Fillings: Their purposes and Procedures.

When a tooth has damaged tooth structure, either from decay, physical trauma, or a defect in the tooth structure itself, it becomes necessary to restore that damaged area of the tooth.  When we have any of the above situations with our teeth, the teeth are weakened.   A filling replaces or repairs the damaged tooth structure, but does not strengthen the tooth.  Another purpose of fillings is to restore the original contours of the tooth to ensure proper oral hygiene and protect the supportive tissues.   I will discuss the necessary procedures for filling a tooth to repair the different types of damage that may occur.

1)  Decay:  The first step is to access the decayed area and remove the demineralized (decayed) tooth structure.  This is done with a high speed dental handpiece (drill) to gain access and a slow speed handpiece to remove all of the decayed tooth structure.  Then an insultative and protective base material is place over the dentin.  The filling is then placed on top of the base to replace the damaged tooth structure.

2)  Physical trauma:  This usually means a chipped tooth or some other damage to the enamel.  It also may be cause by harmful habits like grinding our teeth.  Mechanical trauma can occur from using a hard or medium bristle toothbrush.  With physical trauma to the teeth, the affected area is prepared to remove any loose or damaged tooth fragments.  Then the tooth is restored to its previous shape and contours.

3 Enamel defects:  These defects can occur during formation of the tooth.  They can range for very small areas of hypocalcification (poorly formed spots) in the enamel  to enamel defects that affect all the enamel of the tooth.  These defects need to evaluated and then the proper procedure done to repair the defective area.  This can range from a simple filling to a full coverage crown.

Fillings are used to repair or replace damaged tooth  structure.  They do not add any strength to the teeth.  Removal of all damaged or diseased tooth structure must be done before the filling is place.  If the damage to the tooth is significant, a more supportive type of restoration may be necessary.  Most fillings are covered by dental insurance at about 80% of cost.


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