Filling is the most common method of restoring damaged teeth. It is used in the treatment of cavities, pulpitis, restorations after traumatic damage (chips, fractures). In general, the filling restores the anatomical integrity of the tooth, its normal functioning, as well as prevents further development of the processes of destruction, in particular caries.
Indications and Contraindications for Fillings
Fillings are applied in the following cases:
- Treatment of caries.
- Fillings after traumatic damage – chipped enamel, fractures, deep cracks affecting the tooth roots.
- Increased erosion of the enamel surface due to careless handling of teeth – eating too hard food, opening hard objects, biting nails, etc.
As such, there are no contraindications to the placement of fillings, but there may be restrictions depending on the materials used. For example, some types of fillings are not used on front teeth, because they are visually very different from the enamel.
Types and Materials of Fillings
Fillings are divided into permanent and temporary fillings. A temporary filling is installed during treatment, when it must be broken down into several stages. Accordingly, its service life is short – a maximum of 2 weeks. It is used in the following cases:
- Treatment of deep caries, in which it is necessary to assess the need to remove the pulp. After removal of carious tissues, a temporary filling is placed in the cavity that was formed, and wait a few days. If the tooth does not bother the patient, a permanent filling is placed, but if the patient feels painful, the treatment is continued.
- Treatment of pulpitis. The temporary filling will isolate the medication left in the root canal cavity and prevent the entry of pathogenic bacteria into the tooth cavity.
- Fabrication of ceramic inlays. Inlays are made in the lab for several days, during which time the treated cavity must be sealed.
- A large amount of treatment is required, when the patient is physically difficult to sit in the dentist’s chair for hours on end.
Zinc oxide is the material most commonly used for temporary fillings, but light polymer and glass ionomer cements can also be used. The choice of material is determined by the dentist based on the clinical situation.
A permanent filling is placed after the teeth are treated. Its main purpose is to restore the defect that was formed by the destruction of dental tissues, and to prevent the development of a secondary pathological process. The lifespan of permanent fillings varies from several years to several decades, depending on the material used and the condition of the tooth.
Dental Fillings Types with Description
What materials are used:
- Metals: amalgam, gold. These materials are strong and durable, but have extremely poor aesthetic properties. In addition, amalgam fillings have a certain toxicity. For a while, these materials were hardly used in dentistry, but oddly enough, the demand for them is starting to increase, including gold. This material is durable, inert and has a mild aseptic effect. Gold fillings are installed on chewing teeth, if the thickness of the enamel is sufficiently preserved.
- Plastics. They are more aesthetic than metal, and also cheaper. This is where the advantages end. The disadvantages are toxicity to the pulp, rapid erasability, a tendency to discoloration and deformation. At the present time they are rarely used.
- Cement fillings. They require serious grinding away of the healthy tissue, are quickly destroyed, can not imitate the color and density of the enamel. They are also seldom used today.
- Glass ionomer fillings. They are non-toxic, well compatible with biological tissues, and contain fluoride, which provides prevention of caries and prevents further decay of the tooth. They are also characterized by high compressive strength. But there are also disadvantages – low aesthetic properties, high wearability. Mostly used in pediatric dentistry in the treatment of chewing teeth.
- Ceramic inlays. They are made of ceramic materials, are strong, reliable and maximally close to the parameters of enamel, both in aesthetic and functional parameters. The service life of the filling is dozens of years. Some manufacturers claim 25. allow the restoration of extensive defects, with damage up to 2/3 of the crown of the tooth. The disadvantages are the high cost and the need for high-tech equipment, which limits their availability and mass application. Not every dentistry provides these services.
Currently, in most cases, composite materials are used for fillings. Light-cured and self-cured fillings are the most popular:
- Light-cured fillings are so named because they require exposure to light with certain parameters (blue spectrum with a wavelength of 450-480 nm) to “cure”. Until exposure to light, the filling remains soft, which allows the doctor to carefully adjust it to the shape of the defect to be corrected.
- Chemical fillings are cured through a chemical reaction that occurs when the components of the filling material are mixed. They are used to fill large cavities, such as after a tooth depopulation.
- Another popular and high-quality material is compomer. It is a hybrid of composite and glass ionomer cements. These fillings have excellent aesthetics, but also high brittleness, so they are used mostly on anterior teeth.
What Are the Best Fillings?
As we have already said, composite fillings, particularly light fillings, are the best quality fillings. They have good aesthetics, high enough durability, they can be used on both anterior and posterior teeth. We recommend these materials in most cases. But the disadvantages should also be noted:
- The service life is limited to approximately 5 years.
- Gradually the material deforms, gaps are formed at the junction between the tooth tissues and the filling, where plaque and bacteria get in, which contributes to the development of secondary caries.
- The self-sealing filling can darken over time.
Stages of a Filling
A filling is always placed in several stages. The first is the treatment of the tooth. In this stage, the diseased tissue is removed, the pulp is evaluated, if necessary, the tooth nerve is removed, periodontitis is treated, and the root canals are filled. These procedures are performed under local anesthesia. In the case of deep dental caries without pulpitis, medicated inlays and insulating pads are used, which are placed in the cavity that is formed. Only after that you can get a filling.
Aftercare Tips for Dental Fillings
To ensure that your filling lasts longer, it is recommended to follow a few rules:
- Brush your teeth regularly, at least twice a day.
- Once every six months, have a professional oral hygiene treatment that removes plaque and tartar and grinds the filling.
- The price of dental treatment will depend on the size of the filling and the material used. The cheapest materials are amalgam, plastic and cement. The most expensive are ceramic inlays. Optimal solution is light polymers, they are affordable and have good aesthetic qualities.