Restorative Dentistry


When teeth become damaged they can be restored by dentists through treatments such as fillings, crowns, veneers, inlays, onlays and root fillings. The level of the damage determines the form of treatment needed.

Fillings
Fillings are used to fill in cavities that are caused by tooth decay. The treatment involves injecting a local anaesthetic (unless the patient would prefer without) and then drilling out the decayed or weakened parts of the tooth and cleaning the cavity so the filling can be placed. Fillings available on the NHS are composite resin, glass ionomer or amalgam.

Amalgam fillings consist of mercury, silver, tin and copper. It is durable, long lasting, cheap and self-curing. But it has a silver colour which looks unnatural in the mouth. There has been controversy over the fact it releases low levels of mercury vapour which can be inhaled and high levels of mercury vapour exposure can be toxic. However, fillings only use a small amount and extensive research has been done to show that there are no harmful effects from amalgam fillings. They are still used but precautions are taken when removing the amalgam as drilling amalgam releases high levels of mercury vapour. Amalgam is not used on children, pregnant women or breastfeeding women as a precautionary measure as mercury can be passed through the placenta and breast milk. Some people are allergic to amalgam as well so will need another form of treatment.

White composite fillings are made of a resin and glass mixture. They are tooth-coloured which provides a more natural aesthetic and hold up as well as amalgam in smaller cavities. However, they are more expensive, light-curing and can wear out sooner in larger cavities. The filling can also be stained over time by certain foods such as coffee.

Glass ionomer fillings are made up of powdered glass. They form a chemical link with the tooth and may release fluoride which prevents tooth decay. It is a fairly weak filling and are usually used for children’s teeth, small back fillings or fillings on root surfaces. Like white composite fillings they are tooth coloured. Both types of fillings must be kept completely dry to set and need a blue light. Under the blue light the composite shrinks slightly which can pull on the tooth and cause sensitivity as well as produce a gap between the filling and the tooth to cause further decay. This problem has been reduced in recent years due to more modern composites.

Crowns
A crown covers or caps the tooth in order to protect and maintain what remains of it. Can be needed if the tooth has been broken or weakened by a large filling or a lot of decay. Impressions will need to be made so the crowns can be made to fit the teeth exactly. A local anaesthetic is used to numb the area so the tooth can be shaped to fit the crown.  For teeth at the front of the mouth, crowns are usually made from ceramic. For teeth at the back crowns can be made from porcelain, gold or porcelain bonded onto gold. Gold crowns can be gold or silver in appearance. Newer ceramic crowns are strong enough to be placed in any area of the mouth and look like porcelain crowns.

Veneers
A veneer is a thing moulding that covers the front part of the tooth in order to hide discoloured, crooked or deeply stained teeth. Local anaesthetic is sometimes used to numb the tooth so that the tooth can be filed down to fit the veneer. Thinner veneers are now being used so that more of the tooth can be retained. 

Inlays and Onlays
An inlay is a small and situated on the biting surface of the tooth and an onlay can cover a large area of the tooth. They are similar to fillings but are made by a dental technician and then cemented to the tooth. They are very strong and can be more durable than normal fillings. They are ideal when a crown is not possible without removing healthy tooth and a filling is not enough to resolve the issue. Are usually made from either gold or porcelain.

Root Fillings
A filling in the root canal after root canal treatment. It is a temporary filling that is used until the dentist is sure the infection is gone and then a filling or crown is placed. 

Reasons why restorative dentistry may be needed

  • Dental caries – tooth decay caused by bacteria in plaque that create an acidic environment that demineralises teeth. Prevented by good oral hygiene that removes the plaque
  •  Dental erosion – when the tooth structure is degraded irreversibly due to acids on the tooth enamel surface. The acid can be sources intrinsically (stomach acid) or extrinsically (diet). Tooth surface erosion can also be caused by grinding teeth (such as bruxism), physical wear (such as brushing too hard) and stress fractures from flexing or bending the tooth (such as an injury).
  • Gum disease - where the gums become inflamed or infected due to plaque build-up. Can lead to receding gums and teeth loss.

I hope you found this interesting.

Written by Lizzie Nash

Sources
https://www.nhs.uk/common-health-questions/dental-health/what-are-nhs-fillings-and-crowns-made-of/
https://www.bupasalud.com/contenido/en/health-and-wellness/bupa-life/dental-treatments-%E2%80%93-fillings-and-crowns
https://www.dentalhealth.org/different-filling-materials
https://patient.info/health/toothache/fillings-and-crowns

Comments

  1. Prodental Surat3 September 2020 at 08:56

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  2. Sunny Isles Dental16 August 2021 at 05:13

    It was a nice article. The information you have given was excellent. If you are looking for more treatments of missing and damaged tooth than you can visit restorative dentistry of Sunny Isles Dental. They have all the best treatments with latest technology.

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  5. Maurice Simpson14 March 2022 at 04:08

    White composite fillings can restore cracked teeth, which are the result of an injury or biting down on something hard. Leaving cracked teeth untreated can lead to bigger cracks and expose sensitive nerves. If you are experiencing a crack, dental fillings are the best way to prevent further damage.

    ReplyDelete

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