Filling is the replacement of the lost tooth structure, whether caused by dental caries, cracked teeth, chipped teeth from accidents, reshaping, or color adjustment. It aims to prevent the progression of dental caries, reduce sensitivity or pain, enhance aesthetics, improve speaking efficiency, and provide long-term functional benefits. However, some teeth may take a longer time to fill depending on the lost tooth structure, tooth position, and patient tolerance. For teeth located deep in the mouth or with deep caries, the dentist may need more time than usual. In cases where a large amount of tooth structure is lost or the patient has heavy occlusion, the dentist will treat the tooth by indirect restoration such as crowns, inlays, or onlays to extend the lifespan of that tooth.
Filling Procedure
- Examine the area with caries, defects, or lost structure. Ask the patient about symptoms of the tooth to be restored. Additionally, an X-ray of the tooth may be taken to assess the condition of the dental pulp.
- Plan the treatment considering the position, function, tooth characteristics, and patient satisfaction.
- Prepare the tooth by drilling to ready it for restoration. If the cavity is very deep near the pulp or the patient experiences sensitivity during the procedure, the patient can inform the dentist to apply anesthesia to reduce sensitivity.
- Once the caries is removed, the dentist will place the restorative material to replace the tooth. If a tooth-colored material is used, a light-curing step will be performed to fully harden the material.
- Remove excess material on the chewing surface by having the patient bite on blue and red paper to identify areas that need adjustment where material exceeds the chewing surface.
- Polish the restoration for aesthetics and smoothness, reduce food debris accumulation, and increase durability.
Types of Filling Materials
- Tooth-colored materials or composite resin are currently popular materials used to replace lost tooth structure.
• Advantages: Color closely resembles natural teeth, bonds to the tooth and is easy to repair, requires minimal tooth removal during preparation.
• Disadvantages: Limited in cases of extensive tooth loss, patients with heavy chewing forces may experience fractures, and the restoration process is more detailed. - Metal-colored materials or amalgam, although showing a metallic color and lacking aesthetics, have been used for tooth restoration for many years.
• Advantages: Strong and withstands chewing forces well, long-lasting, and less expensive.
• Disadvantages: Color does not resemble natural teeth, cannot be used within 24 hours as the material needs time to set, and is unsuitable for patients allergic to metals.
However, the choice of restorative material depends on various factors such as the cavity characteristics, function, position in the mouth, patient satisfaction, and the dentist’s discretion.
Care
After filling, if the patient has any questions or concerns, they can return to see the same dentist for advice. The most important factor is the patient’s cooperation in maintaining the restored tooth because neglecting proper cleaning or applying heavy chewing forces such as biting hard foods or objects can affect the lifespan of the restoration.
Oral Health Care
In addition to visiting the dentist regularly every 3-6 months for scaling, it is important to check for any new oral health problems, observe cleaning habits and oral condition, and monitor for new caries. Early treatment can prevent the progression to severe conditions. Such problems can become chronic and severe if dental visits every 6 months are neglected. For example, a simple cavity that can initially be filled may progress to involve the dental pulp if left unchecked, making simple filling impossible and requiring root canal treatment and crowns, which take more time and cost significantly more.
Steps for Dental Care
- Brush teeth properly at least twice a day (ideally after meals: morning, noon, and evening).
- Use dental floss to clean between teeth as some areas cannot be reached by brushing alone.
- Use additional tools in some cases, such as interdental brushes.
- Use toothpaste containing fluoride.
- Avoid certain foods, especially those high in sugar, as they cause dental caries.
- Acidic foods may erode teeth and cause sensitivity.
