Most of
us who have regular dental visits have been told one or
several times by our dentist that some of our teeth have
dental caries and that we need to have them filled. We usually
get surprised because, from what we’ve been told by our
families and friends, teeth that need to be filled are those
that have large cavities or those that are painful. Cavities
have to be filled as soon as they are spotted. A painful
tooth is a sign that a tooth may be severely infected. If
this is the case, the dentist will consider other treatment
options such as extraction or root canal treatment.
Restoration of the tooth at this point is postponed until the
cause of the pain is removed.
WHAT ARE
DENTAL CARIES? HOW DO I SPOT THEM?
Dental
caries, or more commonly known as cavities, is one of the
common diseases of the oral cavity. It starts with the
demineralization of the enamel (outer covering of the tooth),
which is manifested as a chalky white spot, which may turn
darker. This demineralization makes the enamel weak and if
this process is not stopped, the cavity increases in size and
depth until it reaches the pulp tissue inside the tooth. When
this happens, the tooth becomes painful. Cavities may appear
small on the outside but are actually large on the inside of
the tooth. This is due to the configuration of the enamel.
Large
cavities may be manifested by a difference in the color of the
tooth with the one next to it. The discoloration is usually
grayish.
Sensitivity or pain is also an indication that your tooth MAY
need restoration. It is best to see your dentist so that he
can evaluate whether or not the tooth is for restoration.
WHAT CAN THE DENTIST DO IF I
HAVE DENTAL CARIES?
Commonly, restorations are performed on carious
teeth. Restoring teeth involves removal of the infected areas
of the tooth and replacing it with the appropriate materials
so that the tooth can resume its normal function.
IS IT PAINFUL TO HAVE MY
TEETH FILLED?
That would depend on the depth of the cavity.
Restoration of teeth with small and shallow cavities is not
painful. Restoration of teeth with large and deep cavities
may become painful especially when it gets near the pulp.
Your dentist may have to administer a local anesthetic in
these cases.
WHAT
ARE THE MATERIALS COMMONLY USED TO RESTORE TEETH?
The materials used for restoration are dental
amalgam, composite, metal alloys, gold, glass ionomer cement,
and zinc oxide eugenol cement. The dentist will decide which
material is best suited in restoring the tooth based on the
oral examination and the patient’s needs. Dental amalgam,
composite, metal alloys, and gold are used as permanent
restorations. Glass ionomer cement is usually used in cases
where in the release of fluoride is needed, i.e. children’s
teeth. Zinc oxide eugenol is used mainly as a temporary
restoration.
WHAT
IS THE DIFFERENCE BETWEEN A PERMANENT RESTORATION AND A
TEMPORARY RESTORATION?
As their
names imply, a permanent restoration lasts longer than
a temporary restoration. A temporary restoration, also
called an intermediate restoration, is a type of
filling material used in tooth preparations that will receive
lab-fabricated/casted restorations. A temporary restoration
is also used in teeth with deep cavities where in the
condition of the tooth’s pulpal tissue requires further
observation.
If I have a temporary
filling, when should I come back to have the tooth permanently
restored? / further evaluated?
Your dentist will advise you as
to when you should come back to the clinic.
As an intermediate restoration,
temporary restorations are usually replaced once the permanent
restoration is ready for placement. This applies to casted or
lab-fabricated restorations such as inlays.
For deep cavities, your dentist
will advise you when to come back for pulpal evaluation. The
observation period can last for a few days to a few weeks.
NOTE: Temporary restorations do not last as long as permanent
restorations. It is important to heed your doctor’s advice
regarding when you should return for further treatment.
Failure to do so could lead to complications.
I
HAVE A FEW SILVER TOOTH FILLINGS. THEY SAY THAT THESE SHOULD
BE REPLACED WITH TOOTH COLORED ONES BECAUSE THE SILVER ONES
HAVE MERCURY IN THEM. IS THIS ADVISABLE?
Not really. It is true that the silver
restorations have mercury in them and that mercury is toxic.
But the amount of mercury in the restoration is negligible.
The mercury also stabilizes once the restoration is fully
set. The only way for mercury to leak out of the restoration
is when the restoration is subjected to extremely high
temperatures. The temperature of hot food is not enough for
the mercury to leak out of the restoration and get into your
system. The only time an amalgam restoration needs to be
replaced is when it is broken or when there is recurrent
dental caries.
THERE ARE SPACES BETWEEN MY FRONT TEETH. I DON’T WANT TO GET
BRACES. IS THERE ANY OTHER WAY TO CLOSE THE SPACES?
Restorative dentistry is not limited to teeth
affected with dental caries. Some aesthetic concerns, such as
spaces between teeth (diastemae), tooth discoloration and
staining, crooked teeth, etc., can also be addressed.
NOTE: Not
all spaces between teeth can be closed by putting fillings
within the spaces. The dentist will conduct a thorough
evaluation and measure the amount of spacing. Extremely large
spaces can only be corrected through orthodontic treatment.
Merely restoring large spaces will result in extremely large
teeth that may look disproportional.
SOMETIMES
MY TEETH HURT WHEN I EAT ICECREAM. WHAT CAUSES THIS? HOW CAN
THIS BE TREATED?
There are many reasons for a tooth to become painful (or
extremely sensitive) when one eats ice cream or cold food in
general. The most common causes of tooth sensitivity are
receded gums or teeth with abrasion/erosion/abfraction defects
(teeth with notched areas near the gum line.) Deep notches
are restored. Shallow notches usually receive desensitization
procedures only. |
