Some of us have been lucky enough to have never experienced having a dental filling. However, a large majority of us have had a filling placed in our mouths at one time or another. A filling, as the name suggests, fills something up. In dentistry, we may place a filling into a tooth if there is decay (an infection), an old filling is leaking (kind of like when the caulking has lost its seal), the tooth is worn down, fractured, or chipped due to function, or to cover up some aesthetic imperfections.
Does it hurt to have a filling done?
Here at Braeside Dental Centre, we will use a devise called a Wand. This is a special instrument that will help deliver the anesthesia (freezing) in a way that most of our patients find much more comfortable. I have been asked many times what just happened after the patient just received the freezing. To a lot of surprise, I tell them that they just got the freezing. To which they say, “no needle?”. Not quite, but a lot more comfortable. Once the tooth is frozen, there should be no discomfort during the procedure. Most patients tell us that the procedure was better than they expected and after a couple of days things are back to normal. Once in while, it may take a little longer for the tooth to settle down. This usually occurs when the decay was very deep and close to the nerve or if someone grinds and clenches their teeth (it can cause further trauma to the teeth).
Am I getting a white filling? What type of filling am I getting?
There are many types of fillings. Like most things, each type of filling has both advantages and disadvantages. Most commonly, the type of dental filling used today is the composite filling. Composite fillings are what we refer to as a direct fillings or a filling that goes directly into the cavity. And yes, it is a white filling. It is a material that has come a long way over the last 40 years or so. There was a time when it did not wear well, was not strong enough, or it discoloured quickly and was more technique sensitive. Today though, we are able to place it in most situations and it is able to provide our patients excellent service. It was not always that way. Most of us can remember when dental amalgams were the most common type of material used. However, amalgam, or silver mercury metal fillings, have gone out of favour due to the health concerns associated with mercury.
Another type of filling used is called an indirect filling: porcelain and gold. Because the fillings are fabricated and shaped outside of the mouth (typically in a lab) they tend to have less post operative sensitivity, more durability, seal better, sculpt better, and last longer. Unfortunately, they require two appointments and because of the extra time involved, they are also more expensive. Please ask us if you would like a particular type of filling or want further information to decide which one is best for you. We would love to have that discussion with you to individualize your care.
Is this filling going to last forever? How long is it going to last?
Like any man made material, there is a limit to its longevity. I usually tell people that the only thing that was meant to last forever was their own natural teeth and they don’t last forever either. The indirect fillings will last the longest compared to direct fillings. However, composite fillings can last a very long time as well, if properly looked after, so don’t discount this option! This would include brushing and flossing regularly, having your teeth cleaned professionally with a fluoride application, and reducing the amount of functional or parafunctional load placed on them.
How long am I going to be frozen?
This depends on a number of factors: What type of freezing was used? Where in the mouth was the freezing being placed – is it on the top jaw or the bottom jaw? What is the metabolism of the patient? How much freezing was required? How long was the procedure? In general, I don’t want the freezing to come out before the procedure is complete and not too long after the patient leaves the office. Most times, the freezing will last somewhere between 2-4 hours. If someone has concerns, I will usually ask if there is something the patient has to attend to after their visit with us or if the freezing has lasted longer on them in the past. Since we have a number of different types of anesthetics (freezing), we can individualize your care so that we can better approximate your needs.
How is a filling done?
This depends on the type of filling. In general though, we will first use a rubber dam (a rubber rain coat) to isolate the tooth and use a tool to open up the tooth and expose the cavity (the decay/infection). In our office, we will use may different methods to ensure that the infection has been completely removed. We will use tactile sense (with a sickle probe), chemical die that binds to the bacteria and highlights the infection, and an intraoral camera with florescence that uses a special wavelength of light to make the infection visible to the naked eye. Once we have all the infection removed, we will place a number of medicaments to prepare the tooth to receive the filling, while also reducing the post operative sensitivity. We will then carefully sculpt the filling (as much as possible) to fit the natural shape of the tooth. Once that is complete, we will check the bite to ensure that function is optimal and polish it so it does not feel rough. When doing a filling, there is mix of both science and art to produce the best result.
Fillings have come a long way over the decades. They are an essential part of the tools we have in dentistry to conservatively save peoples teeth, improve their health, help with their smile, maintain function, and reduce tooth sensitivity. Please ask us the next time you are in our office if there are any further questions we may be able to answer.
Dr. Goel
Braeside Dental Centre
