury used in amalgam."

Read more: Amalgam


Composite resins, or tooth-colored fillings, are strong, and provide good durability for small- to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. They can be used on either front or back teeth. Our composites are BPA free. It generally takes longer to place a composite filling than it does for a silver filling or crown. That is because composite fillings require the tooth be kept clean and dry while the cavity is being filled. Composites are indicated for small restorations on children who are able to sit calmly in the dental chair for the procedure.

A wiggling or distressed child makes it difficult to keep a tooth dry, which results in a compromised restoration. At SHPD we discuss all restorative materials with parents prior to their placement, and our doctors make recommendations based on the size of the cavity as well as its location on a tooth and the type of forces the restoration will need to withstand after placement.

Read more: Composite Fillings


Our doctors might recommend placing a crown (commonly referred to as a "cap") on your child's tooth. A crown is indicated when the cavity has taken away so much tooth structure that a filling would not predictably stay in a tooth. A crown might also be indicated if a cavity has infected the nerve of a tooth, or if the decay has affected multiple sides of the tooth. Sometimes there is loss of tooth structure without decay being present; a crown may be indicated here as well. Children who are high risk for developing decay benefit from crowns as well, as a crown is the strongest and most predictable restoration we have in pediatric dentistry.

Crowns on primary teeth can be placed very quickly; children do not need multiple appointments for crown placement. There are different types of crowns available, and one of our doctors will evaluate your child's restorative needs with you to determine the right crown for your child.