Although many do not enjoy getting work done at the dentist (don’t worry, we don’t take it personally), at some point you’ll probably have to. It’s important that, when that happens, you know what to expect and how to make intelligent decisions about your dental care.
Aside from basic cleaning, the most common procedure dentists perform is the filling. There are severe cases in which a filling could be necessary — a chipped or cracked tooth, advanced bruxism – but mostly, if we’re talking about fillings, we’re talking about cavities, holes borne into the teeth by bacteria.
We’ve discussed how decay works before, and how to help prevent it. And while I am sure that you are doing everything absolutely perfectly with regards to your oral hygiene, and only ever eating the best foods and avoiding sugar and tobacco like the plague, cavities are still tricky to stave off. There are lots of places in your mouth for food to get trapped in – between teeth, under gums – and the bacteria are everywhere, waiting for whatever comes their way.
Where a cavity is will play a role in determining how a dentist will eventually go about treating it, but finding the problem is the first hurdle. The best way to get over it is for you to tell us. If you’ve been feeling sensitivity to heat, cold or sweet in any part of your mouth, that’s the first place we’ll look.
Otherwise, most dentists will start poking around during a regular cleaning; literally. You know when we scrape your teeth with that evil-looking spiked? Well, we’re not just doing it to see you squirm. The “explorer,” as it’s called, is used to check the protective enamel coating around your teeth. Enamel is the hardest substance in the body, so if the spike just scrapes the outside, we know that all is well. If there is a little give to the surface, however, or the spike gets stuck at a certain point, that’s usually a sign of a problem.
Like we said, though, sometimes these things are in difficult locations, and for that, we have other tricks. There are dyes that stain weaker areas in the enamel, revealing holes and soft spots, and for the particularly hidden growths, there are dental x-rays.
Ideally, we’re able to spot at risk areas before they develop into full-blown cavities, but none of these techniques is perfect, so sometimes it is not until the situation has reached an unfortunately late stage before it becomes noticeable.
In these cases, a filling will be necessary. Dentists and their clients have several options to work with when this happens, depending on the location and the extent of the damage.
Regardless of which direction you choose to go, the process remains more or less the same. First we have to identify where the enamel has started to give. Then comes the drilling. It’s important to get out all the damaged material, especially parts that haven’t begun to show yet. For that reason, we have to drill around the cavity itself. If the hole goes all the way through the enamel and to the soft, spongy material underneath, a “base” or “liner” is usually required, so that the filling doesn’t irritate the root.
Either way, we’ll also need to shape the hole to fit the mold. From there, all that’s left is to choose which of the various materials used for fillings you want, each of which carries its own advantages and disadvantages.
Gold and silver fillings, interestingly enough, can be on the cheaper side, and lost longer than any of the other options (about 15 years). But not everyone wants prominent mouth jewelry, and the size of the fillings often requires healthy tooth to be removed along with the decaying portions. Temperature changes – a regular part of eating – moreover, will have a greater expansion and shrinking effect on the fillings, which can lead to cracked teeth.
Meanwhile, a composite filling – a mix of glass and resin – will look closer to tooth color, and actually fuse to the tooth, reducing the likelihood that bacteria manages to sneak under the filling and go back to work on the original hole. Composites cost more than metal fillings, though, last only around 5-7 years, and are weaker in general.
Whatever you choose to go with, it will be necessary to come back for regular check ups and maintenance. At some point, too, the filling will need to be replaced.