Filling Treatment

Tooth decay is a disease that occurs in teeth and is usually caused by bacterial plaque on the surface of the teeth. These bacteria create acid by consuming sugar and carbohydrate-rich foods, which then erodes the tooth enamel and dentin. This erosion leads to the formation of cavities in the teeth. The treatment process involves cleaning the cavities and filling them with filling material. This procedure prevents the loss of teeth and the development of more serious dental problems.

The Causes of Tooth Decay Include

Bacteria: Bacteria that live on the surface of the teeth feed on sugary and starchy foods and produce acid. This acid breaks down the mineral structure of the tooth enamel and causes decay.
Sugary and starchy foods: Foods containing sugar and starch cause bacteria to produce acid. Additionally, these foods accumulate on the surface of the teeth, leading to the formation of plaque.
Poor hygiene: Failure to regularly brush teeth and clean between them allows bacteria to accumulate on the surface of the teeth, leading to decay.
Weaknesses in tooth structure: Weaknesses in the mineral structure of the tooth enamel increase susceptibility to decay. Cracks or cavities in teeth can also allow bacteria to enter the tooth and cause decay.
Lack of saliva: Saliva is important for protecting teeth. It neutralizes acids and prevents bacteria from adhering to the surface of the teeth. A lack of saliva increases susceptibility to tooth decay.

Tooth decay can occur on the chewing surface of the teeth, between teeth, and at the gum line. It can manifest as visible signs such as brown stains or cavities, but some decay may require X-ray diagnosis as it may not be visible to the naked eye.

Tooth decay begins in the enamel and, if left untreated, progresses to the dentin. Since dentin is more soluble than enamel, the decay can progress more rapidly. If the decay reaches the dentin, sensitivity can be felt after exposure to hot, cold, sour, or sweet stimuli. This pain typically goes away once the stimulus is removed.

Conservative Dental Treatment

Conservative dental treatment in dentistry begins with the dentist's efforts to prevent the formation of decay and extends to treating decay at the earliest possible stage. The diagnosis made based on the patient's history and X-rays taken during the first visit allows the dentist to make a choice between conservative or endodontic treatment. The simplest form of conservative treatment is recommendations to prevent decay. The most common form of conservative treatment is repairing a decayed tooth using filling materials.

To make a filling in teeth, the tooth tissue must have been damaged due to various reasons (decay, wear, color and structural deformities, developmental problems, trauma, etc.). The aim is to restore lost esthetic and functional features to the natural tooth using filling. Different materials are used for filling. While the use of amalgam fillings has decreased, the use of esthetic filling materials (composite) and porcelain fillings, which match the natural color of the teeth, has increased.

Types of Dental Fillings

Dental filling is a treatment method used to solve problems such as decay, wear, cracks, fractures, structural deformities, and color changes in teeth. The materials used for filling can vary depending on how much the tooth tissue has been damaged and the patient's preference. Here are the types of dental fillings:

Amalgam Fillings

Amalgam fillings are also known as metal fillings. These fillings are obtained by the reaction of silver, tin, and copper alloys with mercury. Mercury binds the metals together to create a durable filling material. Amalgam fillings are known among dentists as the longest-lasting, most durable, and easiest to apply filling type. Although there are some concerns about the mercury content in these fillings, the amount of mercury in the filling is much less than what is obtained from water, air, and food, and therefore does not pose a health risk.

When Is Amalgam Filling Applied?

It can be used in back teeth, especially in cases of large decay, where excessive chewing forces are effective.
It can be used in cases where a tooth has been severely decayed, that is, when a large portion of the tooth tissue has been lost.
It can be preferred in patients with difficulty controlling saliva, such as those who complain of dry mouth.
It can be safely used in patients without mercury or metal allergy.

After the amalgam filling application, it is recommended to avoid chewing on the area where the filling was repaired for at least 2 hours and to avoid hard and sticky foods in the next 24 hours. This can extend the life of the filling. In addition, after 24 hours, a polishing process is carried out to adjust the height of the filling and create a smooth surface.

After deep decay, sensitivity may occur in the tooth when hot or cold foods are consumed for a while following amalgam filling. This condition is generally short-lived and temporary. However, if sensitivity persists for a long time or there are additional symptoms such as swelling or pain in the gums, it is necessary to consult a dentist.

Composite Fillings

Composite fillings are aesthetic filling materials developed as an alternative to amalgam fillings. They adhere to the hard tissue of the tooth through bonding agents and offer a wide range of color options. Therefore, they are preferred to provide an aesthetic appearance, especially in the front teeth. Composite fillings are placed layer by layer on the tooth and each layer is cured with light. The filling material is completed by shaping and correction on the tooth. The process is finished with polishing.

Composite fillings play an important role in modern dentistry. They are more economical and can be completed in a single session compared to porcelain or gold fillings. Also, since they have an aesthetic appearance unlike amalgam fillings, they are a preferred filling material in dentistry.

Although composite fillings are not as hard as natural teeth, they are a preferred filling material due to their aesthetic appearance and easy applicability. However, material can be damaged due to habits such as nail-biting, consuming hard foods, and biting pens, and the lifespan of the filling may vary depending on oral habits and the size of the filling.

Composite filling application begins with the identification of the color of the tooth after cleaning the tooth decay, followed by applying the paste-like composite material. The material is shaped and cured with a light device. After the filling material is cured, the filling is given height and anatomical shape. Finally, the material is polished and polished like other tooth surfaces. The procedure takes between 30 minutes to an hour.

After composite filling, substances that leave stains such as tea, coffee, cigarettes, and others may stain the filling material. Therefore, it is recommended to avoid staining foods for the first 48 hours. In addition, regular brushing and routine dental visits are important for the long life of the filling.

Porcelain Fillings (Inlay, Onlay, Endocrown)

Porcelain fillings are high aesthetic and durable fillings produced in the latest CAD-CAM systems and laboratory environments. Compared to composite fillings, they provide better compatibility with the applied tooth and gum tissue. After cleaning the broken, decayed, or old-filled area of the tooth, precise measurements are taken using digital methods, and they are prepared with a special porcelain material. With this method, maximum adhesion is achieved with minimum intervention to the tooth. Porcelain fillings made from a compressed special porcelain material cause less edge leakage than other filling types. They also do not cause tooth wear because they have a hardness very close to the enamel of the tooth. They are more compatible with other porcelain materials and provide a more natural fit with the gum tissue. Especially in cases of significant substance loss, they are preferred to achieve the most natural result closest to the natural structure of the tooth.