Your Child’s Cavity Doesn’t Have to Mean a Silver Filling: What Chevy Chase Parents Should Know

The Filling Your Child Gets Today Matters More Than You Think

If your child has been told they have a cavity, your first instinct is probably to get it fixed as quickly as possible. That makes complete sense. But before you schedule that appointment, there’s one question worth asking your dentist: “Will my child be getting a tooth-colored filling or a silver one?”

The answer matters — for their health, their comfort, and yes, even for how their smile looks when they laugh at school pickup.

At Smiles of Chevy Chase, Dr. Despina Markogiannakis, a dentist in Chevy Chase, MD, offers tooth-colored composite fillings as the standard of care for pediatric patients. No silver. No mercury. Just a safe, minimally invasive restoration that blends right in — and holds up just as well as the old metal alternative.

Here’s what every parent in the Chevy Chase area should know before their child sits in the dental chair. Call our Chevy Chase dental office at (301) 652-2939 to schedule your child’s dental appointment.

Why the FDA Has Changed Its Guidance on Silver Fillings in Children

Silver amalgam fillings have been used in dentistry for over 150 years. They’re durable and affordable, and for much of the 20th century, they were the only widely available option. But they come with a material that has drawn increasing scrutiny: mercury.

Amalgam is made from a mixture of mercury, silver, tin, copper, and zinc. While the FDA long maintained that amalgam was safe for most adults, the agency significantly updated its guidance in 2023, and the update specifically named children as a high-risk group.

The FDA now recommends avoiding dental amalgam in:

• Children under 6
• Pregnant women and those planning to become pregnant
• Women who are breastfeeding
• People with kidney problems
• People with neurological conditions
• Those with known sensitivities to mercury or other amalgam components

The concern centers on mercury vapor, which can be released from amalgam fillings in small amounts during chewing, grinding, and brushing. The FDA acknowledges that for developing nervous systems — such as those of young children — even low-level mercury exposure warrants extra caution.

For the parents in Chevy Chase, this is simply a good reason to ask for a composite filling from the start.

What Are Tooth-Colored Fillings, and Are They as Strong as Metal?

This is the first question most parents ask — and it’s the right one. The short answer: yes, composite fillings are strong enough for children’s teeth, including baby teeth that still have years of use ahead of them.

Tooth-colored fillings (also called composite fillings, white fillings, or mercury-free fillings) are made from a blend of medical-grade acrylic resin and finely ground glass or ceramic particles. The material bonds directly to your child’s tooth surface, which is a fundamental difference from how amalgam works.

Silver amalgam is packed into a cavity and held in place mechanically, which requires the dentist to remove more healthy tooth structure to create a stable fit. Composite resin chemically bonds to the tooth, so Dr. Markogiannakis only needs to remove the decayed material — nothing more. For a child’s still-developing teeth, preserving that healthy enamel matters.

Composite vs. Amalgam: A Quick Comparison for Parents

• Appearance: Composite matches your child’s natural tooth color. Amalgam is a dark silver metal that becomes more visible as it ages.
• Mercury: Composite contains none. Amalgam contains a mercury alloy.
• Tooth Structure Removed: Composite requires minimal removal — only the decayed portion. Amalgam requires more healthy enamel to be drilled away to create a mechanical lock.
• Temperature Behavior: Composite is stable. Amalgam expands and contracts slightly with hot and cold temperatures, which can cause micro-cracks in the surrounding tooth over time.
• Safety for Children: Composite is FDA-recommended for children under 6. Amalgam is explicitly listed as a high-risk filling material for this age group.
• Longevity: Both last approximately 10–15 years with good care. Modern composites often exceed this.

Are Composite Fillings Safe? What About BPA?

A fair question, and one Dr. Markogiannakis hears regularly from informed Chevy Chase parents. The answer is yes — composite fillings are considered safe by the FDA and major dental health organizations.

Some composite materials contain trace amounts of bisphenol A (BPA) or BPA-related compounds called bis-GMA or bis-DMA. However, the quantities involved are extremely small — far below any threshold associated with health effects — and many modern composites are formulated to be entirely BPA-free.

At Smiles of Chevy Chase, Dr. Markogiannakis uses advanced composite materials selected for both performance and biocompatibility. If you have specific questions about the materials used for your child’s filling, we encourage you to ask during your consultation—we’re happy to walk you through it.

In practical terms, the documented health risks of dental amalgam in children — as recognized by the FDA — are substantially more established than any concern about trace BPA in composite resin. For most parents, once those facts are laid side by side, the choice becomes straightforward.

Do Composite Fillings Work on Baby Teeth?

Absolutely. Composite resin bonds just as effectively to primary (baby) teeth as it does to permanent ones. This is a common misconception — some parents assume that because a baby tooth will eventually fall out, the type of filling material doesn’t matter much. But baby teeth serve critical functions that justify proper treatment.

Baby teeth matter because they:

• Hold space for permanent teeth — a lost or severely damaged baby tooth can cause spacing and alignment problems that require orthodontic correction later
• Help your child chew properly, which affects nutrition and digestion
• Support clear speech development
• Remain in place for years — first molars, for example, aren’t replaced by permanent teeth until around age 12

A composite filling placed in a baby tooth by Dr. Markogiannakis will look natural, hold up through the remaining life of that tooth, and won’t expose your child to unnecessary materials in the process.

According to the CDC’s Oral Health Data, more than 52% of children aged 6–11 have had a cavity in a primary tooth. That’s the majority of school-age kids, which means composite fillings are a routine, well-established procedure, not an unusual request.

What to Expect During Your Child’s Filling Appointment at Smiles of Chevy Chase

One of the most common things anxious parents tell us is that they’re not sure what the appointment will actually look like. Here’s a plain-language walkthrough of what happens when your child comes in for a composite filling with Dr. Markogiannakis.

1. Exam and X-Rays: Dr. Markogiannakis will review the area with digital X-rays to confirm the extent of the decay and ensure there are no surprises. You’ll see exactly what she’s seeing.
2. Shade Matching: A composite color is selected to match your child’s natural tooth. For younger kids, this often blends so naturally that classmates and teachers will never notice.
3. Local Anesthetic: The area is numbed so your child won’t feel any discomfort during the procedure. Dr. Markogiannakis is experienced in working with younger patients and takes a calm, gentle approach.
4. Decay Removal: Only the damaged material is removed. Because composite bonds chemically to the tooth, no extra healthy enamel needs to be drilled away.
5. Composite Placement and Curing: The filling is placed in thin layers, each hardened in seconds with a specialized curing light. This layered technique creates a strong, lifelike result.
6. Shaping and Polishing: The filling is shaped to match your child’s bite and polished smooth. Most kids are surprised that there’s nothing to see when it’s done.

Most single-tooth appointments take 45 to 90 minutes. The composite cures completely during the appointment, so there’s no waiting period — your child can eat once the anesthetic wears off. We just ask that they wait for full sensation to return before eating, particularly anything hot, so they don’t accidentally bite or burn a numb cheek.

For children who experience dental anxiety—and many do—Smiles of Chevy Chase offers both nitrous oxide (laughing gas) and oral conscious sedation. Mention your child’s anxiety when you call, and we’ll build their appointment around their comfort level.

How Long Do Kids’ Composite Fillings Last?

With proper care, composite fillings in children’s teeth last as long as the tooth needs them to — typically 10 to 15 years, which covers the remaining lifespan of most primary teeth and then some. For permanent teeth, the same filling can last well into adulthood.

Longevity depends on a few factors:

• Location: Molars take more bite force than front teeth and may show wear sooner
• Oral Hygiene: Brushing twice daily and flossing reduces the risk of new decay forming around the filling margin
• Diet: Limiting sticky and sugary foods helps both the tooth and the filling
• Grinding: If your child grinds their teeth at night, ask Dr. Markogiannakis about a nightguard to protect their restorations
• Regular Checkups: Dr. Markogiannakis checks all existing restorations at every routine exam, so small issues are caught early

The National Institute of Dental and Craniofacial Research (NIDCR) has noted that advances in composite materials over the past decade have significantly improved wear resistance and bond strength. Children receiving composite fillings today are getting a meaningfully better product than those who received them even 10 years ago.

Will My Child’s Insurance Cover a Composite Filling?

Most major dental insurance plans cover composite fillings for children, though coverage specifics vary by plan. Many plans categorize fillings by the number of tooth surfaces involved (one-surface, two-surface, etc.) and cover composite at the same rate as amalgam for both front and back teeth in pediatric patients.

Some plans include a “downgrade clause” for posterior (back) teeth in adults, meaning they cover the amalgam rate and ask the patient to pay the upgrade difference for a composite. However, this clause often does not apply to children, meaning the composite may be fully covered at your child’s benefit level.

The Smiles of Chevy Chase team will verify your child’s specific benefits before the appointment so you know exactly what to expect. For families without coverage or with gaps, out-of-pocket costs for a single pediatric composite filling in the Chevy Chase area typically range from $150 to $300 per tooth for a standard one- to two-surface restoration. Financing options are also available through the practice.

Call us at (301) 652-0656 to discuss your coverage before scheduling — we’re happy to walk you through the details.

Preventing the Next Cavity: What Chevy Chase Parents Can Do at Home

The best filling is the one your child never needs. While composite fillings are a safe, effective fix when cavities do occur, a few consistent habits at home can reduce how often they’re necessary.

• Brush twice daily with a fluoride toothpaste. For children under 3, use a rice-grain-sized amount. For ages 3–6, a pea-sized amount.
• Floss once a day — even for younger children. As soon as two teeth are touching, food can get trapped between them.
• Limit sticky and sugary snacks, particularly between meals. Crackers, gummies, juice, and sports drinks are frequent culprits.
• Ask about dental sealants. Sealants are a thin protective coating applied to the chewing surfaces of back molars, where most childhood cavities occur. They’re quick, painless, and highly effective.
• Keep up with twice-yearly cleanings. Dr. Markogiannakis and the team at Smiles of Chevy Chase can catch early-stage decay before it becomes a cavity—and before a filling becomes necessary.

According to the CDC, tooth decay is the most common chronic disease in children aged 6 to 11 years and adolescents aged 12 to 19 years. The good news is that it’s largely preventable with consistent care.

Schedule Your Child’s Filling Consultation at Smiles of Chevy Chase

If your child has a cavity — or if it’s been more than six months since their last exam — Dr. Despina Markogiannakis and the team at Smiles of Chevy Chase are here to help. We offer mercury-free, tooth-colored fillings for children and adults, and we take the time to make sure every young patient feels comfortable from the moment they walk in.

We welcome patients from Chevy Chase, Bethesda, Rockville, and Silver Spring, MD, and the surrounding area. Our office is conveniently located at 5454 Wisconsin Ave, Suite 810, Chevy Chase, MD 20815.

Call us today at (301) 652-0656 to schedule your child’s appointment, or book online at smilesofchevychase.com. We’re happy to answer any questions about fillings, sedation options, insurance coverage, or anything else before you come in.

Because your child deserves care that’s safe, comfortable, and built to last — and at Smiles of Chevy Chase, that’s exactly what we deliver.