In it’s early stages, tooth decay has little to no symptoms associated with it. This is because the tooth decaying acids in the mouth will first have to eat through the hard outer layer of enamel on your tooth before it can progress to more advanced stages that will require a dental visit.
If you do not notice any of the early signs of tooth decay, which will result in not taking the necessary preventative measures to remineralize your tooth enamel, the daily build up of acids in your mouth will eventually penetrate through your enamel into the dentin layer of the tooth. At this point there will most likely be more noticeable symptoms of tooth decay such as a tooth ache or sensitivity to hot and cold drinks, and you will not be able to simply reverse tooth decay by making changes to your daily routine.
Once tooth decay progresses into the dentin layer, dental intervention will be required to fix the tooth and prevent any further decay from happening. The two most common dental procedures for fixing a cavity that has entered into the dentin layer are fillings and crowns, and there may also be a new procedure on the horizon known as Electrically Accelerated and Enhanced Remineralisation (EAER).
Tooth decay that has become a cavity, penetrating into the dentin layer will need to be filled and sealed to eliminate the risk of more bacteria build up inside the cavity. If it is not sealed, it will become easier for bacteria and acids to hide inside the cavity, further damaging your tooth from the inside, and accelerating the decay which will eventually penetrate into the tooth pulp.
According to the Canadian Dental Association, there are two main types of fillings used in Canada, metal and tooth colored fillings, which are discussed below. But before we go into the types of fillings, we will discuss the dental filling procedure.
Step-by-Step Dental Filling Procedure
- The dentist will first provide local anesthetic to the area surrounding the effected tooth to eliminate pain during the procedure. This is not necessary but makes the procedure much easier to endure.
- Next, the dentist will use a drilling device to clean out any of the decayed tooth structure that remains in the cavity. This will clean the cavity site so that no bacteria is stuck inside the tooth after the filling is placed.
- The chosen filling material is then placed into the cleaned out cavity site, hardened quickly and smoothed out to give the tooth a natural feel when biting down on it.
Once this procedure is complete, which is usually done in one sitting, you will have a restored tooth that is pretty much good as new.
Dental Amalgam Fillings
Dental amalgam fillings, also known as silver fillings due to their silver color, are the most common material used for fillings in Canada and are made from a mixture of silver, mercury, tin and copper. Because of their color, this type of filling is most often used on the back molars so that they are less visible to others.
These are the most common due to the ease of placing them, their durability and the low cost associated with the materials used. However, the silver color of these fillings plus the thought of having mercury inside the mouth are becoming major reasons for more and more people to choose one of the other filling types.
Cast Gold Fillings
A second metallic option for fillings is to use a mixture of gold, silver and copper. Cast gold fillings are stronger and more durable than amalgam fillings, however, the procedure is a little different and thus they can not be placed in one sitting. The procedure for placing cast gold fillings requires two visits as follows:
- during the first visit, the dentist will clean the cavity site, make a mold of the site to be sent to a lab that will create the filling and place a temporary filling until the mold is created
- in the second visit, the dentist will remove the temporary filling and cement the cast gold filling in place
Cast gold fillings get rid of the worry of having mercury in the mouth, but, they are more expensive as a result of using gold and still do not have a natural white color.
Tooth Colored Fillings
Also known as composite fillings, this type of filling material is a white making it blend nicely with the natural tooth color. It is placed into the cavity site in thin layers and dried with a special light that the dentist places into your mouth after each layer application. Once complete, the top surface is given a more natural shape so you can feel comfortable when biting down on it.
Although this filling provides the benefit of having a more natural look than metal fillings, the material used is not as durable making is a poor choice for the back molars which is where we bite down the hardest.
This is the most common type of dental ceramic used in Canada due to it’s strength and white color. They can even be combined with certain metals to make the material even stronger. Similar to cast gold fillings, porcelain fillings will require at least two dental visits because the filling must be made off-site in a dental lab.
Dental crowns can be used for many different reasons, one of them being to stop tooth decay from progressing into further stages. Crowns are different from fillings because instead of filling the cavity site, a crown is instead a tooth shaped cap that is placed over the damaged tooth. You can look at it as a prosthetic tooth, using the original tooth as an anchor.
Step-by-Step Crown Placement Procedure
Unlike fillings, the placement of a crown will require several dental visits to be completed. Here is a step-by-step
explanation of the procedure:
- Local anesthetic is provided to the area of the decayed tooth
- The dentist then re-shapes the decayed tooth turning it into an anchor for the crown to be placed on. This is usually done by filing down the enamel of the tooth to make it into a pillar-like shape.
- Images are taken of the filed down tooth and surrounding area so that a dental lab can design a tooth that fits perfectly into the site. A temporary crown is then placed until the permanent version is created.
- On the final visit, the dentist will remove the temporary crown and place the permanent one, ensuring that it fits perfectly leaving you with a tooth that looks and feels natural.
Types of Crowns
Similar to fillings, there are several materials that crowns can be made of depending on your personal preference and the area that it will be placed.
Composite Resin Crowns
This is the most affordable crown due to the material they are made of. Composite crowns are very popular due to their low cost and natural appearance, however they are not as durable as other options and tend to wear down quicker from chewing.
Ceramic crowns are also very popular due to their natural look and are made from natural materials like zirconia which makes them bio-compatible. Similar to composite crowns, however, they are not the most durable option and have a higher chance of cracking or chipping.
These crowns will not break or chip and will not succumb to tooth decay, making them the most durable crown available. The downside, however, is that they are made out of metal meaning that they can be rejected by some bodies and they do not have a natural look at all. Metal crowns are a great choice for the molars at the back of the mouth where they won’t be noticeable.
Porcelain Fused to Metal Crowns
With this type of crown you get the best of both worlds. You get a similar strength to metal crowns but with the natural look achieved by porcelain and ceramic crowns, making them a very popular choice. These are essentially a metal crown with a thin porcelain outer layer.
Electrically Accelerated and Enhanced Remineralization
In the near future, there may be a new method for repairing tooth decay. EAER is a technique developed in London at King’s College which accelerates the remineralization of calcium and phosphorous into the decayed tooth, allowing the tooth to pretty much repair itself. This will eliminate the need for fillings and crowns in people suffering from tooth decay.
According to an article published on The Guardian, this approach to fixing tooth decay may be available as soon as 2017.