Posted by Matthieu Dash - 12 Oct 2017
What does my dentist actually do when he removes decay and places a filling?
Typically teeth have fillings placed because there is decay developing, which once it progresses to a certain point can cause pain and even result in teeth being extracted! So having a filling done before it gets to that point seems to be a no brainer?
The first step would be to place local anaesthetic to allow us to perform painless dentistry. Now some people don't like needles, but what we can do is to place some topical anaesthetic gel on the gum before we numb the tooth so that you can't feel the needle going in.
What we then do in our practice here is to place a rubber dam, which is an important step for achieving long lasting fillings that don't fall out. This then allows us to proceed and safely remove the decay, which is brown or black in colour with a very soft mushy texture, until the point which we reach firm tooth structure. Once there is a decay free preparation the tooth 'sandblasted' to help create a stronger between the tooth and the filling.
If the hole has extended over the side then we place a band around the tooth to help create a natural tooth shape and to avoid sticking the filling to the tooth next door.
Then it's a case of placing our dental glues that hold the filling the place, prior to placing the filling which we build up in increments. Placing numerous thin layers of filling is a very important step to avoid any sensitivity after the anaesthetic has worn off as well.
When we place fillings we aim to recreate the natural contours and shape of the tooth to allow it to function like a normal tooth. With fillings that are flat, patients can experience less efficient chewing and they may find the fillings start to crack or break. This can occur because forces aren't spread evenly over the tooth, leaving any weak parts of the tooth or filling prone to traumatic forces.
In this case the patient wasn't aware he had decay developing as there was no hole and no pain. Fortunately this was picked up on an x-ray before it had developed far enough to cause pain.
Posted By Matt Dash BDS