Treatments - Dental Fillings

Fillings are dental materials used to fill the holes created by decay or wear of teeth. They can be called cosmetic fillings when used to mend a broken tooth, close gaps between the teeth (diatema closure) or to alter the shape or colour of the teeth.

Caries or dental decay is a disease in which the tooth is destroyed by softening as a result of growth of microorganisms on and around the teeth in the presence of food particles. There are essentially three causes for tooth decay: (1) bacteria in the mouth; (2) food for bacteria, and (3) susceptibility to decay such as heredity or age. Dental plaque is mainly responsible for initiation of decay. Plaque is food debris and their products which form a sticky, concentrated film that adheres to the teeth.

Tooth decay is a gradual process which generally begins in the outer layer of enamel. The longer this process is untreated, the greater the rate of destruction until the decay reaches the dentin and then affects the pulp tissue (which contains tiny nerves and blood vessels). It may then cause pain and sometimes even facial swelling due to pus formation (abscess).

           
                                                    Tooth decay

Fillings are placed after cleaning the decayed and weakened tooth structure using appropriate small drills. This is usually a painless procedure unless the decay has reached the deeper pulp tissues, in which case the dentist needs to evaluate the tooth more closely. Sometimes local anaesthesia may be required to numb the tooth so that painless cleaning is possible.
Different types of materials are available today with different properties of colour and strength. Your dentist will decide the best material for you depending upon the type and site of decay.

                    
             Before                                                     After

Fillings can be done directly by using materials such as dental cements, amalgam (silver fillings) or composite resins (which harden by blue light). They can also be done indirectly (fabricating restorations outside the mouth) and these are called inlays or onlays (made of metal, composite or porcelain) which are then fixed in the tooth.

Dental composites have become popular as filling materials because of their excellent colour matching, translucency  and texture which can simulate the real tooth closely and provide much better aesthetic results than old amalgam / silver fillings which can be unsightly when a person smiles. Cosmetic dentists often replace old metal fillings with these tooth coloured fillings. There is much debate in dentistry about the safety of mercury containing silver amalgam fillings in the long run.

                    Before                                                  After
Fillings if done in time can prevent further more invasive procedures such as root canal treatments, minor surgeries to preserve the tooth or extraction (removal) of the tooth.