Is Your Child's Dental Filling Done Right? Signs You Need a Second Opinion

Is the dental filling procedure normal? Does it need to be redone?

My 8-year-old child had a permanent front tooth that showed signs of calcification as soon as it erupted, with some uneven surfaces.
Recently, my child complained that a specific area of this tooth was very sensitive to touch, and upon closer inspection, I noticed a cavity.
Yesterday, we took him to see a general dentist, who suspected it was a cavity.
The dentist used a sharp instrument to scrape the surface, and I saw debris coming off.
The doctor mentioned that drilling would be necessary.
She patiently communicated with my child, but he expressed discomfort and was unwilling to cooperate.
The dentist explained that the tooth needed to be drilled and cleaned thoroughly, and due to my child's lack of cooperation, it would be challenging to manage, so she recommended we find a pediatric dentist.
Today, we visited a pediatric dental clinic and waited for our turn.
I informed the dentist which tooth was causing my child pain.
The dentist then explained to my child that he would use a soft-bristled tool to gently clean the tooth, followed by rinsing with water.
After rinsing, the dentist used a syringe-like device to apply material to the tooth and then cured it with a light, repeating the process once more.
The dentist then stated that the tooth was fixed, and the entire procedure took about three minutes.

Since the decayed part of the tooth was not cleaned, I felt confused and asked the dentist if the cavity area needed to be cleaned.
The dentist asked if this tooth had been filled before and if the material had fallen out.
I responded that this tooth had never been filled.
The dentist looked again and replied that it should not have decayed that much.

Due to the surprising and unsettling nature of the process, I researched and discovered that the dentist did not clean the decayed area, did not dry the tooth after rinsing, and did not perform acid etching or final polishing.
I am concerned that if the cavity was not properly cleaned, it may continue to decay.
Should we seek another opinion from a different dentist to re-evaluate the treatment of the tooth?

Hsinchu Mama, 40~49 year old female. Ask Date: 2022/02/10

Dr. Zeng Guanghui reply Dentistry

Is it because the tooth did not actually have a cavity, but rather surface demineralization? After the first dentist removed the demineralized area through grinding, the second dentist cleaned the tooth surface with a brush and water, then filled the demineralized area with resin.
It would be advisable for the filling dentist to discuss the child's caries situation and how to maintain cleanliness after the filling.
Director Tseng Guang-Hui, Nantou Hospital Dental Department.

Reply Date: 2022/02/10

More Info

When it comes to your child's dental health, especially regarding fillings and potential cavities, it's crucial to ensure that the treatment provided is thorough and appropriate. Based on your description, there are several important factors to consider regarding the dental care your child has received.

First, it is concerning that your child has experienced pain and sensitivity in the tooth, which may indicate the presence of a cavity. The initial dentist's recommendation to drill and clean the area is standard practice when a cavity is suspected. Cavities, if left untreated, can progress and lead to more severe dental issues, including infections or the need for more extensive treatments like root canals or extractions.

The second dentist's approach, which involved applying a material without cleaning out the cavity, raises some red flags. Typically, for a filling to be effective, the decayed part of the tooth must be removed first. This is to ensure that all bacteria and decayed tissue are eliminated, preventing further decay under the filling. If the decayed area was not adequately cleaned, there is a significant risk that the cavity could continue to progress, leading to further complications.

Here are some signs that may indicate your child’s dental filling was not done correctly or that a second opinion is warranted:
1. Persistent Pain or Sensitivity: If your child continues to experience pain or sensitivity in the treated tooth after the procedure, this could indicate that the cavity was not fully addressed.

2. Visible Decay: If you can see any discoloration or visible decay around the filling site, this is a sign that the filling may not be properly sealed or that decay remains.

3. Filling Material Issues: If the filling material appears to be coming loose or if there are gaps between the filling and the tooth, this can lead to further decay.

4. Lack of Thoroughness in Treatment: As you mentioned, the second dentist did not clean the cavity before applying the filling material. This lack of thoroughness is concerning and suggests that the treatment may not have been adequate.

5. Inconsistent Explanations: If the explanations provided by the dentists are inconsistent or confusing, it may be a sign that the treatment plan is not being communicated effectively, which can lead to misunderstandings about your child's dental health.

Given these considerations, it is advisable to seek a second opinion from another pediatric dentist. When doing so, you might want to ask specific questions about the treatment process, including:
- What steps will be taken to ensure that all decay is removed?
- How will the dentist ensure that the filling is properly sealed?
- What materials will be used for the filling, and what are their benefits?
Additionally, it may be beneficial to request X-rays to assess the condition of the tooth and surrounding structures. This can provide a clearer picture of any underlying issues that may not be visible during a clinical examination.

In conclusion, your child's dental health is paramount, and if you have concerns about the adequacy of the treatment received, seeking a second opinion is a prudent step. Ensuring that your child receives appropriate and thorough dental care will help prevent further complications and promote long-term dental health.

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