Fillings are among the most frequently prescribed and versatile of all dental restorations. In a procedure known as a cavity preparation, the dentist uses a variety of dental burs to remove damaged tooth structure, and any tooth structure that has been weakened or undermined by decay. Applying their knowledge of ideal tooth shape (anatomy), dentists replace the missing tooth structure with filling material of various types. The material of choice at Blue Sky Dental is a tooth colored composite restoration.
Fillings are placed into teeth following the removal of tooth decay (caries), and filling material can also be used to restore chipped or partially broken teeth to their normal contour and function.
Advantages and Benefits of Cavity Fillings
The following are advantages and intended benefits of fillings in teeth:
- They restore the affected tooth to its normal contour and function.
- Bonded fillings are minimally invasive and can strengthen the teeth to help prevent them from breaking—in some cases delaying the need for crowns or onlays.
- Removing decay and filling the cavities reduces the number of active bacteria in the mouth.
- Early intervention by filling cavities before they get bigger preserves tooth structure and extends the tooth’s life.
- Preserving the teeth preserves the jaw bones, and the contours of the face.
- Preserving the teeth prevents unwanted tooth movement and changes in the bite.
- Fillings are the most economical way to restore teeth. They can also be among the most cosmetically pleasing, and in certain applications, can last decades.
Disadvantages and Risks of Fillings
Preparing teeth for fillings involves the removal of both diseased and healthy tooth structure. Ideally, the amount of healthy tooth that is removed is kept to a minimum. However, teeth are living tissues, and working on them is considered a surgical procedure. Surgical procedures of any kind have the following risks:
- Discomfort, either during or after the procedure. Generally, this is minor and easily controlled.
- Risks associated with local anesthetic (if used). These are also generally minor.
- Sensitivity to biting, cold, or heat, following the procedure. Normally this is temporary. The risk of post-operative sensitivity is greater if a tooth is not isolated from mouth moisture for fillings which are bonded into place. It is also greater with larger fillings.
- Inflammation of the tooth pulp (pulpitis), which may be temporary (reversible), or irreversible. If your tooth sensitivity does not resolve, the tooth may require root canal (endodontic) therapy.
- Infection of the tooth pulp or the surrounding gum tissues following the procedure. Unless the decay extends deep inside the tooth, the risk of pulp infection is relatively low for routine fillings. Whether or not a tooth gets better on its own afterward depends on many factors, including age of the patient, immune status of the patient, restorative history of the tooth (i.e. whether it has been worked on before). In general, young, healthy patients will have more healing cells and immune cells per litre of blood volume, and are less likely to develop complications post-operatively (with a wide degree of variation).
- Deep decay may extend into the tooth pulp (nerve and blood vessel tissue inside the tooth). If so, the tooth may require root canal (endodontic) therapy, and a crown or onlay may be recommended after the root canal treatment is completed.
- Some teeth have small offshoots of nerve tissue called ectopic pulp horns, which may be encountered even in a routine cavity preparation. These are rare, but when encountered can result in the need for root canal (endodontic) therapy.
- Fillings can break and require replacement.
- Large fillings involving surfaces that touch the adjacent teeth may result in an open contact with the neighboring teeth. This can lead to a collection of food between the teeth. There are usually options to placing large fillings, however the cost may be greater. Your dentist is the most qualified person to tell you whether your tooth could get by with a large filling, or whether some other type of restoration would be more appropriate.
- New fillings may have overextended areas called overhangs or flash, which can shred dental floss and collect food. Left uncorrected, flash can lead to inflammation of the periodontal tissues and a re-occurrence of decay in the tooth. Generally, flash is easy to remove/re-contour, so be sure to let your dentist know if you’re experiencing this problem.