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Five Essentials If You Are Told You Need Dental Fillings
Courtesy of: and Craig Sommer DDS

“You’ve Got Cavities And You Need A Few Dental Fillings.”

If you just heard this from your dentist, keep reading, because in this article I will explain: 1) what a cavity is, 2) why you might need a dental filling, 3) why a filling may be the right choice and 4) what materials might be best, 5) why an alternative to a filling may be necessary.

What is a cavity?  The term is used to describe the disease process of tooth softening as a result of bacterial infection, officially called caries, (latin for rottenness). The term cavity is also used to describe the hole created by caries,the disease. In either case you have a tooth that needs repair with a dental filling.

I Applaud You For Doing Your Homework

It’s OK to be ultra-careful. If you ever get a cavity, and you’ve researched it, you are ready. Maybe you are researching for a friend or family member, but you want to be sure the right choice is made. Good for you, be proactive about your health. I applaud you, since what goes into those holes in your teeth to repair them is going to be with you for a long time.

Dental fillings are most often the treatment of choice for your small to medium size cavities. They are used to fill in the hole where bacteria have damaged your tooth by eating through the hard enamel layer into the softer second layer called dentin.

Where Do Cavities Usually Start?

The hills and valleys on your teeth are great for grinding up groceries, but food often remains after a meal. Take a look in a mirror and you will see what I mean. It gets stuck in grooves, crevices and pits on the tooth biting surface. It’s the most common place for cavities in children and young adults.

Teeth aren’t perfect. They can have small defects, crevices, fissures and pits, each with thin spots in the hard enamel outer layer. These occur most often in the biting surface areas of your teeth.

These little holes and crevices in your teeth were there when the tooth formed deep in the gums. Potential food traps, present even before they started coming through the gums, just waiting to catch food. Sometimes it isn’t your fault you have cavities.

No Fault Cavities

These cavities are due to the shape of your teeth and have little to do with brushing, sodas, or anything else for that matter. So you can give yourself a little reprieve. They are the result of inheriting tooth shape genes from, guess who? Mom and Dad.

They bring about the most frustration and frequent thoughts of “NO FAIR” from everyone concerned, even your dentist.

You’ve Got “Mom and Dad” Cavities

I suggest the next time you have a chance, give them a big hug and a kiss and say, “thanks.” After the family ribbing unfortunately, it still feels like you got the short end of the stick. Sorry, not fair. I know.

It’s not that uncommon for your dentist to see or feel holes in your teeth shortly after a new tooth breaks through the gums. Some are tiny and may not, in her opinion, require any treatment right away. With the right food selections and good habits you may have very slow or no cavity development in many of these teeth for years.

Cavities Waiting In The Wings

Sometimes, I have seen or felt large cavities or holes in a new tooth that’s only barely visible. These holes can also be found on the sides of certain teeth. I then have to inform you or your parents that a cavity is waiting in the wings and as soon as it pops through the gums completely, an early filling may best repair the hole.

If you decide to have these defects filled early, before they become painful, you can often prevent bacteria from eating through the tooth into the nerve in the center. At that point it will be more complicated to address and likely with a poorer outcome. Early detection is key.

Stop The Destruction

Dental fillings are used to stop cavities from continuing to destroy teeth. It’s only by removing the live bacteria from the inside of the tooth that the process of tooth destruction can be stopped.

The bacteria in the softened (infected) enamel and dentin layers must be scraped or “drilled” out of the tooth. But, if bacteria is left behind, it continues to eat its way towards the nerve of your tooth, followed by extreme pain and possible tooth loss. After the bacteria is removed the remaining hole needs to be filled with a dental filling material. This is where you must pay careful attention.

Caveat Emptor-May The Buyer Beware

In most modern dental offices you will have a choice of materials to fill the remaining hole in your tooth. In my opinion, the dental filling of choice is one that doesn’t contain any mercury. Even though the  number of dentists still placing mercury fillings is dropping, 45% of dentists are still willing to place toxic mercury based “silver” fillings into your teeth. Unless you demand that no mercury based filling material is used, you or your family may be exposed to toxic mercury from dental fillings. Caveat emptor: May the buyer beware.

Make Me A Promise

Regardless of the reason that a filling is recommended, your choices are still relatively simple.

Accept no mercury containing fillings no matter what. OK? Make me a promise that you won’t do that. So let’s scratch that one off the list right away.

Another choice for a filling would be what is called a composite resin filling. That’s a filling consisting of a mixture of plastic resins and super-fine zirconia or silica nano-particles.

It’s the filler material part of the composite resin that gives it wear resistance or toughness over time. The latest nano-particle-resin composite fillings rival the durability of the old mercury based “silver” fillings if they are carefully placed.

The resin part of the composite filling can bond or glue directly to your tooth, making it stronger, unlike mercury silver fillings that weaken a tooth. Composite resins are a great substitute for the old mercury filling technology.

Mercury Containing Fillings Are Ugly

Another important advantage of the composite resin fillings is they are tooth colored and blend in so well they are almost invisible in your teeth. Teeth that look like white dice with black spots are not nearly as attractive as teeth without the blackening mercury containing “silver” fillings.

It was hard as a dental student to be proud of a filling that was so noticeable initially and would eventually blacken from corrosion and often crack or split the tooth.

Are Fillings Always The Best Choice?

If the cavity in your tooth is very large, it can weaken your tooth too much to rely on a composite filling for an extended period of time. Your dentist may suggest other choices for toughness or durability including a strong porcelain material for maximum cosmetic appearance. Have a discussion with your dentist about the variety of porcelains available. A promising one is a zirconia based porcelain.

In this article I explained 1) what a cavity is, 2) why you might need a dental filling to repair a cavity in a tooth, or where a hole was present in a tooth when it first came in, 3) why a filling may be the right choice, 4) what materials might be best, 5) why an alternative to a filling may be necessary.

No decisions can be made without proper guidance from your holistic or biological dentist so please have that discussion.