Fillings

Dental Fillings

If you have never had a cavity, congratulations! If you have had one, you are not alone. About 78% of us have had at least one cavity by the time we reach age 17, according to a 2000 report by the U.S. Surgeon General. Fortunately there’s a time-tested treatment for cavities: the dental filling.

Fillings do just what the name implies — seal a small hole in your tooth, i.e., a cavity, caused by decay. This prevents the decay (a bacteria-induced infection) from spreading further into your tooth and, if untreated, continue on to the sensitive inner pulp (nerve) tissue located in the root canal. Should that happen, you would need root canal treatment.

There are a variety of materials used to fill teeth these days, but the process of filling a tooth is similar regardless. The first step is a clinical exam of the tooth with x-rays, to determine the extent of the decay. Then the decayed area of the tooth is removed, usually with a handheld instrument such as a dental drill. Of course, your tooth will be anesthetized first, so you won’t feel any discomfort. If you normally feel nervous about receiving numbing injections, it’s possible that taking an anti-anxiety medication or using nitrous oxide can help you feel more relaxed. After removing the decay, the remaining tooth structure is roughened or “etched” with a mildly acidic solution; then translucent cement is applied to bond the tooth and the filling material together.

Bonding uses tooth-colored materials to replace missing tooth structure or hide cosmetically unappealing minor defects in a tooth — chips, discoloration, and even minor spacing irregularities. Bonding materials are called “composite resins” because they contain a mixture of plastic and glass, which adds strength and translucency. The composite actually bonds, or becomes one, with the rest of the tooth.

Composite resins come in a variety of tooth shades for truly lifelike results. When bonding is done with a skilled hand and an artistic eye, it may be impossible to distinguish the bonded tooth from its neighbors. Though bonding will not last as long as a dental veneer, it also does not require the involvement of a dental laboratory and, most often, can be done without drilling of the tooth. It’s a particularly good solution for teens, who often need to wait until their teeth have finished maturing before choosing a more permanent type of dental restoration.

The Bonding Process

Because it does not involve dental laboratory work, tooth bonding can usually be accomplished in a single visit to the dental office. Expect the whole procedure to take 30 minutes to an hour. First, the surface of the tooth to be bonded will be cleaned so it is plaque-free. The surface will then need to be “etched” with an acidic gel that opens up tiny pores in the surface. After the etching gel is rinsed off, the liquid composite resin in a well-matched shade is painted on in a thin layer, filling these tiny pores to create a strong micromechanical bond. A special curing light is used to harden this bonding material. Once the first layer is cured, another layer is painted on and cured. Layers can continue to be built up until the restoration has the necessary thickness. The bonding material is then shaped using a dental drill to give it just the right form. Once the tooth not only looks great but fits in perfectly with your bite, it will receive a final polishing.

Caring for Bonded Teeth

Bonded teeth should be brushed and flossed daily, and professionally cleaned at the dental office twice per year, just the same as the rest of your teeth. The most important thing to keep in mind about caring for your bonded tooth is that composite resin can absorb stain, just as natural teeth can. Therefore, you will want to avoid smoking, red wine, coffee and tea to the extent possible. Also, while composite can darken, it cannot be lightened. So if you are thinking about having your teeth whitened, it should be done before your tooth is bonded so that a composite shade can be selected to match the lighter color of your whitened teeth. If you whiten your teeth after bonding, the bonded tooth may not match all the rest. Finally, try not to bite your nails, hold writing implements in your mouth, or use your teeth in other ways that could put excessive force on the bonding material and chip it. With proper care, a bonded tooth should stay beautiful for 3 to 10 years.