Management of Tooth Decay

Tooth decay, also known as dental caries, is a bacterial infection that causes demineralization or break down of tooth enamel, leading to cavities. It is a progressive condition which can lead to pain, infection and even tooth loss if left untreated.

Let’s understand the stages of dental cavity progression which can help you take preventive measures and seek timely treatment.

Stages of Dental Caries/Cavity

Stage 1: Initial Demineralization

Tooth enamel weakens and begins to lose its minerals, they appear as white spots on the teeth. This can be detected by a dentist during routine checkup.

This stage is managed by fluoride treatment and good oral hygiene.

Stage 2: Enamel Decay

If left untreated the cavity progresses and starts to break down enamel which is the hardest substance in the body. At this stage it will appear as pits or small cavities on the tooth surface. Patient will not have any symptoms and is detected during routine dental checkups.

Treatment is removal of the decayed portion of the tooth and replacing it with a suitable material to restore the form, function and aesthetics.

Stage 3: Dentin Decay

If left undetected or treated the cavity progresses to the next layer of the tooth, dentin. At this stage patient experience mild to moderate level of sensitivity. A visible cavity and food lodgment and sestivity to cold food are the common symptoms.

This stage is also treated with filling/restoration as stage 2

Stage 4: Pulp Involvement

The cavity then progresses to the third layer called the pulp. Pulp maintains the vitality of the tooth and provided nutrition. It’s a chamber filled with blood and nerve vessels. A large cavity with pain and sensitivity to hot and cold food, difficulty in chewing are the common symptoms.

At this stage treatments like pulp capping, root canal treatment or even extraction are recommended.

Stage 5: Abscess Formation

At this stage bacteria infect the pulp and start producing pus, it can appear as a pimple or a swelling in the gums. In severe cases even as a large swelling. The infection has now penetrated deep into the root and infected the surrounding gum and bone as well. At this stage root canal treatment or extraction is performed.

How are cavities filled/restored?

The lost tooth structure must be restored back to function. It involves 3 steps

Removal of decay: Scooping out the decayed portion with a dental drill or hand instrument
Preparation: Shaping and smoothening the walls of the cavity the tooth for filling.
Filling material: Placing a filling material (e.g., amalgam, composite resin, gold).
Shaping and polishing: Shaping and polishing the filling to restore the tooth form, function and aesthetics.

Types of Restoration/Fillings

Filling or restoration: Used to repair small cavities or decay
Inlays: Custom made fillings made of ceramic, gold or composite used to repair a large cavity.
Onlays: A custom-made dental restoration that covers a larger portion of the tooth than inlay. Its designed to repair extensive decay and restore and strengthen the tooths form and structure.
Crowns: Cap entire tooth, restoring shape,size and function. Visit page Crowns and bridges to learn more.
Bridge or Implant: If the tooth has been removed, it should be replaced with a bridge or implant.

What are the different types of materials used for filling a tooth?

Amalgam (Silver) Fillings

It is made from a mixture of mercury, silver, tin, and copper. These are more durable and long-lasting and used mostly for large fillings. However, it is not aesthetically very pleasing because of the metallic color. Due to mercury toxicity, it causes, amalgam fillings are no longer used in practice.

Composite (Tooth-Colored) Fillings

Composite is the most widely accepted and used material today for filling a tooth decay. It is made from a mixture of resin and silica. As it is tooth colored it holds esthetic dominance. These are used for small to medium-sized filling But as a matter of fact it's not as durable as amalgam.

Gold Fillings

The self-explanatory filling material made of gold alloy. These are durable and long lasting. Compared to tooth colored material it's aesthetics is controversial. However, a golden tooth can be aesthetically pleasing for some. But it's expensive.

Ceramic Fillings

Ceramic dental fillings are a type of tooth-colored filling made from ceramic materials, such as porcelain or ceramic glass. They are used to restore teeth that have been damaged by decay or trauma. These are aesthetically pleasing, but more expensive than composite fillings.

Glass Ionomer Fillings

This is made from a mixture of glass and acrylic acid. These are white colored material used mostly in non-load bearing teeth. In addition to that they release fluoride to prevent further decay. But the material is not as durable as other materials.

Resin Ionomer Fillings

As the name suggests it is made from a mixture of resin and acrylic acid. This also features release of fluoride to prevent further decay. It's important to note that the choice of filling material depends on various factors, including the location of the filling, the size of the filling, and the patient's preferences. We will recommend the best filling material for your specific needs.

In conclusion “Prevention is Key”!

– Brush and floss regularly

– Limit sugary and acidic foods/drinks

– Visit your dentist for regular check-ups and cleanings

Early detection and treatment can save your teeth and prevent more severe problems. If you suspect dental caries, consult your dentist today!

FAQs

What is a dental filling?

A dental filling is a material used to restore a tooth damaged by decay or trauma.

What types of fillings are available?

Common types include composite (tooth-colored), amalgam (silver), inlays, and onlays.

Which filling material is best for me?

Your dentist will recommend the most suitable material based on the tooth's location, extent of damage, and your preferences.

Are composite fillings tooth-colored?

Yes, composite fillings match your natural tooth color.

Is amalgam (silver) filling safe?

Yes, amalgam fillings are safe and have been used for decades.

How long do fillings last?

Fillings can last 5-15 years or more, depending on material and oral care.

Does getting a filling hurt?

Local anesthesia ensures minimal discomfort during the procedure.

Can I eat normally after a filling?

Wait until the anesthesia wears off, then resume normal eating habits.

How do I care for my fillings?

Practice good oral hygiene, avoid hard foods, and visit your dentist regularly.

Are inlays and onlays more expensive than regular fillings?

Yes, they are custom-made and more expensive but offer superior durability and aesthetics.