Fillings
Tooth decay – what to do – cavities must be filled
Fillings and alternatives
Aesthetic filling
Aesthetic dentistry means that we use materials highly similar to the shape, colour and composition of teeth and to the naked eye are virtually unnoticeable. Amalgam is outdated and as such is not used at our clinic. Old fillings with decays are routinely replaced with tooth-coloured fillings. We use fillings manufactured by 3M as we think they fit best international quality standards. It is a relatively low cost, aesthetically pleasing alternative, but not as permanent as gold or ceramics. These tooth-coloured fillings are not as long-lasting as traditional amalgam fillings, either, so they have to be replaced more frequently. Filling is hardened in the cleansed and prepared tooth with the use of special light. Afterwards the surface is shaped and finally polished.
Should there be a small gap in the hard dental tissues (dentin, enamel) as a result of physical or chemical causes, these chipped or cracked teeth can be corrected with the use of filling materials. Teeth may decay, erode, chip off. If the outer layer, the enamel becomes penetrable, dentin, making up the most part of the tooth comes to the surface and the alive tooth may become sensitive or even painful. This happens because in the dentin channels lead towards the innermost part of the tooth, the so-called pulp. Through these channels nerves inside the tooth are stimulated and we experience toothache. Toothache can be caused by cold or heat, sugary, sweet or acid food and beverages, and, in the case of decay, by bacteria. Besides, dentin is a much softer and much more porous material than enamel, so cavities grow faster in this layer. This is why it is crucial to replace the lost material, thereby preventing further tooth decay and its related consequences of disease and pain in the body.
Fillings can be used in the treatment of minor or medium-sized caries in frontal teeth as well as in molars. Fillings are also used to correct the edge of incisors and canines and to treat cervical abrasions.
Before the filling is applied, the cavity has to be cleansed. Decayed and soft tooth material has to be removed, together with the bacteria, and, if it is on a visible surface, discoloured parts will have to be removed as well. After various steps of preparations, depending on the filling material and surface, the cavity is filled in with a soft and mouldable material that solidifies by itself or upon exposure to light. The surface of the filling is then elaborated and the occlusal surface reproduced and eventually polished in order to get a surface as smooth as that of the tooth.
3M aesthetic fillings
Our dental clinics use the tooth-coloured high-performance light-curing composites meeting the highest aesthetic standards, produced by the market leader 3M ESPE. Composites have been used for decades in dentistry and the latest products are optically so similar to various parts of the tooth (enamel, dentin, cervical and edge areas) that dentists can make „invisible” fillings.
The greatest advantage of new filling materials is that in a treatment aiming to conserve teeth they create chemical bonds with the tooth, which povide microscopic ties. This is why only a minimal amount of dental tissue has to be removed. Only caries and discoloured parts are removed.
The cavity having been cleansed, a special acid is applied to condition the surface that is about to receive the filling. The surface is microscopically unevened and extended then it receives „cement”, a so-called bond, which connects the filling material to the tooth and by consolidating is able to pass pressure from one to the other (from filling to tooth). After the adhesive bond is applied, it is polimerized for a few seconds with blue light. That is when the filling material itself is put into the cavity. It is a composite resin enforced by glass and porcelain granulates, thus biocompatible. The filling is made layer by layer, the mouldable material is applied colour by colour and all layers are exposed to the blue light. As a result, the layers solidify (polymerization) and the filling can be put to use immediately. Layers are created according to the colour most appropriate for the part of tooth, transparent or reflexive and eventually the grooves and edges are formed to reproduce the original shape of the tooth. A natural effect is achieved. As a last step, the filling is finished and polished in order to create a smooth surface. Fillings prepared in this way meet all protective and aesthetic expectations.
Traditional amalgam fillings
Before the invention of aesthetic, composite materials specifically developed for dental fillings, amalgam fillings were used worldwide, that is why so many people today still have amalgam fillings.
If we see amalgam fillings in our patients’ teeth, we recommend that – if no complaints are experienced and no decays are found underneath – they should be kept. However, if the filling needs replacement, we recommend the use of aesthetic filling or inlay.
