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A dental filling is a material which is used by a dentist to fill the cavities (gaps and holes) in the enamel or tooth (dentin). A filling is used by dentists when the tooth has decay, has undergone root canal treatment, has cavities, or has been damaged. Its main purpose is to repair the surface of the tooth and restore its function, as well as to secure the tooth from bacteria, decay or physical damage.
A cavity filling is an alternative to dental crowns or veneers, which are used when the damage is too great to be amended by a filling or onlay. Often a filling is a relatively quick and simple procedure, which is used for small cavities in the teeth. Dental crowns and veneers are more durable, however the procedure tends to take longer and they are a more expensive option. If there is a problem with the dental pulp of the tooth, root canal treatment may be necessary. This branch of dentistry is known as ‘endodontics’ – the dental speciality concerned with the study and treatment of dental pulp. This dental pulp consists of nerves, blood vessels and lymph vessels. It can become inflamed and/or infected by bacteria from tooth decay, however there may be other reasons. irreversible pulpitis occurs when the inflammation and/or pain is so severe that the pulp cannot be saved. Root canal or endodontic treatment is then required Tooth filling can be made of various materials. The most popular include composite resin in the colour of a natural tooth, porcelain, amalgam (a composition of silver, copper, mercury and other vestigial elements) and, up until recently, the most popular- gold. Since amalgam and gold contain some mercury, they are now viewed negatively by scientists as posing a potential threat to human health.
A filling is also termed an onlay/inlay, depending on the size of the restorative piece. Sometimes these can get confused, so here is a more in-depth explanation of the terms.
Inlays and onlays are only other terms for fillings and are used for bigger cavities – filling being the most basic dental restoration. In both cases, these ‘fillings’ require the removal of existing decay and part of a tooth. Smaller cavities require less work and may be completed during one visit using an amalgam or composite filling prepared on-the-spot.
If the cavity is larger the dentist will need to use inlays and the process may be prolonged because the filling piece (inlay) is created in a laboratory in order to perfectly fit the size and shape of the cavity.
Onlays are bigger and cover larger cavities together with the whole tooth cusps. However, they are smaller than dental crowns. Onlays are also produced in a laboratory and cemented onto the tooth in the same way as inlays.
You will need a filling in the following situations, when:
Even if you have any of the above-mentioned symptoms, only after a dental check-up will you know for certain that you a dental filling is required. Your mouth will be checked using a small mirror and any abnormalities in tooth surfaces will be examined closely, and , where necessary, x-rays will be taken for further clarification.
Then, if an NHS dentist, a treatment plan will be prepared, or if the work is being done privately the dentist may go on to complete the filling immediately.
The first step in filling a tooth cavity is removing the decayed part of the tooth, usually by drilling and disinfecting it. The clean hole will then be filled with the recommended material type.
So, you might wonder what steps are involved in filling a tooth? It’s a very easy dental procedure.
Before the procedure can begin, you will require a check-up with your dentist.
During the check-up you can discuss any issues with the dentist, who will then take the necessary steps .
After inspecting the tooth, the dentist will choose the best type of dental filling. If root canal treatment is required, then the dentist will have to perform this procedure first. This may prolong the process, necessitating up to one or two more visits.
If the tooth is diagnosed with decay, the decayed part of the tooth is first removed by drilling. This may mean using the conventional rotary dental drills or , where appropriate, newer systems like laser ablation systems and air abrasion devices. Next the cavity is cleansed of any bacteria and debris. Finally the affected area of the tooth is then cleaned, washed, and dried.
If everything is OK, the dentist will numb your gums by injecting local anaesthetic into the appropriate place. This is painless. A general anaesthetic is not usually used because a local anaesthetic is much simpler and quicker. The numbness from the local anaesthetic can last up to a few hours after the procedure itself. Sometimes the patient may also experience problems with correct enunciation (saying words properly) after a local anaesthetic, so, if you plan anything requiring your verbal skills after the treatment, it may be better to postpone it.
Less often used is intraligamentary anaesthesia where only the specific tooth is numbed – not the gums and surrounding area. Not all dentists, however, will offer this procedure.
In the case of so-called direct fillings – i.e. made on the spot – the doctor prepares the dental filling and inserts it into the hole, thus filling in the gap and restoring the tooth’s original shape and function. It’s cured with the use of a UV light to ensure that the filling bonds quickly and securely with the natural tooth structure.
A liner made of glass ionomer, composite resin, or other material may be necessary in some cases in order to secure the tooth’s nerve.
If the material is tooth-coloured then it will have to be built up in layers, with a special laser light hardening each layer. Using the laser light on these multi-layers may take time.
After that a check will be made that the new filling has not changed or inhibited in any way the natural bite pattern. If necessary, the dentist will trim down the filling to a perfect fit and then polish it again.
In the case of indirect fillings, the dentist will install only a temporary filling, most commonly a composite one, for the time being. Another visit is then required for the indirect filling to be placed, because the material is prepared off-site in a laboratory. What are indirect fillings?
A patient who wants to replace an old filling will discover that the process is quick and painless. Staying with traditional fillings will require only one visit.
Composite resin and tooth-coloured direct fillings are very similar to indirect fillings with just one exception: the indirect fillings are prepared in a laboratory and then trimmed by the dentist at the surgery. This requires at least two visits to the surgery instead of one. However, they are more resistant to damage and last for a longer time.
Dentists use indirect fillings in cases of badly damaged teeth, requiring larger filling materials and sometimes constituting a large part of the tooth. However, if the tooth does not have enough tooth structure for support, then a dental crown will be recommended instead of an indirect filling. Indirect fillings are divided into inlays and onlays. Inlays are smaller, require less work and cover smaller tooth cavities, usually between the cusps of the tooth. Onlays sit on top of the teeth and cover one or more of the tooth cusps. For this reason, onlays are sometimes called partial dental crowns.
Dental fillings should not be mistaken for dental veneers – which are cemented to the front of the tooth – or dental crowns, which are used when more than 30% of the tooth is missing and offer more resistance to bite pressure.
Sometimes only a small part of the tooth, at the front, is visibly chipped. Patients often think that this can be amended by just ‘sticking on’ a dental filling in the right size, especially as it is such a small defect. In most cases, however, despite its relatively insignificant size, a dental crown will be recommended because fillings do not offer a high enough resistance to biting, grinding and physical pressure produced during eating or drinking and may possibly fall off, thereby causing even more damage.
In the case of indirect fillings – inlays or onlays – the laboratory needs impressions of the teeth in order to prepare the filling with precision.
In addition, a temporary dental filling (read about it below) will be necessary to keep the tooth protected from bacteria and food. At the first visit the patient receives a temporary filling which is exchanged for the permanent indirect filling at the second visit.
In comparison to common dental fillings, indirect fillings – inlays and onlays – offer more durability and strength. Sometimes they can last up to 30 years and in total are not that expensive. The materials used for preparing these fillings will be presented in depth below, but generally speaking, nowadays, tooth-coloured composite resin, porcelain, or gold are most often used.
Any larger tooth damage requires the application of a bigger single-tooth restoration. Since inlays cover only the space between the tooth’s cusps, they cannot be used for major restorations, whereas onlays cover the cusps, so are a good repair option. A dental crown covers the whole upper part of a tooth, or just part of it, offering more protection and resilience. However, of the two – onlay and crown – dental onlays are the cheaper option.
Direct dental fillings do not require a lot of time or complicated procedures to be inserted. So, if the dentist is using a direct filling, often about one hour is required to complete the whole process. More precision and shaping, especially when it comes to tooth cusps, may take longer, especially if the dentist uses a dental or rubber dam to isolate the tooth.
Where there are several cavities to fill, indirect fillings are being used or root canal treatment is required beforehand, multiple visits and longer appointments may be necessary. It will depend on the condition of your teeth.
Temporary fillings are used under the following circumstances:
The most basic and rudimentary condition for avoiding cavities and thus need for dental fillings is of course keeping regular good oral hygiene. Brushing your teeth twice a day and flossing once per day should keep your teeth in good condition – providing you don’t smoke or e-smoke. Any plaque, debris and food particles, especially sugar, which has accumulated between your teeth can be easily removed in this way.
The brushing process should take at least several minutes. Avoiding the over-use of mouthwashes is also a good idea as chlorhexidine, which is a common ingredient of mouthwashes can cause discolouration of the teeth.
It is equally important to regularly visit your dentist for check-ups and the hygienist for scraping, polishing and cleaning. This is the most effective way to prevent and quickly fight off caries and cavities.
If a cavity is left untreated, in time, the tooth will decay eventually lead to more problematic dental issues and diseases. Keep in mind that filling any dental cavity nowadays is a very quick and painless process, so there is no need to worry.
Several dental filling materials are currently available on the market. Teeth can be filled with gold, porcelain, silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper), or tooth-coloured composite resin fillings. There is also a material that contains glass particles and is known as glass ionomer, used in a similar way to composite resin.
The factors which have the greatest influence on the type of dental filling most suitable in your particular case, include the condition of your teeth, insurance policy stipulations, specialist’s recommendation, and of course the cost of the procedure.
Nowadays, there are several options on the market from which to choose. From the most established materials to the newest the list looks like this:
Recently there have been growing concerns over amalgam dental fillings, due to the inclusion in them of the toxic substance – mercury. Mercury is thought to be responsible for a number of diseases like Alzheimer’s, autism, or sclerosis. Public health organisations like ADA, FDA and others have not confirmed such claims, despite agreeing that mercury is detrimental to pregnant women and may have neurotoxic effects on the human nervous system. There is no scientific data to back up such claims, however, the retreat from silver fillings on the dental market continues. The shift in FDA and ADA’s stand on mercury use in dental fillings is due to lawsuits filed by consumer groups.
There is no single perfect solution that suits every dental case. It all depends on the condition of the cavities, extent of the damages, necessary treatments involved, aesthetic preferences, allergies to certain substances, and of course the cost of the procedure and materials employed by the dentist.
Anytime you drink, eat, chew, bite your nails or even speak you’re possibly wearing down your dental filling, if it is in a place affected by the action. Depending on the area, filling size, health of tooth, or other dental problems, typically dental fillings last approximately:
All of the above are, of course, average lifespans, which can be altered by good or bad oral habits.
Dental Filling Allergies and Deteriorating Fillings
There are many dental filling health problems and issues, though most of them are unlikely if the procedure is performed by a specialist. Risks and complications of having a dental filling are as follows:
Does Dental Insurance Cover the Cost of Composites?
Most dental insurance plans cover the cost of the composite fillings up to the price of the silver filling, then the patient may have to pay the difference.
How Should I Care for My Teeth With Fillings?
To maintain fillings, you should follow good oral hygiene — visiting your dentist regularly for cleaning, brush with a fluoride toothpaste, floss and use an antibacterial mouthwash at least once daily. If your dentist suspects that a filling might be cracked or is “leaking” (when the sides of the filling don’t fit tightly against the tooth) this means that debris and saliva can seep down between the filling and the tooth, and lead to decay. X-rays are needed to assess the situation. If your tooth is extremely sensitive, if you feel a sharp edge, if you notice a crack in the filling, or if a piece of the filling is missing, call your dentist for an appointment.
Dental fillings are a cheap alternative to dental veneers and crowns, especially if funded by the NHS or inserted abroad, where you can obtain fillings at less than half the price in the UK and USA.
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