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There is more than one way to treat a cavity. This page names the options a dentist may raise and says what each one broadly is, so the conversation is easier to follow. It does not recommend between them, and it cannot tell you what your own child needs — that is a decision for your dentist and your family, made with the tooth in front of them.
“Getting a filling” is the version most of us grew up with, and it is only one of the things a dentist can do. Some approaches rebuild the tooth, one covers it, one is painted on to stop the damage spreading, one treats the nerve inside, and sometimes a tooth cannot be kept. Each has its own page on this site.
What follows describes what each option is. It does not compare them and it does not say which is better, because that answer changes from tooth to tooth.
Dentists have lots of different ways to help a poorly tooth. Some are quick, some take a bit longer, and none of them are a surprise — your dentist will tell you and your grown-up what is going to happen before it happens. You are allowed to ask questions the whole time.
Repairing a tooth and treating the disease are two different jobs. The AAPD is explicit that restorative treatment of dental caries alone does not stop the disease process, and that the restorative plan must be prepared alongside an individually tailored preventive programme. That is why the appointment where a tooth gets fixed is usually also the appointment where brushing, fluoride and snacks come up again.
Whatever the method, the AAPD sets out the same underlying objectives for restorative treatment:
The AAPD also notes that restorations have finite lifespans. A repaired tooth is still a tooth that needs looking after, and it will be checked again at future visits.
These are the six you are most likely to hear named in a paediatric dental appointment. Each one links to its own page. Seeing a name here does not mean your child needs it.
The decayed tissue is removed and the missing structure is rebuilt with a filling material. The AAPD reviews evidence for several, including composite, glass ionomer and amalgam.
A preformed cover cemented over the whole tooth. The AAPD lists preformed metal crowns as indicated for teeth with extensive decay or developmental defects, and following a pulpotomy or pulpectomy.
A liquid painted onto the lesion to arrest it rather than drill it away. The AAPD describes it as a minimally invasive approach that may prevent or delay the need for more extensive procedures. It permanently stains the treated area black.
Used when removing decay exposes the pulp — the living tissue inside the tooth. The AAPD describes amputating the pulp in the crown of the tooth and treating the remaining living tissue in the roots.
Removing a tooth that cannot be kept. Where a baby tooth is lost earlier than it would have been naturally, the question of holding the space open follows on from it.
A small appliance that keeps the gap open after a baby tooth is lost early. The AAPD says their use to reduce the prevalence and severity of malocclusion following premature loss of primary teeth should be considered.
If two children you know were treated differently for what sounds like the same problem, that is not necessarily an inconsistency. Three things the AAPD states plainly are worth knowing before the conversation starts:
You are meant to be part of this decision. Writing about silver diamine fluoride, the AAPD states that the ultimate decision regarding disease management is to be made by the practitioner and the patient or parent, acknowledging individual differences in disease propensity, lifestyle and environment. It also notes that before-and-after images of treated teeth can be helpful in the consent process. The AAPD says that about one treatment in particular, but expecting the same of any option on this page is reasonable.
If it helps to go in with something written down, there is a list of questions to ask a dentist, and a page on treatment decision guides, in the For Parents section.
My dentist has recommended something and I want to understand it. Ask them directly — what it is, what it involves, what the alternatives are, and what happens if you wait. Nothing on this page is a second opinion, and none of it is based on your child’s teeth. Your dentist has looked at them; this website has not.
Not necessarily, and only your dentist can answer it. The AAPD states that not every caries lesion requires restoration, and that some lesions may not progress. It also lists approaches other than a conventional filling. What is right for one tooth is not automatically right for another, which is why this page names options rather than predicting one.
Treating the tooth and treating the disease are separate. The AAPD is direct about this: restorative treatment of dental caries alone does not stop the disease process, and the restorative plan is meant to sit alongside a preventive one. A treated tooth can develop new decay, and so can its neighbours, which is why the prevention conversation keeps coming back.
Ask them — the reason will be specific to that tooth, and they can show you. In general terms, the AAPD lists preformed metal crowns as indicated for teeth with extensive decay or developmental defects, where other restorative materials are likely to fail, and following a pulpotomy or pulpectomy. Whether any of that applies to your child’s tooth is a question for the person who examined it.
Yes. The AAPD describes permanent black discoloration of the demineralised or cavitated surface as a side effect of silver diamine fluoride, and notes that before-and-after images can be helpful when consent is being discussed. It is worth asking to see those images, and asking which teeth would be affected, before agreeing to it.
That is a decision for your dentist, and it depends on the tooth, the child and how long that tooth still has to do its job. The AAPD guidance on restorative dentistry covers primary teeth throughout rather than treating them as a separate case. There is more on why decay in baby teeth is taken seriously on What is a cavity?
Every clinical statement on this page comes from the American Academy of Pediatric Dentistry. Descriptions of each treatment are drawn from the documents below and are deliberately kept to what those documents say.
This website is for education only and does not replace care from your dentist, physician, or emergency services.