Dental caries (tooth decay) is a set of deteriorations that causes the destruction of the hard tissues of the teeth which are dissolved by acid. The decayed tooth tissue cavitates over time forming a gap. A ‘filling’ is the restoration and recovery of the functions of the tooth which is carried out by filling the gap. First of all, the decay is thoroughly cleaned, the healthy tooth tissue is brought out and the filling is placed.

Dental caries on the first molar and its elimination

The bacterias which are constantly present in our mouth are nourished with uncleaned food rests. These bacterias and food rests adhere to the plaque layer on the surface of the teeth and start to form acid after a certain time. This acid causes an irreversible destruction, corrosion and decay in the main structure of the tooth enamel.

For this reason, brushing our teeth at certain intervals not only eliminates the plaque layer and the food rests from our teeth but is also the most effective way to combat dental caries. The structural properties also contribute to the formation of a dental caries. The molar teeth which have twisted and recessed areas decay easily as these recessions are more apt to accumulate food rests and bacterias. Similarly, the interfaces of the teeth which are hard to clean with a tooth brush are also more likely to decay. As tooth brushes will be insufficient in cleansing the interfaces, the use of dental floss is a must.

Interdental caries is encountered very frequently

The enamel layer is the hardest layer of our body. It takes a very long time for bacteria to perforate this layer. But after accomplishing the perforation of this layer which measures 1,5-2 mm in thickness, the caries comes across the dentin and moves very quickly, reaching finally the nerves of the tooth, namely the dental pulp. During this process the first reaction is the sugar sensitivity, then cold and finally the hot sensitivity. But sometimes the caries progresses so that your tooth may lose its vitality without experiencing any pain. If you have a big caries but don’t feel any pain or sensitivity, you should be aware that the nerves of your tooth are dead and it should absolutely be treated with a root canal treatment.

A decayed teeth is easily recognized by its dark colored hollow. But sometimes the decayed hollow stays hidden and it can only be distinguished with auxiliary diagnostic tools such as a radiograph.

The decays of the teeth are cleaned under local anesthesia. Afterwards, the appropriate filling material is chosen and the filling is made. While making a decision for the most appropriate filling material, the dentist will take into consideration factors such as the depth of the hollow, its form, its location, etc.

Here are the types of fillings most commonly used today:

AMALGAM FILLINGS:

The use of amalgam fillings date back to about 150 years and they are the oldest known filling material. They consist of mercury, silver and some metal alloys. They are the most cost-effective fillings, moreover they are durable and solid. Therefore, until recently they have been regarded as the only choice for the back teeth which are confronted with high mastication pressure.

The biggest disadvantage of amalgam fillings are their unesthetic appearances

Their biggest disadvantage is their color (silver) and their darkening property over time in case their surface isn’t polished smooth enough. This disadvantage is a restriction in their use.

As it is widely believed, the claim that the mercury they contain may be harmful to health isn’t true, at least it is exaggerated. The mercury vapor percentage of the amalgam filling is way below the amount that could be harmful to health.

COMPOSITE FILLINGS:

These are tooth-colored fillings also known as the "esthetic fillings".

They are in active use since about 50 years. Initially as they were very apt to crack, they were only used at the front and not at the back where the mastication pressure is high. But with the field of dentistry they have correspondingly exhibited a technological development and have turned into durable fillings which aren’t easily abraded. Therefore today they are successfully used both at the front and the back area.

As they provide both esthetics and function, they are widely used. Compared to the amalgams they can be applied by causing much less tissue loss in the tooth which counts as an important advantage.

Nowadays amalgam fillings are being replaced with composite fillings

Apart from tooth decays, composite fillings are also used for the treatment of cracks of the front teeth.

The cracked front incisor after restoration with composite filling

The composite fillings form the most practical and economic solution for the formation imperfection and spaces of the front teeth. This restoration technique which is named as ‘bonding’ provides affordable and satisfactory results in just one session without the need for anesthesia.

Various examples of space closure in front teeth with bonding applications

PORCELAIN INLAY FILLINGS:

These fillings are used for teeth with greater material loss. After the caries has been removed, an impression of the tooth is made and the lost part of the tooth is prepared at the laboratory using the plaster model. Besides this, concerning areas where it is hard to restore the tooth with a filling, for example in case of a caries which goes beneath the gingival line, the porcelain filling method ensures perfect tooth appearance and function in two visits.

Porcelain fillings in premolar teeth

Porcelain fillings in molar teeth

As porcelain fillings are prepared and polished at the laboratory, they possess perfectly bright surfaces. Those porcelains are a product of high technology with a resistance against 6 tons of pressure per cm2.

Their disadvantages exist in the fact that they are costly and can’t be completed in one visit.

The information contained in the site is to inform about dentistry and treatment methods.
This information is definitely not a substitute for the physician to examine the patient for medical purposes or to make a diagnosis.