FILLINGS AND EXTRACTIONS
Expert Oral Surgery for the Whole Family
Wisdom Teeth Removal, Teeth Filling and Oral Surgery in Archdale, NC
If you have never had a cavity, congratulations! If you have had one, you are not alone. About 78% of us have had at least one cavity by the time we reach age 17, according to a 2000 report by the U.S. Surgeon General. Fortunately, there's a time-tested treatment for cavities: the dental filling.
Patrick M. Pitts, DDS provides professional wisdom teeth removal, teeth filling and oral surgery services for patients throughout Archdale, NC. Contact our dental clinic today to arrange a consultation.
Teeth Filling Treatments
Fillings do just what the name implies
— seal a small hole in your tooth, i.e., a cavity, caused by decay. This prevents the decay (a bacteria-induced infection) from spreading further into your tooth and, if untreated, continue on to the sensitive inner pulp (nerve) tissue located in the root canal. Should that happen, you would need root canal treatment.
There are a variety of materials used to fill teeth these days, but the process of filling a tooth is similar regardless. The first step is a clinical exam of the tooth with x-rays, to determine the extent of the decay. Then the decayed area of the tooth is removed, usually with a handheld instrument such as a dental drill. Of course, your tooth will be anesthetized first, so you won't feel any discomfort. If you normally feel nervous about receiving numbing injections, it's possible that taking an anti-anxiety medication or using nitrous oxide can help you feel more relaxed. After removing the decay, the remaining tooth structure is roughened or “etched” with a mildly acidic solution; then translucent cement is applied to bond the tooth and the filling material together.
Types of Fillings
There are two broad categories of dental fillings:
metal fillings and tooth-colored fillings. Each may offer particular advantages and disadvantages in certain situations.
Metal Fillings
Amalgam
— The classic “silver” filling in use for more than a century, dental amalgam is actually an alloy made up of mercury, silver, tin, and copper. The mercury combines with the other metals in the amalgam to make it stable and safe. These fillings are strong and inexpensive, but also quite noticeable. They also require relatively more tooth preparation (drilling) than other types.
Cast Gold
— Among the most expensive restorative dental materials, cast gold combines gold with other metals for a very strong, long-lasting filling. It is also highly noticeable, which can be considered a plus or minus.
Tooth-Colored Fillings
Composite
— A popular choice for those who don't want their fillings to show, composite is a mixture of plastic and glass, which actually bonds to the rest of the tooth. Composites are more expensive than amalgam fillings, and the newer materials can hold up almost as long. Less drilling of the tooth is necessary when placing composite as compared to amalgam.
Porcelain
— These high-tech dental ceramics are strong, lifelike, and don't stain as composites can. They are sometimes more expensive than composites because they may require the use of a dental laboratory or specialized computer-generated technology. While considered the most aesthetic filling, they can also, because of their relatively high glass content, be brittle.
Glass Ionomer
— Made of acrylic and glass powders, these inexpensive, translucent fillings have the advantages of blending in pretty well with natural tooth color and releasing small amounts of fluoride to help prevent decay. They generally don't last as long as other restorative materials.
What to Expect After Getting a Filling
The numbness caused by your local anesthesia should wear off within a couple of hours. Until then, it's best to avoid drinking hot or cold liquids, and eating on the side of your mouth with the new filling. Some sensitivity to hot and cold is normal in the first couple of weeks after getting a tooth filled. If it persists beyond that, or you have any actual pain when biting, it could signal that an adjustment to your filling needs to be made. Continue to brush and floss as normal every day, and visit the dental office at least twice per year for your regular checkups and cleanings. And remember, tooth decay is a very preventable disease; with good oral hygiene and professional care, you can make your most recent cavity your last!
The main goal of dentistry is to preserve your natural teeth and keep them healthy for as long as possible. There are times, however, when it is in your best interest (or your child's) to have a tooth extracted (removed). This could be the case for a variety of reasons. Perhaps you have a tooth that has been severely damaged by trauma or decay; or an impacted wisdom tooth that may cause trouble for you later on. Maybe your teenager will soon undergo orthodontic treatment and has insignificant space for his adult teeth, referred to as crowding. Or your younger child has a baby tooth that's stubbornly adhering, even though it's past time for it to go.
Whatever the reason, tooth extraction is more often than not a very routine procedure. How straightforward this minor surgery is will depend on where the tooth to be extracted is located in the mouth, and what its roots are like. For example, a front tooth with a single straight root is easier to remove than a molar with multiple roots. This is especially true when that molar is a wisdom tooth that is impacted, meaning it is below the surface surrounded by gum tissue and bone. Often, a wisdom tooth is blocked from fully erupting (growing in) by other teeth in its path.
Still, tooth extraction is nothing to be feared when done by an experienced hand. Keep in mind that a tooth is not rigidly fixed in its surrounding bone, though that's how some may picture it. In fact, it is attached to the bone via a network of fibers that form what's known as the periodontal ligament. By carefully manipulating the tooth, these fibers can be detached and the tooth freed without much trouble.
Reasons for Extracting a Tooth
As mentioned above, there can be a variety of reasons for extracting a tooth. Be sure to ask questions about the pros and cons of any dental treatment or oral surgery, including extraction.
In both of these situations, there are several ways to try and save the tooth. The damaged tooth might need a full-coverage crown, a root canal treatment, or both. But sometimes even these methods are not enough to keep the tooth functioning well and looking good; it might be better to remove the tooth and replace it with a strong and lifelike dental implant.
Teeth are sometimes extracted when there are too many of them for the size of the dental arches (jaws), a situation known as crowding. After an adequate amount of space is opened up through the extraction of one or more teeth, the remaining teeth can be aligned properly. The teeth most frequently removed for orthodontic reasons are the first premolars, which are right next to the eyeteeth (canines).
Impacted Wisdom Teeth
— Early wisdom teeth removal can prevent damage to neighboring healthy teeth, bone, gum tissue, even nerves and blood vessels. If an impacted wisdom tooth is in a bad position, it's best to remove it before its roots are fully formed.
Baby Teeth
— If a baby tooth is out of position or not lost in the right sequence, the permanent tooth underneath it might not erupt normally. In this case, removing the baby tooth could prevent a need for orthodontic treatment later on.
The Process of Extracting a Tooth
The first step in any extraction is a radiographic (x-ray) examination to assess the position of the tooth roots and the condition of the surrounding bone. This will allow any possible complications to be anticipated. A thorough medical and drug history is taken, to ensure that you are healthy enough to undergo the procedure, and your options for anesthesia will be discussed.
Tooth extraction is usually carried out with local anesthesia, which will numb the teeth to be removed, and the surrounding bone and gum tissues. Additional sedatives might also be used, including oral sedatives (taken in pill form), nitrous oxide (which is inhaled) and/or conscious sedation, which is given intravenously (into a vein). The latter is usually required for more complicated (or multiple) tooth extractions. By the time the sedation medication has worn off, you won't even be aware that the surgery was done.
As your tooth is being removed, steps are taken to ensure the bone that surrounds it isn't damaged. Sometimes, in the process of removing a tooth, a small amount of lab-processed bone-grafting material is placed into the socket to help preserve the bone volume there. This is particularly important when the extraction is going to be followed at some point by the placement of a dental implant, which needs to fuse to existing bone, or orthodontics, which gently moves teeth through bone.
What to Expect After Tooth Extraction
Immediately after your tooth is extracted, the socket will be covered with sterile gauze; gentle pressure will be applied for 10-20 minutes to control any bleeding. Small sutures (stitches) might also be used for this purpose. It's normal to experience some mild to moderate post-operative discomfort and/or swelling.
Taking non-steroidal, anti-inflammatory drugs such as ibuprofen and/or aspirin the day of surgery should control most symptoms. Antibiotics may also be prescribed to ensure infection-free healing. Using ice packs on the outside of your jaw and eating softer foods until you feel more comfortable can also be helpful. Within a few days, all should be back to normal.
