Which dentist treats caries? What is the name of the doctor who inserts teeth, places crowns and braces, and removes teeth. What does careless filling lead to?

It has been established that the first attempts to treat caries could have been made about 8,000 years ago, as eloquently evidenced by the discovered skulls of people whose individual teeth were clearly drilled with hand tools. Unfortunately, no manuscripts about ancient methods of treating caries have reached us.

The first records of successful treatment of teeth affected by caries date back to the times of the Roman Empire, when the emperor's physician Archigenes actually carried out the treatment procedure by drilling the patient's tooth with a tool similar to today's hand drill.

This is interesting

In the 15th century, Giovanni Arcolani, in an attempt to cure caries, cauterized the cavity by filling it with gold. Before this, for many years, dental treatment was reduced only to removing the affected tissue, often along with the tooth itself (if traditional medicine methods did not help).

With the advent of the first drill, which found practical application thanks to the French doctor Fauchard, the treatment of caries became more effective and very productive for that time.

Every year equipment and materials were improved, new approaches and ideas appeared. We will talk in more detail about how caries is treated today and what a patient can expect at the dentist’s office.

What exactly are we treating?

Caries is a local pathological process, usually beginning under dental plaque as a result of fermentation (fermentation) of carbohydrate food residues by microorganisms (the main role is attributed to the anaerobic Streptococcus mutans, although other bacteria also contribute). As a result of the vital activity of bacteria, organic acids are released, which “corrode” tooth enamel, leaching out minerals from it, which in turn leads to the formation of pores. This is focal demineralization of the enamel (caries in the spot stage) - the first stage of destruction.

If not carried out in a timely manner, dental tissue defects are formed: superficial, medium and deep carious cavities.

Thus, the treatment of caries involves restoring the functional properties of the hard tissues of the tooth: let’s say, the surface of the tooth was white, smooth and hard, but instead a dark-colored hole appeared, in which, moreover, the hard tissues lost their hardness. Accordingly, treatment will be aimed at eliminating this hole, removing softened tissues and replacing them with full-fledged solid structures that would form one whole with the tooth.

This is a simplified explanation, but in fact there are many interesting nuances here (see below).

General principles of caries treatment

Currently, there are two fundamentally different approaches to the treatment of caries:

1. Conservative therapy without preparation (that is, without excision of tissue with a drill);
2. Treatment with preparation of hard dental tissues (that is, the well-known “drilling” of teeth is assumed).

Conservative techniques refer to non-invasive methods of caries treatment. They are used both for initial forms in the stage of focal demineralization (spots) and for already formed cavities.

This is interesting

Currently, before starting dental treatment, including caries, the patient's informed consent to this procedure is required. Without it, manipulations cannot begin, since a document must first be signed that explains to the patient the medical and legal aspects that protect his interests. This document will also protect the doctor in the event of unsuccessful treatment that is not associated with intentional harm. In addition to consent, a medical history must be filled out in the patient’s card, where all manipulations related to the treatment of caries are recorded in detail.

Treatment of caries using tissue preparation techniques consists of the following steps:

1. Preparing the oral cavity. This may include not only removing plaque or tartar from the tooth planned for treatment, but also generally carrying out professional hygiene of all teeth.
   
2. Pain relief (if necessary). In most cases, caries treatment is carried out under local anesthesia, but sometimes, for example, with multiple dental lesions or with panic in young patients, treatment is carried out under anesthesia, that is, with “turning off” consciousness. This is a riskier option, but it is justified if there are medical indications for it.
   
3. Preparation. This stage involves the removal of destroyed tissue from the carious cavity and subsequent medical treatment with special antiseptic solutions. This allows you to create all the conditions so that bacteria do not multiply under the future filling, and it does not fall out due to relapse of caries (the so-called secondary caries).
   
4. Formation of the cavity. This stage is important for creating a cavity shape that will create additional conditions for retaining the filling. Many materials used in the treatment of caries require a certain configuration from the formed cavity. However, among modern filling materials there are those that chemically bond with the tooth and do not require the creation of mechanical means of retention.
5. Applying a therapeutic or insulating pad (according to the clinical situation). This stage is especially important for fillings that are placed in case of deep caries, when it is necessary to provide a long-term anti-inflammatory and antimicrobial effect to the “nerve” located quite close to the bottom of the formed cavity with the help of special therapeutic pads. Insulating gaskets are placed under fillings in most cases, since almost all materials have an irritating effect on the pulp.
   
6. Filling the cavity. During the installation of the filling, its color is determined (when working with aesthetic materials), the working surface is isolated from the rest of the oral cavity with a rubber dam or simple cotton rolls, and then the material itself is introduced into the cavity according to the instructions for it. In this case, a number of additional means are often used to improve the quality and working conditions: matrices to create a gap between the filling and the adjacent tooth, wedges to form an ideal contact point, retraction thread to correct the gums near the working area, etc.
   
7. And finally, finishing. After installing the filling, a prerequisite is its bite correction, grinding and polishing. This is important so that the filling does not injure the tooth, does not cause discomfort and pain, does not have burrs, does not accumulate plaque, has a shine characteristic of a normal tooth, etc. For this, for example, special discs, polishing heads, finishers or polishers are used.

Treatment of deep caries using a drill

Classical methods of therapy with preparation

Long before the advent of modern filling materials, caries treatment was carried out using preparation (an invasive method) and the formation of a carious cavity under the materials used at that time. At the same time, in order to fix and securely hold the fillings, it was necessary to fulfill a number of conditions related to:

• with a large preparation area;
• with the need to maintain certain angles of transition of the walls and the shape of the bottom;
• with a certain cavity configuration;
• with the creation of additional cavities and treatment of healthy tooth tissues;
• with cutting and trimming with burs.

This treatment of caries required certain skills, dexterity and a lot of time.

Below are the “classic” materials that were previously used in dentistry and are still used in budget organizations for permanent fillings:

1. Mineral cements (Silicin, Silidont and some others);
2. Acrylic and epoxy materials (for example, Acrylic oxide);
3. Metal fillings (amalgams).

Photo of amalgam fillings:

Obviously, before modern methods of caries treatment appeared, it took years of work using “classic” filling materials - many people still walk around with such fillings.

On a note

During the Great Patriotic War, surgeon Ivan Ivanovich Shcheglov widely used the method of healing even the most severe wounds by using lotions with a hypertonic solution of table salt. In just a few days, the wounds became clean, pink, and did not fester, which made it possible to significantly reduce mortality among the wounded. Subsequently, individual evidence appeared that Shcheglov’s method can be successfully used to treat complicated caries, or more precisely, to relieve inflammation and severe pain in conditions where there is no way to use more effective methods.

Modern materials for filling teeth

More than a dozen years have passed since the days of unaesthetic and difficult to fix cements and amalgams. Modern dentistry required new solutions in the treatment of caries, and they appeared.

First of all, the trend has led to the abandonment of excessive treatment of the carious cavity and a decrease in the volume of healthy tissue removed by bur, which was previously required only for the mechanical retention of “ancient” fillings.

In addition to the mechanical method of treating a carious cavity with a bur (that is, a “drill”), other methods have appeared:

• Chemical-mechanical (dissolution of “caries” with chemicals and its removal with hand tools);
• Air-abrasive (sandblasting of the cavity);
• Ultrasonic cavity cleaning;
• Laser preparation.

Adhesive techniques have emerged that involve the use of special chemicals (“adhesives”), which make it possible to abandon routine methods of placing fillings and increase the adhesion strength of the material to tooth surfaces by tens of times. Materials have been developed that are biologically compatible with tooth tissue and provide reliable adhesion with minimal preparation and creation of an arbitrary cavity shape.

The most popular classes of materials for the treatment of caries:

• Composites;
• Glass ionomer cements;
• Compomers;
• Ormokers.

However, within each class of materials there are already categories that are only limitedly used in modern dentistry for the treatment of caries due to the ineffectiveness proven over the past decades. Some of the materials have moved to the field of budget dentistry.

Each of the listed materials has its own individual set of properties that can and should be combined to achieve optimal results in the long-term treatment of caries in primary and permanent teeth. At the same time, more than one technique has been developed for their competent combination and introduction into the cavity.

Modern approaches to the treatment of deep caries

Deep caries is always associated with very serious tooth decay. And if the stage of a carious spot often does not require mechanical treatment of the cavity (a non-invasive method of treatment), and with superficial and medium caries one can limit oneself to gentle preparation techniques with minimal tissue excision, then deep caries usually requires a long-term treatment of the cavity from the doctor, special preparation regimes, and the application of therapeutic and insulating gaskets for seals.

The possibility of preserving the living pulp (“nerve”) is determined by performing a series of manipulations that are important to ensure that caries under the filling does not reappear after treatment. Such manipulations include:

1. Careful work with burs, taking into account the anatomy of the tooth;
2. Alternating work with high-speed handpieces and a handpiece for a micromotor at low speeds at the bottom of the cavity to prevent the risk of accidental opening of the pulp chamber;
3. The use of caries detectors (indicators) to recognize carious tissues in the cavity;
4. Air-water cooling to protect the tooth from overheating;
5. Use of therapeutic pads based on calcium hydroxide;
6. The use of insulating gaskets (most often glass ionomer cements);
7. The use of techniques for the treatment of deep caries in several visits with monitoring of the therapeutic effect of the drugs used based on calcium hydroxide.

From the practice of a dentist:

The following materials are widely represented on the market of materials for therapeutic pads:

1. Aqueous suspension based on calcium hydroxide (Calradent, Calcicur, Calasept, CalciumHydroxide, Calcipuipe);
2. Varnishes based on calcium hydroxide (Contrasil);
3. Calcium salicylate cements working on the principle of chemical curing (Septocalcine Ultra, Calcesil, Dycal, Life, Calcimol, Alkaliner, Reocap);
4. Light-curing materials based on polymers combined with calcium hydroxide (Esterfil Ca, Calcesil LC, Ultra-Blend, CalcimolLC,).

Studies have shown that the greatest therapeutic effect is exerted by preparations based on an aqueous suspension of calcium hydroxide, but they are applied under a temporary filling and can cure deep caries in only a few visits, in contrast to calcium salicylate cements, which are applied immediately under a permanent filling, but have a therapeutic effect they are less pronounced. Most dentists are inclined to believe that varnishes and light-curing medicinal pads have weak antiseptic and anti-inflammatory effects on the dental pulp.

Treatment of caries without a drill

Many people today are concerned about the possibility of treating caries without the use of a drill. And modern dentistry actually has in its arsenal methods that allow this to be done.

Let's list the main ones:

• Treatment of the tooth surface with remineralizing compounds;
• Using ICON technology;
• ART technique.

Remineralizing therapy is, in fact, the restoration of a partially destroyed crystal lattice of enamel, replenishment of its mineral components during focal demineralization. At home, it is difficult to independently select the required combination of drugs and their concentration for the safe and effective treatment of caries in the spot stage, so it is highly advisable to see a dentist.

Remineralizing therapy consists of systemic and local measures. Systemic ones include, for example, the administration of fluoridated salt, milk, fluoride tablets, etc. And to local ones - treatment of the tooth surface with special remineralizing solutions or gels containing compounds of calcium, fluorine and phosphorus, and sometimes a number of other important minerals in various combinations for accelerated mineralization of enamel.

Examples of drugs for the treatment of caries in the white spot stage:

• Multifluoride;
• Bifluoride;
• Belak F;
• Gluflutored;
• Enamel-sealing liquid;
• Belagel Ca/P, Belagel F.

As for the ICON technology, it is one of the most promising in the treatment of caries in the spot stage. In addition, for example, when wearing braces for a long time, demineralization of individual areas of the enamel can also occur: in this case, treatment will be required after the orthodontic appliances are removed.

The essence of the ICON technology: after application and polymerization of the infiltrant with a UV lamp, the enamel surface acquires its original color, since the liquid based on polymer resins “flows” into the areas of the damaged crystal lattice of the enamel and actually “clogs” the micropores. The method of infiltrating the affected enamel structures with the compositions included in ICON allows you to achieve results already on the first visit.

The main condition for treating caries using the ICON method is to use it only on enamel, since dentin cannot be infiltrated.

In the photos below you can observe some stages of caries treatment using ICON technology:

Now a few words about the so-called ART method of caries treatment.

The “classical” ART technique is an atraumatic restorative treatment or a non-invasive method of caries treatment. It was developed in the Netherlands. Instead of a drill, excavators are used to treat caries - special hand tools that literally “scrape off” carious infected tissue from the bottom and walls of the cavity. Then the cavity is filled with glass ionomer cement, which releases fluoride into the tissue and stops caries.

Do not delude yourself and look for a doctor who is ready to treat you with caries using the ART method. Hand instruments are most often unable to efficiently remove all pigmented and infected tissues from the cavity, which often leads to the need to re-treat the tooth. By the way, WHO recommends the ART method for active implementation for residents of poor regions, emigrants, refugees, etc.

In some cases, this technique can be used for people who experience panic fear of a drill.

Promising options for caries treatment: sandwich technique

Today, every competent dentist has information about modern filling materials for the treatment of dental caries. The ability to combine 2-3 different materials during work provides invaluable benefits, as this allows you to make the most of the advantages of each option.

One of the most promising options for caries treatment is the sandwich technique or, in fact, the “sandwich” technique.

This is interesting

The justification for using the sandwich technique is due to the fact that light-curing composites, or, otherwise, “light” fillings, have a number of disadvantages:

• High rates of shrinkage or deformation, which leads over time to the appearance of a “hole” at the site of the filling;
• Lack of anti-caries effect;
• Insufficient biocompatibility with tooth tissues (have a toxic effect on pulp tissue through the bottom of the cavity).

All these disadvantages are successfully compensated for by glass ionomer cements (GIC). Sandwich technology is also understood as a combination of composites and compomers, as well as amalgam and composite, but they are used less frequently.

For example, the following algorithms for applying a glass ionomer cement liner when treating caries using the sandwich method are possible:

1. Closed sandwich: the gasket does not reach the edges of the cavity, which means it does not come into contact with the oral fluid;
2. Open sandwich: the lining covers one of the walls and is in contact with the oral environment.

Advantages of the technique:

• The ability of GIC linings to release fluoride into the tooth tissue for a long time, which reduces the risk of secondary caries;
• Reduced shrinkage of composite fillings, since GIC reliably compensates for it;
• Improving the natural color characteristics of the future filling due to the color of GIC, simulating darker dentin at the bottom;
• The ability of GIC to suppress the growth of cariogenic microorganisms;
• The use of this technique is often the only reliable way to fill cervical and subgingival defects, especially when. Due to the poor adhesion of composites to only one dentin and the impossibility of creating a perfectly dry surface of gingival and subgingival restorations, GICs make it possible to create an ideally strong foundation for them, as well as to ensure the connection of the main filling with the tooth tissues through glass ionomer cements.

The photo below shows a tooth before and after caries treatment with sandwich filling:

Possible complications of caries treatment: what overly impressionable patients should not know about

During the treatment of caries, due to one or a combination of several factors (poor equipment, materials, level of personnel training, complex tooth anatomy, inconveniently located carious cavity, etc.), complications sometimes arise. We list the most popular of them:

The picture below schematically shows examples of mistakes made by doctors when treating caries (and not the worst ones):

To avoid having to treat your teeth “excruciatingly painfully” later, it is important to pay significant attention to the prevention of caries development. In most cases, it is enough to follow a number of simple rules to get rid of caries forever:

• Clean your teeth with brushes containing pastes containing fluorides, and clean the interdental spaces with dental floss soaked in fluoride compounds, after each meal.
• Follow the correct technique for brushing your teeth, and if necessary, have this skill adjusted by your dentist.
• If possible, limit your carbohydrate intake (sweets, cakes...)
• At least once every 6 months, carry out professional teeth cleaning to remove plaque and tartar and draw up an individual plan according to the cariogenic situation of the oral cavity and the level of caries resistance (the condition of tooth enamel and its mineralization, the composition of saliva and its quantity).

On a note

Not every person can decide to immediately brush their teeth with toothpaste after eating. Most people strive to prolong the feeling of pleasure from delicious food for as long as possible. Moreover, the culture of behavior established since the times of the Soviet Union has always dictated unreasonable rules: brush your teeth in the morning and evening, forgetting that there are also lunches and snacks during the day, when it is important to promptly remove the developing plaque and eliminate cariogenic situation in the oral cavity.

By following these simple rules, you get a significant chance to keep your teeth healthy until old age and save yourself from caries treatment for life.

Interesting video: this is what caries treatment looks like under a microscope

Restoration for deep caries on the upper front teeth

A feature of the pathology is the fact that caries develops near the gums, at the border of contact with the tooth. The pathological process quickly destroys tissue, moving into a deep stage. Caries in the cervical area requires immediate treatment. Otherwise, the disease develops into a number of complications.

Causes of cervical caries

Radical caries is mainly provoked by pathogenic microorganisms. The enamel layer in this area of ​​the tooth is somewhat thinner. The border with the gum tissue makes it difficult to remove all food debris and plaque. As a result, this zone is constantly attacked by bacteria and comes into contact with their waste products.

There are other causes of cervical caries. Let's consider the factors that provoke pathology:

• Formation of a gum pocket in which food debris accumulates.
• Disease of the soft tissues of the oral cavity (,).
• A large amount of carbohydrates in the diet.
• Bad habits (smoking, drinking alcohol).
• Excessive content of acidic dishes and foods in the diet.
• Pregnancy.
• Disturbances in the functioning of the endocrine system.
• Long-term treatment with antibacterial drugs.

Experts recommend being wary if cervical caries affects several units at the same time. This fact may indicate the presence of serious disturbances in the body's metabolic processes or indicate a severe deficiency of minerals.

Symptoms

Radical caries in various stages of its development is expressed by special signs. Based on these symptoms, the specialist is able to diagnose the degree of pathological progress. General signs of caries:

• Destruction of the protective layer.
• The formation of a cavity as a result of tissue decay.
• Darkening at the site of the lesion.
• Excessive sensitivity to temperature changes.
• Pain on contact with sour, sweet, salty foods.
• The appearance of an unpleasant odor.

If root caries is not treated, the pathological process quickly progresses, covering adjacent tissues.

Stages of development of cervical caries

In total, there are 3 stages of cervical caries. Let's look at the stages of disease progression:

1. It all starts with demineralization of the enamel area. A white spot forms in this place, more like a cosmetic defect rather than a rotting carious cavity.
2. The second stage is called the superficial stage, where the demineralized stain darkens. During this period, the patient complains of pain after contact with cold and hot foods, drinks, and air.
3. As the disease progresses in the middle stage, a small cavity appears. A person experiences pain during hygiene procedures and eating.

If treatment of cervical caries has not been carried out, the nerve is affected and occurs. The complication gives the patient a lot of painful sensations. Usually during this period most people turn to the doctor.

Which doctor treats cervical caries?

If the above symptoms appear, you should immediately contact your dentist. The doctor will examine the oral cavity and determine the degree of tooth decay. Having studied the clinical picture, the dentist will not only carry out treatment, but also familiarize the patient with measures to prevent cervical caries.
In some cases, to establish the cause of the development of pathology, consultation with highly specialized specialists (gastroenterologist, endocrinologist, nutritionist) is required.

Diagnostics

Upon careful examination, cervical caries can also be noticed at home. The presence of a white or dark spot near the gum indicates the development of pathology.

In dentistry, the doctor determines caries already at the stage of visual examination and questioning the patient about complaints. The diagnosis can be confirmed through testing. The patient is asked to rinse his mouth with a special solution. The site of the carious lesion will change color. The reaction is due to the porosity of the affected enamel.

To confirm the diagnosis and determine the severity of the disease, in some cases additional studies are carried out:

• X-ray;
• transillumination;
• radiovisiographic examination.

Treatment of cervical caries

Caries of the tooth neck is often found in children. This is due to the fact that the enamel of the milk set is somewhat thinner than that of the permanent units. In addition, children are not always taught the rules of oral hygiene. According to statistics, most often root caries is localized on the child’s front teeth. Consider the actions of a dentist:

1. Cleaning the surface of dental plaque.
2. At the initial stage, fluoridation is performed. The technique does not involve drilling or filling. The carious cavity is treated with an antiseptic, then covered with fluoride varnish. Cervical caries in a child is “preserved” until it is replaced with a permanent unit.
3. Deep cavities are filled if the child is able to withstand this procedure.

Caries in adults at the incipient stage is treated by remineralization of the tooth. The unit is treated with an antiseptic and special compounds that replenish the lack of minerals. For the treatment of stages 2 and 3, the following methods are used:

1. Cleaning and filling channels.
2. Tooth restoration.
3. Strengthening the unit.

Treatment at home for cervical caries is advisable only at the beginning of the onset of the disease. Let's look at them:

• Regular use of remineralizing pastes. You can alternate fluoride-containing and calcium-containing products.
• Rinsing with sage decoction will have an antimicrobial and soothing effect (2 tablespoons per glass of boiling water).
• Propolis is also used for rinsing. In its pure form, it is applied to the affected area for 30 minutes, covered with a cotton swab.
• Baths made from sea salt solution. Add 1 tbsp to a glass of water. l. powder. Keep in mouth for 2-3 minutes. Carry out procedures 5–8 times a day.

It is worth noting that self-medication is dangerous. It is difficult to stop the pathological process without determining why gingival caries of the lateral or anterior teeth developed. It is better to entrust your health to a specialist.

Possible complications

If the process of tissue decay is not stopped, it mercilessly spreads to neighboring tissues. Especially when caries develops under the gum. Its localization does not allow timely diagnosis of the disease. Usually a person consults a doctor only after pain appears. By this time, he is already developing complications:

• Pulpitis (damage to the nerve bundle).
• (infection affects the tissue connecting the root to the alveoli).
• (formation at the root apex filled with pus).
• Cyst.
• Tooth fracture.
• Multiple basal caries.

Most often, complications develop in childhood due to the fact that during this period the stages of the disease quickly replace one another. Up to certain moments, the child may not feel pain even with pulpitis. And visually it is not always possible to notice a carious cavity, especially if it is localized on the side.

Prevention

In order to prevent cervical caries, doctors give several tips:

• Careful oral hygiene.
• Application.
• Balanced diet.
• A healthy lifestyle, including avoidance of nicotine and alcohol.

Following these simple rules helps prevent the development of pathogenic microflora in the mouth.

In order to protect your teeth from decay, you need to visit the dentist once every six months for a preventive examination. During such visits, it is possible to detect the disease at the initial stage of its development. All this makes it possible to quickly and easily eliminate pathology and preserve the health of your smile for many years.

Useful video about cervical caries

Dentists in clinics often ask you before filling, “Are we going to get a good filling?” Well, of course, a good one!

And you choose the most expensive filling, and then you are sincerely surprised when it falls out or at the next appointment you are diagnosed with extensive caries underneath it. How so?

Of course, the filling material plays a big role. But even the most expensive filling won't last long if it's done incorrectly. put!

It is about the “pitfalls” of installing a filling that we will talk about in this article.

What does careless filling lead to?

Dental filling is the most common and probably familiar dental treatment procedure to every person. But you don’t even suspect how many problems an incorrectly installed filling can cause.

For example, she can:

• simply fall out in a few weeks, or even by evening
• cause discomfort while eating and even at rest
• injure the gums and lead to periodontitis (inflammation of the gums)

Moreover, in some cases, improper filling can even cause jaw pain and headaches!

This is exactly the story our patient told.

“Some time after installing fillings on all the chewing teeth, I noticed that the lower jaw seemed to be “moving” from side to side.

As it turned out, all my fillings were made flat! And this led to a violation of the natural position of the jaw. I couldn’t even imagine that this could happen!”

To avoid trouble, remember -

How to determine whether a filling is installed correctly

High-quality installation of fillings meets these criteria.

1. The anatomical surface of the tooth has been restored

That is, a special shape with tubercles and depressions (fissures), thanks to which the teeth perform the main function of grinding and crushing food. And they keep the jaws in the correct position so that the story you just read does not repeat itself.

1. Poor quality filling 2. Correct filling

At the DentaBravo clinic, after treatment, we show the patient the installed filling in a mirror and advise him to listen to his own feelings. You should not feel discomfort when you close your teeth.

2. A point contact point has been formed

Normally, adjacent teeth touch tightly at one point. Therefore, after installing a filling on the side surface of a tooth, there should be no gaps left between adjacent teeth where food debris can accumulate, causing the development of caries below the filling.

And our dentists know for sure that the filling material should not completely fill the space between the teeth, connecting two teeth.

Firstly, then the load on the teeth during chewing is distributed unevenly, and secondly, the filling itself will collapse faster.

If your gums become inflamed and bleed at the place where the filling is placed, and your teeth hurt when chewing, most likely the reason is a poor contact point.

3. The filling material does not hang over the edges of the tooth

If the filling does not exactly follow the contour of the tooth, but protrudes beyond its limits and has uneven edges, then food can again get stuck under it. And this, as you remember, is a direct path to caries.

4. The surface of the filling does not have microvoids or cracks

After installation, the filling is treated with burs and then polished to a perfectly smooth surface. At the same time, microscopic cracks and voids that are invisible to the eye may remain on the surface of the filling.

To get rid of them, we apply a special composite material to the surface of the filling, thanks to which the strength and color of the filling are preserved.

At the DentaBravo clinic, after filling, the doctor will definitely tell you how to care for your teeth in order to preserve the enamel and extend the life of the filling.

A filling made of high-quality material, made using technology, will last from 5-8 to 20 years (!), without causing you any inconvenience. And if the work was done by a dentist without sufficient experience and qualifications, then using even the most expensive material will not fix anything.

Therefore, when going to have your teeth treated, focus not only on the quality of the material, but also on the professionalism and experience of the doctor - and our advice will help you with this.

If you have already found a dentist you trust, we are very happy! And if not, come to our clinic, where the quality of treatment is guaranteed by specialists with 10 years of experience.

Filling is the process of restoring the shape and function of a damaged tooth. Typically, destruction occurs due to, but sometimes part of the tooth breaks off for other reasons - for example, due to a blow or fall.

Filling helps prevent tooth decay and isolate the sensitive tissues of the cavity from germs and bacteria, which provoke the development of caries.

Types of filling materials

Depending on the period of use, permanent fillings are distinguished:

About the materials used

Today in dentistry the following types of fillings are used:

1. Cement fillings are the cheapest. They do not grind well, stand out against the background of natural enamel and can destroy the teeth that they come into contact with in the bite. They are rarely used, mainly in pediatric dentistry.
2. Metal (almagam) made from an alloy of silver and copper. They are durable, but, like cement fillings, they are very noticeable. They are usually placed on the chewing teeth. Among the disadvantages, high toxicity is noted.
3. Composite are made from a mixture of various components, including finely ground glass and artificial resin. Such fillings were previously considered fragile, so they were placed only on the front teeth. However, over time the material has improved. The composite filling is applied in layers. Each layer should be exposed to light for 30-40 seconds. This material can be easily matched to the natural color of the enamel, which is why doctors usually choose them for the restoration of front teeth.
4. These are ceramic fillings. In appearance and composition they are very close to tooth enamel. Making an inlay takes up to a week, so installing a filling on a tooth occurs in several stages. The ceramic filling is resistant to temperature changes and does not stain the tooth. Among its advantages is aesthetics. These fillings are usually matched to the color of the tooth and are virtually invisible.

How does the installation work?

The procedure for filling a tooth, regardless of the material used, begins the same:

Use of cement

Cement fillings are made from glass ionomer, phosphate and silicate cements. One of the characteristics of cement is that it hardens through a chemical reaction when mixed with a liquid.

Because of this, the dentist does not have much time to install the filling and it is quite difficult to form the surface relief.

Another feature of a cement filling is its long time for final hardening. Therefore, after treatment, it is not recommended to eat for two hours.

Depending on the type of cement used, the following must be taken into account:

1. Fillings from phosphate cement is the cheapest. They are poorly fixed, wear out quickly and have poor edge adhesion. The latter means that food debris often gets trapped under such a filling, which causes secondary caries.
2. Glass ionomer Cement fillings adhere much better to the tooth tissue, which significantly reduces the risk of secondary caries. This seal is installed using an ultraviolet lamp. That is, the doctor slowly shapes the tooth while the filling is still soft, and then “hardens” it using ultraviolet light, completing the work.
3. Fillings from silicate cement release free phosphoric acid, which has a bad effect on living pulp. Therefore, it is recommended to place them on a gasket. Among the advantages of these fillings are the ability to choose the color and good marginal fit.

Glass ionomer cement filling

Installation and features of a metal seal

Among the advantages of metal fillings, it is worth highlighting their hardness and resistance to corrosion. These fillings are quite flexible and resistant to moisture.

Among the disadvantages, toxicity stands out, since it is made from amalgam - an alloy of various materials with mercury.

Expansion is another disadvantage of metal fillings. Because of this, the tooth wall adjacent to the filling often breaks off. Of course, today the risk of spalling is minimized, but it is still present.

The color of such a filling does not match the color of the enamel. Therefore, most often metal fillings are placed under.

Quite difficult to install. It hardens for a long time - two to three hours. The day after installation, this filling requires polishing. However, it can serve for decades.

Composites - a breakthrough in the field of dentistry

With composite filling, the tooth cavity is treated with an adhesive. This substance helps to glue the filling into the tooth cavity.

After this, the dentist places the filling in layers, shining each layer for 20-40 seconds. When all layers are installed, the filling is ground to the shape of the tooth and polished.

After installation of a composite filling, the patient may experience symptoms. Also, these fillings may darken if the patient often drinks tea or coffee. However, if you cover the filling with a transparent film, discoloration can be avoided.

Installation of a dental inlay

In color, light reflection and strength, ceramics are more similar to tooth enamel than other materials. An inlay glued to a tooth almost completely restores its original strength.

Unlike other types of fillings, inlays are made in a laboratory rather than in the patient's mouth.

Most often, ceramic fillings are placed when the tooth is severely damaged, but is still alive. The tab allows you to save it, that is, to avoid depulpation and.

Installation of a ceramic filling occurs in several stages. First, the dentist completely cleans the tooth of dead tissue and takes an impression to make an inlay. The inlay is then made in the laboratory. After this, fitting occurs.

If everything is fine, the dentist places the tab on a special glue, and then grinds down the unevenness and polishes it.

Features of canal filling

If, in the process of getting rid of dead tissue from the tooth cavity, it turns out that the pulp is affected, the dentist removes it and fills the canals. High-quality filled canals are the key to saving the tooth.

Filling the canals begins immediately after.

In order for canal filling to be successful, the dentist needs to know the shape and placement of the tooth roots, which may require.

Typically, root canals are very narrow, so the dentist widens them, passing the instrument along the entire length - from the root to the apex - and treats them with medication.

Then the canals are filled with gutta-percha. At this stage, a special hardening paste (sealer) and gutta-percha pins (first the main ones, then additional ones) are introduced into the canals. Additional pins have a smaller diameter.

After the pins are compacted and the channel is completely filled, the tops of the pins are cut off with a special hot tool.

The photo shows root canal filling using the single pin method.

Video of gutta-percha three-dimensional filling of teeth:

A few words about pain

Adults often... This is a fear that has survived from Soviet times. But today medicine has made a huge leap forward. The variety of anesthetics used in modern dentistry is enormous. Even allergies no longer interfere with comfortable treatment.

Most often, during the filling process, the patient who has had it done does not experience any pain. The exception is severe inflammation. In this case, it is recommended to increase the dose of anesthetic.

After the tooth has been treated, the patient may experience slight sensitivity, which usually goes away in a day or two.

Possible complications

After installing a filling, the following complications are possible:

1. is considered normal within 24 hours after installation. If it lasts longer, it means that the carious cavity was treated poorly and re-treatment is required.
2. The same thing means filling falling out.

Filling today remains the most popular way to treat caries. A variety of materials allows the patient to choose the optimal option, and anesthetics allow the treatment to be simple and painless.

However, it is important to understand that tooth decay is a disease. And like any disease, it requires treatment. The earlier caries is detected, the easier and cheaper it is to get rid of it.

Greetings, dear readers of this site. Today I would like to raise an important topic that will be of interest to many. It affected some people personally, while others had to watch from the sidelines.

From this article you will learn about how 21st century dentists treat caries. What has appeared in the arsenal of medicine in recent years, decades? How effective are the methods used in the territory of the former USSR? These and other questions are relevant for millions of our compatriots. After all, dental diseases worry almost every second person.

A little history

Over the centuries, tooth decay has been treated differently. For example, wealthy residents of medieval Europe considered black spots on their teeth to be the norm. This indicated that they did not eat rough food like the poor. Of course, they were also concerned about the pain associated with pulp damage. They treated her with ancient methods, sometimes barbaric and far from medical concepts.

Nowadays, having caries on your front teeth is no longer considered a sign of high status. People are much more concerned about their health and appearance. Along with the era, attitudes towards dentistry have also changed. On the other hand, problems with teeth have not decreased.

Why is tooth decay so common?

There are several reasons. They are diverse and sometimes deeper than we think. The diet has been shaped over centuries. Now for many, it no longer includes products that clean the oral cavity and disinfect it.

The second problem is lack of hygiene. People have food particles between their teeth, but without them they cannot be removed. However, many people believe that a brush is enough to remove all the organic debris remaining after eating.

Problem number three is the collapse of the immune system of modern man. We have been fed antibiotics since childhood so abundantly and often that a banal bacterium entering the mouth can overwhelm the body’s defenses. For millions of years, humans have been able to defeat bacteria, fungi, and even retroviruses on their own. Nowadays the pills do everything for us.

Antibiotics enter the body through food, in particular from meat and even mineral water.

The fourth problem of humanity in the 3rd millennium is the fear of doctors. It affects adults and children, teenagers and brutal military men, men and women. People put off visiting the dentist until the last minute.

How are carious teeth treated now?

To protect the patient from the development of the process and its complications, the doctor must effectively clean the affected tooth from destroyed tissue, removing the source of proliferation of pathogenic bacteria. Antiseptic agents may be used. They are necessary so that after removing the affected area of ​​enamel and dentin, bacteria do not remain in the same place. Cleaning is done with a drill. If the pulp is not affected, the patient does not feel pain. There may be some discomfort from vibration and heat from the tooth.

In general, the technique depends on the degree of tooth damage. There are four forms of caries. Each of them has its own specifics of the dentist’s work.

The next stage is determining the color of the enamel. When there is no plaque on it, the doctor sees the natural color of the tissues, to match which the filling material is selected. Modern fillings look so natural that they are practically invisible in the patient’s mouth. If a tooth affected by caries is located in the smile zone, this point becomes even more relevant. It is unlikely that anyone would want a gray or yellow filling visible in their mouth, standing out noticeably against the background of natural enamel.

Another important point is anesthesia. Sometimes the patient is more sensitive to the discomfort felt. Everything here is individual and depends on the characteristics of each person’s nervous system. The choice of pain relief depends on the presence of allergies to any drugs, chronic diseases, etc. Anesthetics for pregnant women are selected separately. They should not pass through the placenta.

The injection itself can also be painful if performed incorrectly. It is important to observe the speed of drug administration. The higher it is, the more unpleasant the procedure is for the patient.

Now there is a large selection of anesthetics. If not so long ago the choice was between novocaine and lidocaine, then in our time ultracaine, ubistezin, scandonest (without adrenaline), septanest (a good analogue of ultracaine) have appeared.

Next, the same process described above begins - the removal of tissue affected by bacteria. If previously this could only be done by drilling, now clinics offer a similar procedure performed using a laser. It does not overheat the tooth, which means it does not irritate the pulp. Therefore, this method is considered more effective. At the same time, laser treatment of caries is more expensive than traditional methods.

After cleaning, the doctor can fill the tooth with a regular or photopolymer filling. Composite and photopolymer materials have now become much higher quality and provide better adhesion to dental tissues. The filling is ground and polished to give it an anatomical shape that is comfortable for chewing.

Treatment of caries in childhood and adolescence

Why do children develop caries more often than adults? Firstly, they have weaker enamel. Secondly, everything is much worse with hygiene. Thirdly, the immune system’s defenses cannot cope with bacteria.

Many parents underestimate the threat posed by caries in baby teeth. Their early destruction may lead to the need for removal. This causes problems in the growth of permanent teeth, and sometimes, with deep lesions, affects their rudiments and leads to adentia (lack of teeth).

It is very important to detect caries at the spot stage, when it is not a threat and can be eliminated with the help of remineralizing procedures. In other cases, treatment is carried out according to the same scheme as in adult patients.

Some clinics treat children under general anesthesia or using drugs to induce sleep. This is a common practice in the USA. The advantage of the technique is that the child does not develop a fear of doctors, there is no stress. He sleeps and does not feel discomfort.

Local anesthesia is not always performed by injection. Special sprays containing lidocaine are available.

Treatment of a child is much more complicated than a similar procedure in adults. It is more difficult to persuade children to sit still and not move. After all, such behavior is not natural for them.

Let's sum it up

Modern dentistry has come a long way from the days when teeth were treated with herbs and fillings were made of lead. Nowadays, medicine has advanced technologies based on laser and ultrasound. The main problem people have in the fight against caries is fear. If it weren’t for him, dentists would have almost no work left besides prevention.

Almost 90% of cases of deep caries are the fault of the patients themselves, and in the case of children, parents are to blame. Only a small percentage of the population undergoes routine examination regularly (twice a year). The result is advanced cases, many of which end in pulpitis, periodontitis and other complications.

Another problem is the underfunding of budget dental clinics. This problem does not allow us to provide qualified assistance in many cases. Therefore, I advise you not to start caries and contact only good dentists. It may be more expensive, but it is more reliable and safe!

Video - How caries is treated in dentistry