General Dental Care: Understanding Tooth Decay and Preventive Care

Why live with painful and unsightly cavities when you can have them filled by our dentists in a painless procedure!
In order to repair a cavity, the decayed portion of your tooth will be removed by your dentist. The portion of the tooth occupied by the decayed material will then be filled. Fillings are utilised to repair teeth that are broken, cracked, or that have cavities.

What Are The Steps For Filling Teeth?
Initially, a local anaesthetic will be injected into the area that surrounds the tooth. Novocaine is normally used. Then, a drill, laser, or air abrasion will be utilised to remove the area that is decayed. The type of instrument that is used will depend on the preference and training of your dentist, along with the extent and location of the tooth decay.

Your dentist will then test and probe the area of decay to ensure that all decayed material has been removed. After the removal of the decay, the space to be occupied by the filling will be cleaned so that all debris and bacteria are removed. If the area of the decay is close to the root, a liner constructed of a composite resin, glass ionomer or other type of material may be used in order to provide protection to the nerve. After the insertion of the filling, it will be finished and polished.

Additional steps are needed for fillings that are tooth-coloured. Subsequent to the removal of decay and cleaning of the area, the material that is tooth-coloured will be applied in layers. A specially designed light that hardens or cures each layer is used. After the completion of the multi-layering procedure, the composite material will be shaped by your dentist, excess material will be trimmed, and it will be polished.

Filling Materials Used
There are several types of filling materials that are currently available. Teeth may be filled with porcelain, gold, silver amalgam, or tooth-coloured composite resins. Silver amalgam is comprised of mercury with tin, silver, copper, and zinc mixed with it. The extent and location of the cavity, expense of filling material, insurance coverage of the patient, and the recommendation of the dentist will determine the kind of filling material that will best suit your needs

Gold Fillings
Pros

• Extremely durable – will usually last for the life of the patient. Will not corrode.
• Strength – Can withstand almost any chewing forces
• Aesthetics – Some people prefer the look of gold to sliver amalgam
  
  

Cons

• Expense – more costly than other types of material. Can be 10 X more costly than amalgam
• Multiple Office Visits – requires a minimum of two visits
• Aesthetics – some patients don’t like its appearance
  
  

Silver Amalgam Fillings
Pros

• Durability – Normally lasts longer than composites. Normally lasts ten to fifteen years or more.
• Strength – able to withstand all chewing forces
• Expense – costs less than gold or composite fillings
  
  

Cons

• Generally poor aesthetics – natural colour of teeth is not matched
• Requires more space – A portion of the tooth that is healthy must be removed, at times, to provide a large enough area for the amalgam filling.
• Discolouration – a hue that is greyish may be imparted to the adjacent tooth structure
• Fractures and Cracks – All teeth expand and contract with temperature changes, which can cause cracking. However, amalgam materials may expand and contract to a greater extent than other materials, leading to an increased incidence of fractures and cracks.
• Allergies – approximately 1% of patients have allergies to the mercury that is in silver amalgam
  
  

Composite Fillings – Tooth Coloured
Pros

• Aesthetics – composites can be closely matched to the colour of the patient’s teeth. They are particularly useful for teeth that are visible
• Bonding – composite fillings will bond chemically with a tooth and provide structural support to the tooth
• Versatile – can also be utilised in the repair of broken, worn, or chipped teeth
• Space requirement – at times less tooth material is needed to be removed in comparison to silver amalgam fillings when preparing a space for this filling.

Cons

• Reduced durability – Composite fillings do not last as long as amalgams or gold. In addition, they often don’t hold up as well under the pressure of use, particularly if they are used to fill large cavities.
• Takes Longer – due to the process needed to fill a tooth with composite materials, it takes longer in the dentists chair to place them.
• More than one visit – if composites are being used for onlays or inlays, it may require more than one office visit
• Chipping – composite materials are more likely to chip than amalgams
• Cost – composite filling may cost twice as much as amalgam fillings
  
  

Additional Filling Materials
In addition to composite resins that are tooth coloured, there are two other types of tooth-coloured fillings. Glass ionomer and ceramics.

Glass Ionomer
This material is constructed of a specific type of glass and acrylic. It is commonly utilised on fillings that are beneath the gum line and for young children. This material releases fluoride, which may protect a tooth from additional decay. Nevertheless, glass ionomer is not as strong as composite resin and more prone to fracture and wear. It normally lasts for five years or less and the expense is similar to composites.

Ceramics
Usually constructed of porcelain. Ceramics are stain resistant, compared to composites, but are more abrasive. Ceramics are very durable, and usually last for 15 years or more, but, they are costly, and the expense can be similar to gold.