INFORMATION ON RESTORATIVE DENTAL FILLINGS

Dentists recommend and perform routine procedures every day. At least, they are routine for the dentist. Dentists can sometimes forget that patients can be very nervous about treatments, or that a patient may not really understand what the treatment involves. If you are dental phobic, not knowing exactly what the treatment involves will probably add to your anxiety. Therefore, we’ve prepared a guide to the most common treatments that will hopefully help you to understand some of the most complex jargon, understand the procedures and feel more comfortable about them.

What is a filling?

When teeth decay, cavities form. Food gets trapped in these cavities and causes our teeth to ache. When we get toothache, that is normally the point at which most of us will visit the dentist and find out that we need a filling. There are a number of different types of ‘filling’ for tooth cavities, but they all perform the same function: to plug the gap in the tooth so that the ache stops.

Why do I need one?

Well, let’s imagine what would happen if you didn’t have a filling. The more food that gets trapped in your teeth, then the more problems it creates with tooth decay. Your toothache will, therefore, gradually increase in intensity. A filling will stop the toothache and patch up a tooth with a cavity. However, it will also ensure that they tooth does not degrade any further. This, in turn, may prevent a need for more serious dental work in the future, such as root canal surgery.

What does the treatment involve?

Local anaesthetic is normally required for your dentist to repair a tooth and fill a cavity. Before the cavity is filled, your dentist will drill away the decay and clean the cavity so that no food is trapped in there. The drilling is often the part which sufferers of dental phobia fear most. Once the tooth has been cleaned sufficiently, the cavity is filled with the appropriate material. It usually begins to set hard within a few minutes.

Will I only require one appointment?

How many appointments you require will depend on the amount of treatment involved. Most cavities can normally be filled in one appointment. In more severe cases, the dentist may choose to fill the tooth with a temporary filling. Temporary fillings will stop pain and stop the tooth from decaying any further, but they are not a long-term solution. Therefore, you should make another appointment to return to the dentist and have a proper filling applied.

What questions do I need to ask?

The most important question to ask your dentist is ‘What kind of filling will they use?’. There are two types of filling that are most commonly used by dentists, so make sure you are getting the one you want.

Amalgam Filling: amalgams are probably the type of filling that we all picture in our minds when we hear the word. They are composites of a variety of metals which include mercury, copper, tin and silver. Amalgam fillings harden quickly and last a very long time. However, they can be unsightly because their colour.

Tooth-coloured fillings: the popular alternative to amalgams are tooth-coloured fillings. The issue with tooth-coloured fillings is that the materials do not last as long as traditional amalgam fillings. Therefore, dentists will only usually recommend them if you need a filling in a particularly visible position, for example in the teeth that are visible when you smile rather than in the teeth at the back of the mouth.
Inlays

Inlays are not unlike fillings, they are able to improve and maintain the biting surface of the tooth.

Sometimes, a tooth is planned to be restored with restoration, but the decay or fracture is so extensive that a direct restoration, such as amalgam or composite, would compromise the structural integrity of the restored tooth or provide substandard biting forces. In such situations, an indirect gold or porcelain inlay restoration may be indicated. When an inlay is used, the tooth-to-restoration margin may be finished and polished to such a super-fine line of contact that recurrent decay will be all but impossible.

While these restorations might be ten times the price of direct restorations, the superiority of an inlay in terms of resistance to biting forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers an excellent alternative to the direct restoration.

Dental Crowns

If you suffer from dental phobia, it can often mean that you delay what should be fairly routine dental treatments so that, ultimately, you need even more complex dental requirements. If you avoid having a filling, your tooth may decay further and you may require a crown. So what is a crown and what is involved in having one fitted?

What is a crown?

A crown is usually recommended by dentists when the repair job required on a particular tooth is too big for a filling to be appropriate. One of the advantages of having a crown fitted is that the material is tooth-coloured and tooth-shaped – so once you have your crown in place it will look just the same as your natural teeth.

Why do I need one?

There could be a number of reasons why you need a crown. Ultimately, however, it will be because a filling would not provide the right level of repair. Therefore, people have crowns fitted when they teeth have been broken, perhaps in a sporting accident for example. When teeth are broken, they cannot be ‘filled’ and so a crown is fitted over the top of the broken tooth.

Other reasons why a crown may be required are because a tooth has decayed so much that it will not support a filling. A crown can also be used to provide protection for other types of dental work, for example if you have undergone a root filling or if you have had dentures fitted. Once again, a crown will usually be fitted over the top to protect the repair work beneath.

What does the procedure involve?

The procedure for fitting a crown usually requires two appointments with your dentist. The first visit usually involves the preparatory work, while the second involves actually fitting your crown.

Preparatory work: your crown will be shaped to fit your tooth, so during your preparatory visit your dentist will do two things. Firstly, the surface of your existing tooth will be trimmed and shaped for the crown. Once this has been done, your dentist will create the mould that will form the basis for the shape of the crown. The accuracy of the mould is vital, because the crown will have to complement your other teeth and your bite action, so that it does not affect everyday functions you take for granted, such as chewing.

The fitting: during your first visit, your dentist will usually fit a temporary crown so that the right amount of time can be spent getting your permanent crown correct in shape and colour. It has to be the perfect match for you. It will normally take up to two weeks to prepare the permanent crown. Once you and your dentist are happy with the crown, it is fitted in place with dental cement and should then last for many years.

Should I be nervous about having a crown fitted?

No, not at all. Crowns are usually fitted under local anaesthetic and are no more painful that a conventional filling. If you are dental phobic – particularly if you have a phobia about needles or injections, for example – make sure you talk to your dentist in advance.

What questions should I ask my dentist?

One of the most important questions you will have to discuss with your dentist will be what sort of material your crown is made from. The dental industry is constantly striving to create better materials that are more durable, easier to clean, more natural looking, or more cost-effective. So there are new materials appearing all the time.

Most crowns are made from either porcelain, ceramic or glass. Depending on where you need the crown and how strong it needs to be (teeth at the front do less chewing, so the emphasis may be more on aesthetics here), then the crown may also be partly bonded metal, so that it is stronger and lasts longer.

The majority of people prefer their crowns to look as natural as possible. Some people, however, choose the opposite, and gold is often used too.

Dental Bridge

One of the difficulties for dental phobic patients is the thought that a visit to the dentist for a standard check-up may lead to more complex dental work that is lengthy, expensive and hard to endure. These Q&A articles are designed to provide you with a very brief overview of the different types of treatments and procedures that may be required if you have been avoiding the dentist for a long period of time. This article gives a breakdown of dental bridges: what are they, do you need one and what can you expect from the treatment?

What is a bridge?

A bridge is a technique used by dentists to replace missing teeth. The bridge allows a false tooth to be held rigidly in the place where an existing tooth is missing. The bridge usually attaches to existing natural teeth, so you must have some good, healthy teeth on either side of the missing tooth for a bridge to be an appropriate form of treatment.

Why do I need a bridge?

For many people, it is tempting to think that a missing tooth does not need to be replaced. Often, it won’t cause pain or distress in the way that a decayed tooth will, for example. However, there are a number of reasons why it may be worth considering a bridge to replace a missing tooth. Obviously, there are the issues surrounding facial aesthetics and balance. But also, a missing tooth can make your teeth harder to clean and as food becomes lodged in the gap, then the healthy teeth around that gap are more likely to decay. Your teeth around the gap will also attempt to ‘compensate’ for the gap in your bite and will begin to grow crookedly. So the end result will be that your crooked teeth become far more vulnerable to decay and damage.

What does the procedure for a bridge involve?

As we mentioned above, you need to have healthy teeth around the missing tooth which can provide end supports for the bridge. The first step in the process, once these healthy ‘supports’ have been identified, is to reshape them and place crowns on them. The false tooth is then placed between these two crowns and bonded to them with dental cement. The bridge is a permanent solution for a missing tooth, so once it is in place it cannot be removed in the same way that dentures, for example, can be.

What are the alternatives?

The alternatives will depend on how your current teeth are and whether your dentist thinks you have healthy enough teeth to support a bridge. If not, another option could be a dental implant, a procedure in which the false tooth is fastened directly onto the jawbone. Alternatively, dentures may be a more suitable option for you, as they are more flexible and can be removed for cleaning. Your dentist should talk through the various options with you while you are putting together your treatment plan. What questions should I ask my dentist?

One of the most important discussions to have with your dentist is how you look after your bridge and ensure that it stays clean. In particular, your dentist will show you techniques that help you to clean around and under the false tooth, where food can easily become trapped causing gum disease and halitosis.

It is also important to remember that your bridge is only successful because it can attach to healthy, natural teeth. Regular brushing is required to look after these teeth too, so that they can continue performing the support function that your bridge needs.

Cosmetic Bonding

Dentists are constantly looking for ways to make dental treatment easier and less time-consuming for patients. It is all part of creating a good customer experience. After all, if you know that your dentist is recommending the right treatments at the right times, you can confidently return to them for your next appointment.

Dental bonding is a cosmetic technique that dentists use to repair teeth. It is fast and makes a visible difference. Here’s a few of your questions answered on the subject.

What is cosmetic bonding?

Bonding is the technique of applying a flexible, bonding material to a damaged tooth then hardens and protects it. While it does have cosmetic qualities that improve the look of teeth, it also is used to repair teeth in some cases.

Why would I need it?

Dentists can apply a cosmetic bond to a tooth if it is discoloured or maybe chipped or cracked. Bonding can even be used to fill small cavities or gaps in teeth. This means that damaged teeth or fillings that are usually black and unsightly can be colour-matched to your existing teeth. So it really can improve how your smile looks, as well as providing some protection against decay.

What does the procedure involve?

Cosmetic bonding normally only requires a single visit to your dentist. The bond is applied as a resin, of which there are lots of different types depending on the requirement. It is quite a skill applying the resin in the right shape for your tooth, so your dentist will usually apply it gradually, layer by layer. The resin is then hardened under a curing light – so in many cases, you do not even need a local anaesthetic.

What questions should I ask my dentist?

The only disadvantage with cosmetic bonding is that it is not as strong or tough a material as, for example, traditional amalgam fillings. Therefore, over time, your bonding can discolour or chip. You may also find that your bonding stains. Therefore, you may wish to have a conversation with your dentist about the best way to look after and clean your newly restored teeth. Your dentist may also recommend some adjustments to your diet, such as stopping smoking or drinking coffee.