A filling is a dental procedure where the dentist removes tooth decay in a small to medium sized cavity; and fills the site of the cavity with tooth-colored resin material to restore the tooth’s shape and function.
Tooth caries (cavities / decay) is a common dental problem caused by a variety of factors. Practically 100% of the population will experience dental caries at some point, with a large number of patients getting cavities as early as their childhood and adolescent years. Prevention and early treatment of dental caries is crucial – the longer a cavity remains untreated, the larger it becomes, the more extensive the treatment will be, and the higher the likelihood of premature tooth loss in the future.
There are a number of factors contributing to the formation of cavities in the mouth:
- Bacteria found in plaque, especially when there has been inconsistent or ineffective brushing and / or flossing.
- Dry mouth – caused by side effects of medications, cancer treatment, or mouth breathing.
- Acid exposure from health conditions – such as eating disorders or acid reflux.
- Dietary factors – frequent consumption of sugars, carbonated and acidic foods and beverages which wear out the enamel and lead to tooth decay.
- Aggressive brushing – especially with medium or hard toothbrush bristles. Aggressive brushing thins out the enamel over time and leads to tooth decay.
- Anatomical variances – such as deep grooves, hairline fractures, or chipped enamel – make teeth more prone to decay.
- Misalignment and / or crowding of the teeth – the lack of proper alignment compromises enamel in two ways:
- by making it harder to floss and remove food debris between the teeth;
- when the forces of the bite are not equally distributed, the teeth will become more prone to chips and cracks, leading to tooth decay over time.
- Orthodontic devices – braces and permanent wire retainers make it very difficult to keep plaque controlled, thereby contributing to tooth decay. Removable aligners and retainers offer a better choice when it comes to preventing tooth decay.
- Genetic or developmental defects of the enamel – such as amelogenesis imperfecta, or enamel hypoplasia (thin enamel).
The standard of care for small to medium sized cavities is a composite (white) filling. A composite filling is typically done in a single visit.
The patient is typically numbed with local anesthetic.
- The dentist removes the portion of the tooth structure that is decayed.
- Cotton may be applied near the cheek or tongue to keep the area dry.
- Liquid etchant or bonding agent is applied first to help the composite material attach. Sometimes it is necessary to apply a plastic strip or a matrix band between teeth during the procedure to ensure the correct amount of contact space is achieved.
- Shade-matched composite material is applied, and then cured with a UV light that completely hardens it in seconds.
- The bonded restoration is shaped and polished.
- The bite and contact spaces are checked, and any adjustments made if necessary.
- Patients are advised to wait to eat or drink until the anesthetic wears off, to avoid accidental biting of the cheek, lip, or tongue.
The best way to care for teeth with dental fillings is the same as caring for natural teeth. Proper brushing with a soft toothbrush, flossing, and a regular professional cleaning at the dentist office will extend the life of your fillings.
- Longevity – since tooth-colored dental fillings are made of plastic resin, the longevity of this type of restoration is less than that of porcelain restorations (such as porcelain inlays and onlays). It is normal for composite restorations to require replacement more frequently than a porcelain restoration.
- Sensitivity – the deeper the cavity has progressed into the tooth, the more likely it is to experience sensitivity after the filling is completed, especially triggered by cold foods or drinks. If the sensitivity progresses to a level of spontaneous pain or throbbing, notify the office to have the tooth re-evaluated for endodontic treatment.
- Bacterial leakage – composite fillings need to be carefully monitored at routine checkups. Unlike porcelain restorations, composite fillings will “shrink” over time, opening an entry point for bacteria into the tooth. That will invariably lead to recurrent tooth decay.
- Amalgam – amalgam fillings have, in recent years, caused concerns over mercury exposure. Patients should discuss having old amalgam fillings safely replaced with composite or porcelain restorations. The office of Dr. Mazen Natour does not recommend or place any amalgam fillings.
The vast majority of dental insurance plans cover dental fillings. Coverage is typically allowed at 70-90%, with the premium plans covering this procedure at 100%. Some of the more limited dental insurance plans may impose an “alternate benefit” – i.e. a downgrade – to an amalgam filling for benefit calculation purposes. That does not mean you must get an amalgam filling or else the insurance won’t pay towards your treatment. Amalgam fillings are marginally cheaper than composite fillings, which allows the insurance company to pay lesser benefits towards the patient’s care. The office of Dr. Mazen Natour will handle all insurance matters for its patients. Please call us if you have any questions about your coverage.