A filling is a way to restore a tooth damaged by decay back to its normal function and shape. The first step is to remove the decayed material from the tooth; the affected area is then cleaned, shaped and filled with a filling material.
By closing off spaces where bacteria can enter, a filling helps protect the tooth by preventing further decay. Materials used for fillings include composite resin (white fillings), and an amalgam (an alloy made of silver and other metals). No one type of filling is best for everyone. What is right for you will be determined by the extent of the decay and where in your mouth the filling is needed.
What is Tooth Decay?
Tooth decay, also known as dental caries, is an infectious disease that damages tooth structures, resulting in cavities, which are holes in the teeth. It is one of the most common diseases throughout the world; it is estimated that 95 % of the population has had at least one cavity.
A cavity occurs on a tooth surface where enough of its mineral content has been lost that a hole has formed. The process by which this occurs is called demineralization and it takes place because of the presence of acids on a tooth’s surface. When acids build up on an unprotected tooth surface, they dissolve the minerals in the enamel, creating holes and weak spots (cavities). As the decay spreads inward into the middle layer (the dentin), the tooth may become more sensitive to temperature, touch, food and sweets. When the decay reaches the centre of the tooth (the pulp), the resulting inflammation leads to a bad toothache.
The acids that cause tooth decay are produced by specific types of bacteria that live in a complex colony called a biofilm. A biofilm is a well-organized colony of bacteria that adheres to surfaces and is embedded in a slime layer. A biolfim in your mouth is called dental plaque.
The bacteria in dental plaque consume sugars that start to produce the acids that cause tooth demineralization (tooth decay). Dental plaque not only provides a home for oral bacteria but it also acts as a medium that holds the acid they produce directly against a tooth’s surface.
Everyone’s mouth is inhabited by bacteria, but you can minimize your potential for having tooth decay by regular brushing and flossing, thereby not allowing the bacteria that are present to form organized colonies. Remember, there must be both dental plaque and dietary sugars present for tooth decay to occur. It is important to brush and floss often and effectively to completely remove dental plaque from all tooth surfaces. Also, limit the amount, frequency, and duration of sugars in your mouth.
One of the most exciting breakthroughs in modern dentistry is the use of computer assisted technology to manufacture porcelain ceramic crowns. A CEREC crown can be completed in a single appointment, rather than the multiple appointments required with previous techniques. This also reduces the number of local anesthetic injections needed.
The first step in preparing a tooth for a CEREC crown is to file and shape the tooth. Next an impression is taken digitally with a camera. The camera sends a 3-D optical image of the prepared tooth to the computer. The dentist then uses the computer’s CAD/CAM (Computer Aided Design / Computer Aided Manufacturer) technology to design the crown and its specifications are sent to a milling machine. The milling machine—under computer control—carves the actual restoration out of an extremely hard ceramic block using diamond coated instruments. The crown is then placed in your mouth and checked for fit, contacts, occlusion and appearance. If everything is acceptable; the crown will be bonded to your tooth….all in one appointment!
The ceramic material has some properties that make it very suitable for use in dental restorations. It expands and contracts in response to temperature changes at a rate approximately that of enamel and dentin. It also wears at approximately the same rate as enamel. Once your new crown is in place, you may experience a mild sensitivity to hot or cold on the tooth for several weeks. This is only temporary and should subside on its own.
We believe that the best teeth are your own teeth. We will do all we can to make sure you keep your teeth. But sometimes, a tooth is badly damaged or lost. One of the options available to replace a lost tooth (or teeth) is a dental bridge.
A bridge involves one or more false teeth that are held in place by surrounding healthy, natural teeth. Fitting you with a dental bridge involves several steps.
First the teeth on each side on the missing one(s) are filed and shaped in preparation for the bridge; these teeth are called abutments. An impression (or a “mould”) is taken of the teeth, and from it a model is poured.
A dental laboratory works with the doctor to custom hand-craft your bridge from this model, mimicking the size, shape, and colour of your natural teeth. This can take 1 – 2 weeks and during this time a temporary bridge is placed on your teeth. The temporary bridge is designed to protect your teeth and gums between visits, but is not durable enough to last a long time.
When your bridge is ready, your dentist will remove the temporary bridge, clean away the temporary cement and check the fit of the new bridge. If everything is acceptable; the bridge will then be cemented to your teeth. A bridge is not removable, once cemented, it remains in place.
It is important to take good care of your bridge with regular brushing, flossing, check-ups and cleanings. We will show you how to use a floss threader to floss under and around the false tooth (or teeth) in the middle of the bridge.
Cracked Tooth Syndrome
Cracked Tooth Syndrome is a common problem. Unfortunately, unlike teeth with obvious fractures, teeth with cracked tooth syndrome usually have fractures that are difficult to see on X-rays or with the naked eye. Sometimes the fracture is below the gum line, making it even more difficult to identify. Cracked tooth syndrome more often occurs in molars, usually lower molars, which absorb most of the forces of chewing. People who grind or clench their teeth may be more susceptible to cracked tooth syndrome because of the constant forces put on their teeth. Teeth with large fillings or teeth that have undergone root canal treatment are weaker than other teeth and more likely to crack.
The first symptom of a cracked tooth is often intermittent pain in the tooth when you bite or chew. The tooth may be painful only when you eat certain foods or when you bite in a specific way. It may be worse when you eat sugary foods as the sugar leaks into the tooth crack causing pain. You will not feel a constant ache, as you would if you had a cavity or abscess, but the tooth may be more sensitive to cold temperatures. Many people with cracked tooth syndrome have symptoms for months, but it is often difficult to diagnose because the symptoms are not consistent.
To make the diagnosis we will start with a thorough examination of your mouth and teeth, focusing on the tooth in question. We also may take X-rays, although X-rays often do not show the crack. We may use special instruments to test the tooth for fractures. One instrument looks like a toothbrush without bristles that fits over one part of the tooth at a time as you bite down. If you feel pain, the cusp being tested most likely has a crack affecting it. Treatment depends on where the crack is, how deep it is and how large it is.
Sometimes a crack affects one or more cusps of a tooth. These are the highest points of the tooth. In this case, the tooth may be fixed with a crown. Some cracks affect the pulp: the centre of the tooth, where the nerves and blood vessels are. In that case, the tooth will need root canal treatment. About 20% of teeth with cracked tooth syndrome will need root canals. After a root canal, the tooth will no longer be sensitive to temperature, but it still will respond to pressure. If you felt pain before the root canal, you may still feel some pain afterward. It probably will not be as intense or as frequent, but it may still occur.
In some cases, the tooth may need to be removed. Some cracks affect the root of the tooth in the jaw. There’s no way to fix this type of crack. If your tooth is removed, you can have it replaced with an implant or a bridge.
People with one cracked tooth are more likely to have others, either at the same time or in the future. We can make an occlusal splint/ night guard for you, to prevent you from grinding or clenching your teeth. This will reduce the chances of you cracking another tooth. An occlusal splint is usually worn while sleeping. It also can be worn at other times if clenching or grinding happens during waking hours as well.