Filling cracks and breaks off

[missmaria]

Hello everyone, thanks for taking the time to read this and for any advice.

A little over a year ago my 4yo had to have some fillings done on his top front teeth (they are resin I believe, tooth colored). Within the past two months I have had to take him back to his dentist and have the filling on one tooth repaired/replaced twice already because the filling cracked in half and part of it fell off. The first time this happened he was eating corn on the cob and I was told no more harder foods. The second time we were practicing numbers and he spit it out. Yesterday he was just standing there and got a scared look on his face and said his tooth fell out. He handed me half of a filling. Later that night while drinking milk the other half of the filling fell off.

What could be making this happen? We are going back to the dentist tomorrow and some possible causes I could talk with her about will be very helpful. His dentist didn't talk to me about it last time, she rushed in, had to fill it twice after the first try slid off and rushed out again.

Thanks again for reading.

 

[Thomas Karmen]

I am not certain how large these fillings are but it sounds like they are pretty good sized restorations. It sounds to me like it's time to have caps put on these teeth as opposed to filling them. If white fillings were first put in chances are there was a technique called bonding done to hold the fillings in place. Baby teeth don't allow this technique to be as successful as adult teeth and once the filling has come off, it's more difficult to bond it back on. The dentist seems to be trying to keep these teeth looking nice by using the white fillings and there are ways to use little white caps instead. As her if that's a possibility and if there is enough tooth structure left to cap. Hope this helps.

Thomas Karmen DDS

 

[brit]

If the fillings are at the back of the front teeth, you could replace them with amalgam which would be easier to do (composite is technique sensitive).

I personally wouldn't bother with crowns (caps) on front baby teeth on a 4 year old....the front teeth in any event usually fall out around that age. Hence the song 'All I want for Christmas is my two front teeth'
I would do whatever minimises his exposure to procedures even considering extraction before crowns.

 

[decan]

I personally wouldn't bother with crowns (caps) on front baby teeth on a 4 year old

Not even prefabricated crowns?

 

[Thomas Karmen]

Of course visual and digital examination helps to make the decision on to restore or not to restore. Often parents like to maintain esthetics so consultation with the parent and clinical judgement comes into play. Every patient is different so it's a judgement call.

 

[brit]

Not even prefabricated crowns?

No crowns on baby teeth is very much a USA thing. As a Mum I see psychology of child as more important than a perfect smile. Most 4 year olds are lacking a couple of front teeth for a few months so I don't think it would impact on self-esteem but it is a 'let's minimise (lengthy) procedures to avoid dental fear arising' thing.
I also think dental sedation in kids is unreliable and potentially dangerous so should be avoided with the exception of nitrous. Most European dentists would probably agree with me. Less is more sometimes. Preserving the space for the second teeth is not the most important thing here, that's just an argument to persuade parents their kids need lots of treatment when actually maybe they don't.