Sometimes an acronym is just meant to be! This is the case for SMART Fillings.As pediatric dentists, our top priority is to provide safe, effective, and minimally invasive dental treatments for children. One of the ways we achieve this is through the use of the Silver Modified Atraumatic Restorative Technique (SMART) filling.What are SMART Fillings? SMART is a unique type of dental filling that uses a combination of silver diamine fluoride (SDF) and glass ionomer to restore decayed or damaged teeth. The SDF component provides antimicrobial and strengthening properties, while the glass ionomer component releases fluoride and restores structural defects to help prevent future decay. This combination results in a filling that is both strong and long-lasting, making it an ideal choice for children.
Benefits of SMART Fillings for Children:
•Minimal Invasiveness: SMART fillings are placed using a gentle and minimally invasive technique, which helps to preserve as much of the natural tooth structure as possible.
•Pain-Free: Because SMART fillings are placed using a gentle, non-numbing technique, children often experience little to no discomfort during the procedure
•Strengthening: The SDF component of SMART fillings provides strength and durability, helping to prevent further damage or decay in the affected tooth.
•Fluoride Release: The glass ionomer component of SMART fillings releases fluoride over time, helping to prevent future decay and maintain the health of the treated tooth.
SMART Fillings vs Traditional Fillings Traditional dental fillings are typically made of silver amalgam or composite materials. While these fillings are effective, they may require the removal of more tooth structure.
SMART fillings offer many benefits for children who are good candidates for them. Let us know if you have any questions!
Glass ionomer is a “bioactive” material that continues to release fluoride from extrinsic sources (toothpaste, water, food, etc.) into the teeth to help prevent future cavities..
Dr. Franklin will take examine your child’s tooth, likely taking an X-Ray to examine the extent of decay. If your child would benefit from a SMART filling we will discuss it further.
We will place SDF on at the first visit. If your child has hypomineralized, temperature sensitive teeth, they should feel less pain after even just one application.
Sometimes we need to apply SDF more than once for complete sensitivity reduction and for the cavity to arrest enough for the next step.
Once the cavity feels “hard” and the sensitivity has been greatly improved, we will gently clean the tooth with “Mr. Whistle” (our dental handpiece) and place tooth playdough (reinforced glass ionomer).
SDF combats bacteria and fortifies teeth. It remineralizes enamel to make it stronger and more resistant to cavity-causing bacteria and acid. The glass ionomer filling further remineralizes and seals deep grooves, pits and defects that can trap food and lead to recurrent cavities. The white glass ionomer filling also helps conceal the black or brown tooth discoloration caused by SDF.
Smart fillings allow for retention of some demineralized/hypomineralized tooth structure, with the filling still bonding to the tooth. Glass ionomer fillings exhibit stronger bonding to affected teeth compared to traditional fillings. The latter often require complete removal of defective enamel to achieve a clean bonding margin, leading to greater tooth structure loss.
Silver has been used since the 1800’s to help treat cavities. SDF has been widely used in Japan and other Asian countries for over 50 years!
You care for SMART fillings similarly to how you would care for other fillings which are to practice good oral hygiene, attend regular dental appointments, and limit exposure to wear and tear and stains. Your child should brush their teeth twice a day and floss at least once per day, if under 7 they should get help from an adult.
Children should visit the dentist for regular cleanings and exams every 6 months to confirm the filling looks good, check for cavities, and review how to prevent future cavities. SMART fillings take multiple visits. After SDF patients should not eat or drink for an hour. After the Filling part of a SMART Filling, patients should avoid hard foods for two days while the filling finishes setting. Children should always avoid Very hard things such as chewing Ice and Jaw Breakers.
A good candidate for a SMART filling is a child with a cavity, dental anxiety, special needs, sensitive teeth, and/or hypomineralized teeth. The biggest advance of SMART fillings is that they are minimally-invasive and allow for a conservative, strong restoration. Ultimately this improves the comfort of our patients and reduces future fear of the dentist – building strong roots for growing smiles!
One of the most common spots for cavities over a lifetime is under existing fillings? Bioactive glass fillings greatly reduce the risk of developing another cavity by remineralizing the area around the filling.