FILLING you in on FILLINGS

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What isn’t pictured in this meme is that Olivia Cosby had to go to the dentist a few months later. And this, my friends, is how catching feelings can lead to fillings, which is the perfect segue into our topic for today.

Not unlike your car mechanic, what you’re trusting your dentist to do is kind of a mystery for most of the population. It took me months *IN DENTAL SCHOOL* to really grasp what fillings are, how to do them, and when they’re indicated. So it wouldn’t surprise me at all if my patients have a limited understanding regarding why I’m diagnosing cavities and how in the world a filling addresses the issue. The problem is that most people don’t even bother ASKING me any questions... and to no fault of their own! I guess continuing on the mechanic analogy, when I go to get service done to my car, I have no baseline understanding of what’s being done so I kind of just go with whatever they recommend...

I need an oil change? Tires rotated? Engine replaced? New brake light?
(inner me: what the..?)
What I say to the mechanic: Oh.. ok, mhmm, that’s what I thought! *nodding head in agreement*

My husband though... He knows the right questions to ask. He probes, knows the terminology, and he gets to the bottom of the “WHY?” This helps him make educated decisions on what needs to be done, what can wait, and what should probably get a second opinion.

I, on the other hand, agree to what they recommend. They’re the experts...right?

While it’s truly an honor to have patients have blind faith in me and my judgement for their oral health, I want to ensure that to the best of my ability, I have educated everyone in my dental chair on their treatment needs. I want to have the questions asked and I want to make sure everyone feels comfortable knowing that what’s being recommended is genuinely in their best interest. In the end, it’s my job as your dentist to educate and inform. It’s your job to decide what’s best for you and how to move forward.

Fillings: A Prologue

To begin with, in the world of dentistry we call fillings “restorations”. It’s the “thou” and “thee” of dentistry - it’s just the proper way to say things. We preface “restorations” with the type of material used. So, if you have silver in your mouth, it’s likely an “amalgam restoration” and if what you’ve got is tooth-colored, well that’s likely a “resin” or “composite” restoration. To make matters even more complicated, we specify the location of the restoration by using the number assigned to the tooth (including your wisdom teeth the normal person has 32 total, just FYI) and also indicate the surfaces that we're recommending need treatment. There’s 5 surfaces of each tooth that we can work on and any combination of them can be included in your filling. Ex: #5DO (distal occlusal) or #30OB (occlusal buccal)

 

Fillings: My Shameless Plug

At brush., we do exclusively BPA-free fillings. In addition to being void of bisphenol-A, here are some of their other benefits:

  • Requires minimal amount of healthy tooth structure to be removed
  • Bonds to the tooth restoring strength
  • More stable than mercury amalgam
  • Provides a tighter seal
  • More resistant to fracturing
  • Does not react to temperature changes resulting in weakening of the tooth like amalgam
  • Aesthetically pleasing tooth appearance
  • Take less time to harden than amalgam fillings

 

Fillings: The Actual Story

So, your dentist tells you that you need a filling. Here are some of the common reasons why:

  1. Decay (aka a cavity aka caries)
    • This is the most common reason for fillings. Decay can either be primary where it occurs on virgin tooth structure. It can also be secondary where it is related to an existing filling that now needs to be replaced.
  2. Fractured tooth that can be fixed with a filling instead of a crown
  3. Slow loss of tooth structure from heavy grinding of the teeth or aggressive brushing
  4. Tooth discoloration
  5. Replacing old fillings that are failing

 

 

 

Now on to the process. Depending on where the filling is needed and the degree to which the natural tooth structure is compromised, anesthetic may or may not have to be used. This is what put yours tooth to sleep! If you have a cavity, your dentist will then go in and remove the infected area(s) with a drill and/or hand instrument. Once all the infected aka carious aka decayed aka cavitated lesion is removed, the tooth is ready to be filled. If you have a fractured tooth or are filling areas that do not have decay, your dentist may or may not roughen up the enamel surfaces with a drill to allow for better bonding of the filling material. When the tooth is ready to be filled, it’s isolated with cotton rolls or a rubber dam (see image of lady with blue thing around her teeth - sexy, right?), the tooth is then dried, conditioned, bonded, and the filling is placed (with a few small steps in between and after such as more air drying and curing with a UV light).

Fillings: An Epilogue

Immediately after the filling is placed, the bite is checked and adjusted until it's back in harmony. What does this mean? If after you get the filling done your teeth don’t feel like they close the way they used to, SOMETHING IS WRONG! Let your dentist know so they can smooth down some of the filling material, which will bring your bite back into proper occlusion (fancy way of saying “bite”..)

 

Depending on how deep the decay was, there could be some post-operative discomfort. It’s typically not enough to warrant anything more than OTC Advil and should go away within a few days. If it persists, let your dentist know so they can take followup x-rays and do an exam to see what the heck is going on!

 

 

 

I hope this was insightful for my readers and as always, we’d love to see in our office!

Sara Mahmood, DDS MSHM

 

 

 

 

 

Dr. Sara Mahmood is the Founder and Owner of brush. where all team members are committed to providing Dentistry with Integrity. If you have questions or comments, she welcomes you to email her at sarakm.dds@gmail.com. In her spare time, Dr. Mahmood really enjoys writing in the third person.

 

 

 

Sara Mahmoodbrush.