Restorative Dental Treatment - Filling Treatment
This method involves removing unhealthy tooth tissue damaged by decay or trauma and modifying the remaining cavity with filling materials. Fillings can be performed for health reasons as well as for aesthetic concerns. For front teeth in particular, where we are dissatisfied with their appearance, bonding can be applied using special filling materials that match the natural tooth colour and can be shaped as desired within the limits of the anatomy. There are also abrasions that cause tooth tissue loss without decay. These are attrition, abrasion and erosion. The most common of these is the abrasion of the enamel at the gum line, which is the weakest point of the teeth, due to forces such as teeth grinding. Although no decay occurs, the exposure of the dentine layer beneath the enamel due to wear can cause sensitivity. To prevent this, the exposed dentine structure can be covered with a filling, thereby resolving the sensitivity.
Filling Treatment
Contents
How is Filling Treatment Applied? What are the Types of Fillings?
Dental tissue damaged due to decay or trauma is cleaned after local anaesthesia is administered, and a cavity free of decay is prepared for filling. Preparations are made based on which filling material will be applied to the prepared cavity. If composite filling is to be applied, the tooth is isolated and then the white composite filling is bonded to the tooth using advanced adhesion systems. If porcelain filling is planned, the cavity is measured and the measurement is sent to the laboratory. A second appointment is scheduled for 1-2 days later, and the porcelain filling is bonded to the tooth using special adhesives.
Your dentist should decide which filling material to use. Your dentist will choose the most appropriate filling material and carry out the procedure based on factors such as the structure of the tooth and the size of the area that needs to be cleaned. Filling materials can be explained as follows:
Amalgam Filling
Amalgam fillings are preferred due to their high resistance to wear and tear and their cost-effectiveness. However, their dark colour means they are not often used on front teeth. Therefore, different filling materials may be preferred for cavities in the front teeth. However, we can state that amalgam fillings are an ideal option for teeth in the back regions, especially those frequently used for chewing.
Composite Filling
This filling material, often preferred because it matches the colour of teeth, also stands out for having a shorter lifespan than others. With a lifespan of 3 to 10 years, this filling material is not very resistant to wear and tear.
Porcelain Filling
Porcelain fillings, which are resistant to staining, are also prepared in the laboratory specifically for each patient and applied using the bonding method. They can be comparable in cost to gold fillings.
The best filling is one that is applied in the right place with the right technique for the right indication. For example, if a composite filling is used on a tooth with extensive decay, there is a risk of fracture. The patient should be informed of the need for an onlay, and should be guided towards the option that will provide them with long-term, healthy use.
Which Filling Should I Have Done?
The most significant issue with composite fillings was adhesion, meaning the micro-mechanical bonding of the filling to the tooth. With advancing technology, the adhesion problem has been largely resolved, enabling composite fillings to surpass amalgam. Patients now want aesthetic fillings that can mimic the colour of any tooth, rather than black-looking fillings. We therefore prefer composite fillings as our first choice. However, there are still some situations where we cannot and should not use composite.
- We should not use it in areas where we cannot prevent moisture, blood and saliva contamination, especially near the gums. This is because this situation negatively affects the bond, causing discolouration, leakage, secondary decay in unbonded areas and sensitivity.
- The c factor, also known as the configuration factor, is the ratio of the bonded surface to the unbonded surface. If we do not want excessive polymerisation shrinkage, this factor must be close to 1. If we cannot ensure the lower limit of this ratio, we should not use composite.
- There is a difference between the modulus of elasticity of the composite and that of the tooth. Composite should be avoided when a large portion of the tooth needs to be restored, as fractures may occur due to differences in modulus of elasticity. Porcelain has properties closer to those of the tooth, allowing it to move with the tooth.
In cases where we cannot choose composite, we prefer porcelain fillings due to their colour advantage, compatibility, and because our patients do not want black fillings. Amalgam can be used for large cavities under prostheses and those close to the gums.
Should I have my amalgam fillings replaced?
Old amalgam fillings that were placed at the appropriate time do not need to be replaced unless there is a medical necessity, such as a fracture or decay. Once an amalgam filling has been placed and polished, it no longer releases mercury. If amalgam needs to be removed, it should be done under appropriate conditions, using a rubber dam and good suction. This is because the energy generated by the rotational force during removal may cause mercury release.
Is the Filling Procedure Painful?
When anaesthesia is administered, pain is never felt, only perceived as a sensation. After the anaesthetic wears off, pain is generally not felt, but sometimes there may be sensitivity for 1-2 days depending on the depth of the cavity. This is also temporary and can be easily relieved with painkillers.
Why Do Teeth Decay During Pregnancy?
During pregnancy, the expectant mother’s saliva production slows down. Due to this slowness, the saliva necessary for cleaning the teeth is not produced. Therefore, cavities begin to form. At the same time, if there is a cavity in the early stages before pregnancy, this condition becomes even faster during pregnancy and decay occurs. Expectant mothers should pay much more attention to oral and dental health during pregnancy. They should not neglect to visit the dentist throughout their pregnancy. Hormonal changes can also cause gum problems. In this regard, you need to be very careful about oral and dental hygiene. You should consume liquid foods to ensure sufficient saliva secretion. This way, you can prevent tooth decay during pregnancy.
Should I Have Root Canal Treatment or a Filling?
This is not a matter of choice. Each treatment has its own specific areas of application. Teeth have three layers: enamel, dentine and pulp. If the decay is limited to the enamel or dentine, a filling should be applied. Root canal treatment should be performed when the pulp tissue and nerves that keep the tooth alive are affected by decay, thermal or mechanical trauma. We can understand that root canal treatment is necessary based on certain symptoms. If the tooth hurts for no apparent reason or if the pain starts due to external factors (such as heat or sweetness) and lasts for a long time, if the pain increases at night and does not go away even after taking painkillers, if there is a visible change in the colour of the tooth, or if there is swelling in the gums even though there is no pain, root canal treatment should be performed on the tooth.
What is the cost of filling treatment?
The cost of filling treatment may vary depending on the number of teeth to be treated, the quality of the filling material used, and the location where the procedure will be performed. However, porcelain fillings are 4-5 times more expensive than normal fillings. The materials used and the laboratory workmanship are reflected in the prices in this way.
Does composite filling discolour?
Over time, composite fillings may become discoloured, yellowed or stained for various reasons. Dentists provide patients with detailed information about what to watch out for after the procedure.
Do amalgam fillings release mercury?
Amalgam fillings contain mercury. However, once hardened, mercury release does not continue.
Should I have my amalgam fillings replaced?
Old amalgam fillings that were placed at the appropriate time do not need to be replaced unless there is a medical necessity, such as a fracture or decay. Once an amalgam filling has been placed and polished, it no longer releases mercury. If amalgam needs to be removed, it should be done under appropriate conditions, using a rubber dam and good suction. This is because the energy generated by the rotational force during removal can cause mercury to be released.
How long does a composite filling last?
Provided that routine oral care is carried out thoroughly and dental check-ups are not neglected, problems such as deformation, leakage or separation in aesthetic fillings will not occur. During routine dental visits, the necessary care processes for aesthetic fillings can be completed, making them more durable.
Is sensitivity after filling normal?
The development of sensitivity to hot and cold after dental filling treatment is considered normal. Although this condition resolves on its own after a while, the use of toothpastes or mouthwashes with sensitivity-reducing properties can be a comfort-enhancing factor.
Does a dental filling hurt?
As a dental filling is a procedure performed under local anaesthesia, the patient does not feel any pain or discomfort during the procedure.
Should I get a filling or a crown? Which is stronger?
The areas of application for the two treatment procedures differ. After the decay has been removed from the tooth, the dentist should make their choice based on the amount of tooth structure remaining. If there is sufficient tooth structure for a filling, then that is the successful treatment. If the amount of tooth structure remaining is insufficient and there is a risk of the tooth fracturing when a filling is placed, then a crown should be fitted to protect the tooth.