When a Filling is Necessary
This tooth restoration method is used to restore the aesthetics of a tooth unit and its chewing function. It allows for the prevention of further enamel destruction, protects the soft tissues of the tooth from physical impacts, the penetration of pathogenic microorganisms, and, consequently, prevents the recurrence of the disease. Tooth fillings are most often performed at the final stage of treating caries or pulpitis. The doctor removes the affected tissues, shapes the cavity, and seals it with a filling. The dentist may also fill pre-cleaned root canals.
There are other situations in which this dental technique is applied:
- The need to restore a tooth caused by cracks, chips: most often, such defects are found on the front teeth;
- Tooth shape abnormalities caused by developmental anomalies;
- Tooth fracture as a result of trauma;
- Increased wear of tooth enamel caused by bruxism, frequent consumption of hard foods, such as crackers or candies, harmful habits like opening bottles with teeth;
- The need to replace an old, partially destroyed filling;
- The presence of interdental gaps, known as diastemas;
- Preparation for implantation or veneer placement.
Fillings are used if the tooth is destroyed by no more than 30-50%. If the degree of destruction is higher, other restoration methods are required.
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Contraindications
Tooth filling is a safe and effective technique. However, there are situations in which it is not applied.
The main contraindications to filling installation are:
- Destruction of the crown part of the tooth by more than a third;
- The presence of excessively deep carious cavities;
- Subgingival destruction;
- The inability to isolate the tooth or the formed cavity from moisture;
- Individual allergic reaction to the materials used for filling;
- Inflammatory processes in the oral cavity – fillings can be installed after resolving the issue.
Also, some types of materials are not used for restoring front teeth due to a significant visual difference from enamel.
Dental Filling
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Dental Filling
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Main Types of Fillings
Modern dentistry uses different types of fillings, which vary in terms of duration of use and the material from which they are made.
By Duration of Use
Fillings are divided into temporary and permanent based on this criterion.
Temporary fillings are placed for a limited time, maximum – for a few weeks, and then replaced with permanent ones. They are most often used to isolate a prepared tooth or to fix medicinal material used in nerve removal and treatment of infections affecting the tooth's internal tissues.
The main component used for their manufacture is artificial dentin.
Permanent fillings are installed for a long term, measured in years, hence they are characterized by increased strength. They:
- Seal treated carious cavities;
- Restore the anatomical shape, aesthetics, and chewing functions of the tooth.
By Material
Dental cement is a universal material used not only for filling but also for fixing crowns and bridge prostheses. Cement fillings are considered a classic in dentistry. Several types of cement mixtures are used:
- Glass ionomer – based on silicon quartz;
Phosphate – based on zinc oxide.
Cement fillings are especially often used in pediatric dentistry for filling milk teeth. Their advantage is the release of fluoride ions, providing a preventive anti-caries effect.
- Advantages of cement fillings include:
- Relatively low cost;
- Good plasticity, especially important for filling cavities and canals;
Resistance to wear.
However, this material tends to crumble under chewing loads. Phosphate-type fillings have low aesthetic properties and are not used in the smile zone.
Amalgams are alloys of certain metals, especially those based on copper and silver, frequently used in dentistry. Other options are possible, but many of them are toxic, so doctors have long abandoned their use.
Amalgam fillings are strong, inexpensive, suitable for restoring severely damaged teeth. However, they have low plasticity, and many patients develop an allergy to the metal.
Composite photopolymers are the most popular material for tooth fillings. Their peculiarity is that they are soft, pliable, easy to shape, but harden under ultraviolet light in one to two minutes.
The characteristics of composite photopolymers depend on the filler, so the doctor can choose a solution for any teeth – those in the smile zone and those subject to high chewing loads. When restoring front teeth, a composite that does not differ in shade from natural tooth enamel is used.
- Advantages of composite photopolymers:
- Quick curing;
- Good cavity filling;
- Long service life;
- Versatility – suitable for restoring any teeth.
The main disadvantage is that the material does not release fluoride, therefore does not prevent the development of secondary caries.
Dentists also use compomers – materials that combine the advantages of cements and composite polymers. They are more often used for the restoration of front teeth.
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How Tooth Filling is Performed
The procedure for installing a filling consists of several steps.
Diagnosis
The dentist begins by examining the patient. A panoramic or targeted X-ray is essential, helping the dentist to:
- Assess the condition of the affected tooth;
- Determine the scope of work;
- Formulate a treatment plan.
Preparation
Professional cleaning may be required, during which the dentist removes plaque containing pathogenic bacteria from the tooth surface.
Anesthesia
Tooth filling is a painless procedure. However, it is often performed after treating the cavity with a dental drill, causing pain for the patient. Therefore, anesthesia is required.
The traditional solution is local anesthesia, where the dentist injects an anesthetic. Additionally, especially in treating children, topical anesthesia can be applied before the injection to achieve maximum pain relief. In complex situations, general anesthesia or sedation is used. If there's a suspicion of an individual intolerance to certain anesthetics, a provocation test is conducted. If an allergic reaction is observed, the dentist will suggest an alternative.
Isolation of the Working Area
The dentist uses a medical retractor and rubber dam to:
- Protect the rest of the teeth and soft tissues of the oral cavity from mechanical impacts;
- Isolate the area being operated on from saliva – for better adhesion with the filling material, the tooth must be dry.
Isolating the working area with a rubber dam also creates contrast, helping the dentist focus on treating a specific section.
Preparation
The dentist uses a dental drill to remove the affected tissues. Then, they rinse the formed cavity with antiseptic and dry it.
Selection of Filling Material
The dentist decides which material to use and selects the appropriate shade. This is particularly important when placing a filling on front teeth, which are visible to others when the person talks or laughs. Currently, dentists have materials of various shades available, allowing them to find an option that harmonizes with the natural color of the patient's tooth enamel, to avoid drawing attention to the fillings.
Filling
When using a light-curing composite, the dentist:
- Layer by layer, places the material into the cavity;
- Cures each layer with an ultraviolet lamp.
Final Processing
At the end of the procedure, the dentist checks the bite to ensure the filling does not cause the patient discomfort. The surface is then polished.
Additional Treatment
Sometimes, an additional step is added – applying a special fluoride-containing compound to the tooth surface. This is done to strengthen the tooth enamel.
The duration of the filling procedure depends on the specific situation and usually varies from 30-40 to 90 minutes.
AESTHET Dental Clinic is a medical center located in Dubai (UAE), Bluewaters Island. We have highly qualified doctors with extensive practical experience at your service. They have everything needed for high-quality tooth filling: modern equipment, first-class instruments, and advanced materials.
Prices for filling installation are listed in the price list posted on the website. Contact the administrator to ask about the cost of services and to make an appointment with a doctor.
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FAQ
The dentist selects the appropriate solution based on the specific clinical situation. However, we recommend using light-curing fillings, i.e., those made from photopolymer material that hardens under the influence of ultraviolet light. They are strong, durable, and aesthetic, lasting for 5 years or more, and are suitable for use in the smile zone.
Another option is glass ionomer cement. Its composition includes components based on silicates and acrylic. It has high adhesion to the tissues that make up the tooth and can be used for filling root canals.
In some cases, the use of both options – photopolymer and glass ionomer cement – is appropriate. This approach is used, for example, if there is a need to prevent the recurrence of caries.
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