PRINTED IN TCI WEEKLY NEWS
Sept 8th, 2012
A filling (or restoration) is required when there is a cavity (hole) in the tooth. The filling will replace the missing enamel and dentine which make up the hard parts of a tooth.
A hole can occur for several reasons- decay, abrasion and erosion. Decay occurs when sugars and/ or acid have been allowed to build up and attack the enamel of the teeth. Abrasion happens when an area of the tooth has been worn away, and erosion occurs when the enamel has begun to dissolve due to the direct effects of acid on the tooth. This can be seen for example if you consistently eat lots of citrus fruits, suffer with stomach acid reflux or vomit on a regular basis.
If the hole is due to decay, this is usually visible to a dentist and can be identified by the area of the tooth turning brown in colour. In some instances it may not be immediately obvious and it may be that the first sign is the pain. In this case a dentist would x-ray the tooth in question.
Before a filling is placed, the decay is completely removed. If this is not done properly, the decay will continue to erode the tooth underneath the filling and it is likely to become painful.
Metal or White fillings
Metal (amalgam) fillings contain mercury which is known to be toxic. I consider them to be an old-fashioned treatment option and nowadays there are certainly superior alternatives. Personally I have not placed a metal, mercury-based filling for over 15 years. The white (composite) fillings do not contain mercury, are as strong as metal fillings, are bonded to the tooth and are aesthetically more attractive due to them matching the colour of the existing enamel/ other teeth.
The composite material is available is different shades so your dentist can get a good colour match to your natural tooth colour.
If you already have metal fillings in your teeth, they can be replaced with the white fillings. There are two reasons why a metal filling would be changed. Firstly, if the metal filling is breaking down and so potentially releasing the amalgam particles into the body it is clinically advisable to have the fillings replaced. The second reason is cosmetic and is a personal choice in order to achieve a more natural look. However, if your metal fillings are smooth, shiny and not breaking down there is no immediate need to change them.
During pregnancy metal fillings would not be placed or removed, unless there is clear evidence that the filling is breaking down and the risk of leaving it is greater than removing it.
Fissure Sealing
This is a preventative treatment whereby a liquid filling material is used to fill in the narrow fissures (grooves) in the molar teeth. It works by preventing material getting into these hard to clean places and it is proven to reduce the risk of dental decay.It is routinely recommended for children around the age of six or seven, when the first adult molars are completely erupted and can be a useful treatment for some adults.
Composite build-up to combat erosion or abrasion
The groove formed by the action of erosion or abrasion is commonly seen where the tooth meets the gum. This can often lead to pain or sensitivity. These grooves can be filled by bonding tooth-coloured filling material to the tooth.
Chipped teeth can also be built up and repaired using the bonded composite, tooth-coloured filling material.
