Filling materials for children

Abstract

I N THE past decade the profession of dentistry has observed the gradual and steady growth of a lusty, young member of the family, known as pedodontia or children's dentistry, and this new member of the dental family has now assumed such an important place in the profession that no thinking dentist with an eye upon increased future practice can afford to ignore this work. In spite of this increased interest and study there is still much inferior and slipshod work placed in the mouths of children, and apparently much of this inferior work has resulted from the improper choice and use of filling materials in both deciduous and permanent teeth. We are offered the choice of some five materials for the restoration and preservation of the teeth of children, and each has its place in children's dentistry, and every practit ioner should familiarize himself with the use of each material in its proper place. The five materials in order of their importance are. copper amalgam, gold (both inlays and foil), silver amalgam, synthetics, and plastics (copper, silver and zinc cements). Copper amalgam should be the material chosen in 95 per cent of the children from the ages of two to seven years, and as this covers the majori ty of the period called childhood, it is placed first in importance. This material should be used by the dentist much more extensively than it is at the present time and should replace almost entirely the use of silver amalgam in deciduous teeth, for it has all of the necessary qualities of silver plus the very important attribute of the prevention of recurrent caries. Silver amalgam is indicated in all permanent molars where for any reason gold cannot be used, or in those deciduous teeth where the dark color of copper amalgam may be objectionable, but these lat ter cases are very much in the minority. Too much cannot be said in condemnation of the use of plastic cements on occlusal or masticating surfaces in the child mouth, for they wash out rapidly, destroying contacts and tooth form and occasionally may even cause malocclusion through loss of space in the arch. The silicates have only one place in the child mouth, and that is in the labial cavities on deciduous canines, lateral incisors or central incisors, and occasionally if the teeth are thick enough for proper cavity preparation upon the proximal surfaces of these teeth when the discolorations from the use of silver nitrate in these areas would be objectionable. The plastic cements (copper, silver and zinc oxide) should be used only as a base or foundation for building a restoration of metal when caries has approached the pulp too closely or where actual pulp exposure has occurred,