Dental fillings are procedures to repair cavities or damaged teeth. This procedure is done by inserting a filling material into the part of the tooth that is damaged or cavities. The filling method and filling material used will be adjusted to the patient's dental condition.
Cavities occur when bacteria in the mouth produce acids. Over time, these acids can erode the enamel (outer layer) of teeth and cause cavities. If not treated immediately, cavities in the teeth can cause further damage, such as tooth loss (lost) and tooth infection.
Indications for dental fillings
Dental filling procedures aim to restore the shape and function of damaged or perforated teeth. Signs that a tooth needs filling, include:
- Tooth pain that appears suddenly, without any triggers
- Pain when biting or when consuming sweet, cold, or hot food or drinks
- Sensitive teeth
- Tooth discoloration to brown or blackish brown
Fillings can also be done to repair cracked, broken, or eroded teeth due to certain habits, such as grinding your teeth or biting your nails.
Patch Material Type
The dentist will suggest several filling materials, depending on the patient's condition. The following is an explanation of the materials that may be used, along with their advantages and disadvantages:
Composite
Composite is a mixture of acrylic resin and glass powder. This material is the filling material that is most often used today. In addition to dental cavities, composites can also be used in dental veneer procedures or to replace broken teeth.
Some of the advantages of composites when used for dental fillings are:
- The color of the composite material can be adjusted to the color of the teeth
- Strong enough and resistant to pressure when used to chew or bite ordinary food
- No need to repair or replace frequently
Meanwhile, the disadvantages of composite materials include:
- Can come off if often used to bite hard-textured food
- In rare cases, composites can cause local allergic reactions
- Can turn yellow faster than teeth
amalgam
Amalgam is a mixture of several metals, namely mercury, silver, copper, and tin. Amalgam is usually used to fill back teeth. However, now this filling material is rarely used.
Some of the advantages of amalgam are:
- Strong, durable, and resistant to pressure when used for biting and chewing
- Cheapest than other types of filling materials
- No need to repair or replace frequently
Meanwhile, the disadvantages of amalgam include:
- Contains mercury
- In rare cases, amalgam can cause allergic reactions and rashes
- Installation of amalgam material requires the removal of several healthy teeth
- The color of amalgam can turn dark due to corrosion, making it less beautiful to look at
Glass ionomer
Glass ionomer is a mixture of acrylic acid with glass powder. Generally used for small fillings in parts of the teeth that are not often used for biting.
Some of the advantages of glass ionomer when used for dental fillings are:
- Glass ionomer fillings match the color of your teeth
- The risk of developing an allergic reaction is relatively low
- The part of the tooth that is taken is a little
While the disadvantages of glass ionomer are:
- Only for small tooth holes
- Over time, this material can become a place for plaque buildup which increases the risk of gum disease
- In rare cases, glass ionomer can cause allergic reactions and rashes
- There is a risk of fillings with glass ionomers falling off the teeth
Ionomer resin
Ionomer resin is a mixture of acrylic acid and acrylic resin. Ionomer resins are commonly used to fill tooth surfaces that are not used for chewing, or to fill premature teeth in infants.
Some of the advantages of ionomer resins are:
- The color of the material matches the color of the teeth and is more transparent than glass ionomer
- Low risk of local allergic reaction
- The part of the tooth that is taken is a little
Meanwhile, the disadvantages of resin ionomer materials are:
- Limited use, should not be used to bite hard food
- Lower durability compared to composite and amalgam materials
- In rare cases, glass ionomer can cause allergic reactions and rashes
Porcelain
Porcelain or ceramics are not only used as dental fillings, but also dental crowns (dental crown) and dental veneers. Porcelain can also be mixed with metal to increase its resistance to tooth decay.
Some of the advantages of porcelain when used for dental fillings are:
- Translucent porcelain material, so the color can be exactly the same as the teeth
- Very low risk of eroding or rotting
- Low risk of causing infection
- Does not cause allergic reactions
Meanwhile, the disadvantages of porcelain are:
- Porcelain is brittle and breaks easily
- The cost of expensive materials, equivalent to gold materials
gold alloy
Gold alloys contain gold, copper, and several other metals. Gold alloys are more often used to treat large and wide cavities. Some of the advantages of gold alloy material for filling teeth are:
- Excellent durability and not easy to crack under pressure
- Not easy to be eroded
- Low risk of causing infection
- The part of the tooth that must be taken is a little
Meanwhile, the disadvantages of gold alloy materials include:
- High price
- The color does not match the color of the teeth
- In rare cases, it can cause allergic reactions and rashes
Dental filling contraindications
Dental fillings are generally a safe procedure. What needs to be considered is the choice of filling material. Patients who are known to have allergies to resins, acrylics, or metals, are not advised to use fillings containing these mixtures.
Due to the consideration of the mercury content, patients who have at least one of the following conditions are also not advised to have dental fillings with amalgam materials:
- Under 6 years old
- Are pregnant, breastfeeding, or planning a pregnancy
- Have a neurological disease, such as Alzheimer's disease, Parkinson's disease, or multiple sclerosis
- Suffering from kidney disease
Before Tooth Filling
Before dental fillings are carried out, there are several stages of preparation to determine the appropriate method and type of filling material. The preparation includes:
Health history check
The first step taken by the dentist before carrying out a dental filling is to check the patient's medical history. At this stage, tell your doctor if you:
- Are pregnant or breastfeeding
- Are taking drugs or herbal products
- Planning to use braces in the near future
- Have an allergy to metal, mercury, or other ingredients contained in dental fillings
- Taking blood-thinning or blood pressure-lowering drugs
By knowing the patient's condition, the doctor can take preventive steps against the risks that may occur. For example, the doctor will look for alternative filling materials if the patient is allergic to certain filling materials.
Dental check-up
After checking the patient's medical history, the doctor will examine the patient's dental condition. If necessary, the doctor will suggest additional examinations, such as dental X-rays.
Determination of the method and type of filling material
The next step is to determine the method and type of filling material, based on the following factors:
- Overall oral and body health of the patient
- Location of cavities
- Bite pressure on the cavities area
- Required dental durability
- Aesthetic factor
- Patient's financial ability
Next, the dentist will explain about the procedure the patient will undergo, the risks of side effects and complications, as well as the benefits that the patient can get.
Dental Filling Procedure
Based on the method used to fill the filling material, dental filling procedures are divided into two categories, namely:
Fill your teeth directly
Fill teeth directly or direct filling This is done by first cleaning the dirt in the tooth cavity. After that, the dentist will insert the filling material directly into the cavities. The type of filling material that is usually used in direct filling are amalgams and composites.
The direct filling process is generally completed in one meeting. The following are the steps that the dentist will carry out in the direct filling process:
- Give a local anesthetic injection to numb the area around the patient's teeth.
- Remove the damaged part of the tooth by using a special drill, air spray or laser.
- Double-check the area of the tooth to be filled to make sure that all the dirt has been removed.
- Attach fillings to cavities with materials that have been previously selected. If the damage in the tooth is close to the root, the doctor may first make a layer of glass ionomer or composite resin to protect the nerve.
- Brushing or polishing the teeth that have been filled.
Filling teeth indirectly
Filling teeth indirectly or indirect filling performed when the cavities are very large and the remaining tooth structure cannot accommodate the filling material. Finally, the filling must be printed first, according to the part of the tooth that has been damaged.
The filling materials that are often used in this method are gold and porcelain. Because it requires a printing process, indirect filling requires 2 visits. The steps carried out in indirect filling is:
- On first visit, The dentist will clean the dirt on the teeth, then print the cavities. The resulting print will then be made using a filling material. The doctor will place temporary fillings into the cavities until the impression is complete.
- At the second visit, the temporary filling will be removed and the doctor will check for compatibility between the cavities and the impression. Next, the dentist will glue the dental fillings that have been printed onto the cavities.
After Tooth Filling
After the filling procedure is complete, the dentist will teach the patient how to care for the filling and prevent decay that can occur in the filling or other teeth. The ways that patients can do include:
- Eat a balanced nutritious diet
- Brush your teeth with toothpaste that contains fluoride regularly, 2 times a day
- Clean the gaps in the teeth regularly with dental floss (dental floss)
- Check and clean your teeth regularly at the dentist
Sensitive teeth are quite common after a filling procedure. But usually, this complaint will soon disappear by itself. To reduce discomfort, patients are advised to:
- Use the side of the mouth opposite the filling to chew
- Do not consume foods or drinks that are too hot, cold, sweet, and sour
- Gently brush your teeth around the filling
Allergic reactions can also be known a few moments or a few days after filling the tooth. If there is an allergic reaction, such as itching and a rash around the filling site, see a doctor immediately so that the type of filling can be changed.
Dental Filling Risk
There are several risks that may occur due to dental filling procedures, namely:
Sensitive teeth
In some cases, the problem of sensitive teeth may not improve. If tooth sensitivity does not subside within 2–4 weeks or if the tooth feels very sensitive, consult a doctor immediately.
tooth pain
Tooth pain after fillings can occur when biting or when a freshly filled tooth comes into contact with another tooth. If this happens, get checked out by a dentist as the filling may need to be re-evaluated.
Tooth pain can also occur if the damage to the tooth is very close to the root of the tooth. In this condition, the patient will be advised to undergo root treatment.
Worn fillings
Dental fillings can crack or fall out of place due to continuous pressure when chewing or biting. This condition may not be noticed by people who use dental fillings, until the teeth again look cavities or symptoms appear.
Immediately consult a dentist, if you experience the following conditions:
- Teeth feel very sensitive
- Feels like there is a sharp part in the filling of the tooth
- Visible or feeling a gap in the filling of the tooth
- It feels like some of the fillings are missing
If the dentist detects a cracked patch or does not adhere perfectly, the doctor will perform an X-ray examination to see the condition of the tooth in more detail. Fillings that don't stick together allow saliva, food debris, and bacteria to seep into the gap and trigger tooth decay.