Fillings are done to remove decay, and replace the affected tooth structure. It is called a filling because new material fills the hole that decay left. These days most teeth are treated with a bonded tooth colored composite (resin fillings). Caught early enough, cavities can be treated easily and painlessly. If not treated decay can lead to tooth pain and/or infection, and the tooth would need root canal treatment or extraction.
Bonding involves adhering composite resin material that is matched to the color of the tooth, to the front of the tooth. This is done to repair damage done to the tooth by decay, to alter the alignment of the tooth, close gaps between the teeth, or for cosmetic purposes. First the surface of the tooth is roughened in order to accept the bonding and hold it. A gel is applied to micro etch the tooth surface, and a primer/bond agent is applied so the material adheres to the surface. Then the material itself is placed on the tooth and hardened with intense light. The composite resin material is shaped and polished to get a lustrous finish as a last step.
A sealant is a plastic material applied to the back teeth. This plastic resin bonds to the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth, where most cavities in children are found. Toothbrush bristles cannot reach all the way into the depressions and grooves to remove the food and plaque that accumulates. This places your child in danger of tooth decay. Sealants “seal out” food and plaque, thus reducing the risk of decay.
Sealants are very easy to apply and require no anesthesia. It takes one dental visit. The tooth is first cleaned and conditioned. The sealant is then flowed into the grooves of the teeth and hardened with a special light. Your child will be able to eat right after the appointment.
As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. During your regular cleaning, your dentist and/or hygienist will check the condition of the sealants and reapply them as necessary.
The likelihood of developing decay begins early in life, so children and teenagers are obvious candidates. But adults benefit from sealants, as well.
REGULAR DENTAL CLEANING verse NON-SURGICAL GUM TREATMENTS
A regular dental cleaning is recommended for patients without dense deposits or buildup on their teeth. It is for the patient who has little or no buildup around the gumline. It usually includes a comprehensive exam and requires one hour. It may or may not include dental xrays. Routine cleanings are extremely important in preventing dental problems and in diagnosing dental problems. These patients are then placed on a scheduled recall visit for future cleanings, which is usually every 6 months (twice a year).
A debridement is a procedure used to remove dense, heavy deposits on the teeth. It is required when tooth structures are so covered with plaque(soft bacteria) and calculus(hard bacteria) that the dentist or hygienist cannot check for decay, infectious or periodontal disease (gum disease). It is for the patient who has moderate or heavy buildup under and above the gumline. It generally requires 2 to 5 separate dental appointments. A debridement is usually required if it has been a long time since a patient’s last cleaning. These deposits form over a long period of time and therefore require more time to remove. The amount of time needed for appointments varies according to difficulty. Further procedures to treat periodontal disease or other problems may also be needed. If the debridement is not done, the patient is at risk of losing their teeth from periodontal disease(gum disease). After the debridement and completed treatment, the patient will be placed on a scheduled recall appointment. These appointments are either 3 or 4 or 6 months apart, according to the patient’s needs.
Many patients need debridement procedures, cleanings, periodontal treatment or other types of care more frequently than most dental insurance plans cover. Some insurance plans will pay a portion of the cost of a debridement. This may be before or after the patient has met the deductible. Some plans will pay for a regular cleaning and the patient is responsible for the remaining balance when a debridement is performed. Very few plans cover the true fee of a debridement. This does not mean that the debridement is not needed. Remember that only after a debridement will the dentist and hygienist get an accurate picture of a patient’s health. Further procedures may still be needed. Dental benefits reduce the amount a patient has to pay for services, but as stated earlier, dental insurance was never designed to cover all of your dental expenses.
Dental x-rays or radiographs are necessary for detection, diagnosis and treatment of conditions in the mouth. They are used to find decay in the teeth, find abscesses, detect bone cysts, check periodontal (gum disease) conditions, to see condition of apexes (tooth roots), to examine present dental restorations (fillings), to determine presence of impacted or un-erupted teeth(like wisdom teeth), to locate deep plaque and calculus(tarter), to see position of tooth roots to the sinuses and to determine if orthodontics is necessary.
Bitewing x-rays, used for detecting decay in between the teeth (in areas we can not see visually) are taken once a year. Either 2 or 4 bitewing x-rays are taken on each side of the mouth. Panorex x-rays are used for detection of abscesses, cyst, impacted teeth and sinus problems, are taken once every 3 years. The panorex is a film which shows the entire mouth and jaw area. Individual periapical are single films used to diagnose individual teeth for abscesses, decay and cracks. Dental insurance usually covers x-ray cost, as long as they are within the recommended time frame.
In our office we use digital radiography which allows us to take X-rays using 50-70% less radiation versus conventional X-rays. Coupled with computer monitoring, digital x-ray technology allows us to enhance the images for better diagnosis of any dental concerns.