A filling/restoration is a way to restore damaged tooth back to its normal function and shape.Structural loss or tooth damage may be caused because of decay (caries), fracture/chipping off, grinding, abrasion etc.

In many cases, there is accompanying tooth sensitivity/pain, which gets significantly reduced or completely eliminated once an appropriate dental filling material is placed. But in some cases, depending on the extent of tooth decay or damage, the affected tooth may require additional or alternative procedures, including inlays, crowns, RCTs or extractions.

Restoring a tooth to good form and function requires two steps,
(1) removal of decayed portion and preparing the tooth for placement of restorative material and
(2) placement of restorative material or materials. 

• There are several restorative materials which may be used, which include
  • Temporary filling material : Done in some cases where a more permanent filling cannot be done in the same appointment.
  • Silver (Amalgam) Fillings : Use of this material is highly controversial. Amalgam fillings typically have great strength and resist fracture and hence can last for 10-15yrs or more. However, presence of mercury in it has raised concerns about possible mercury toxicity. Amalgam fillings are also believed to cause/propagate micro-cracks in the tooth structure, ultimately leading the tooth to fracture (with the filling still remaining intact). In several countries, its use has been restricted or completely banned. At dentedge, amalgam fillings are not done.
  • Composite (Tooth Coloured) Filling : Also termed as laser fillings. It’s the most commonly used material nowadays and ideal for restoration of front teeth as they can be made to blend in completely with the colour of your teeth.
  • Newer composite materials provide great strength as well as aesthetics, and are being used for restoring posterior teeth also.
  • There are several types and brands of composites. A detailed description of which is beyond the scope of this article.
  • GIC : Used in children (in milk teeth), and several other cases where composites cannot be done. Are flouride releasing and help prevent further decay of teeth. May also be used below large/deep composite fillings.
  • Miracle Mix/ Zirconomer : These are silver or zirconia reinforced GIC filling materials and are typically bluish and whitish in colour respectively. They provide superior strength as compared to composites and are used in posterior teeth where aesthetics are of no major concern.

• Chewing : Some restorations do not develop their maximum strength for 24 hours. Chew only soft foods on the new restorations until that time. As with natural unrestored teeth, avoid chewing excessively hard foods such as hard candy, corn nuts, ice and other hard objects that may break the restoration or remaining natural tooth structure.
• Sensitivity : Due to the size and type of the restoration you may experience mild sensitivity to hot and cold. This sensitivity should disappear in a few weeks. If it does not do so, or should it get worse, please contact us. This sensitivity or other mild discomfort can sometimes be caused by a high spot in your bite.
• The Future : We expect several years of service from these restorations. However, at times, large restorations may break or the tooth structure around them may break. If breakage occurs, the involved tooth or teeth may require a crown for optimum strength.
• Problems : If one or more of the following conditions occur, contact us immediately to
• avoid further problems :
  • A feeling of movement or looseness in the restoration.
  • Sensitivity from sweet foods.
  • A peculiar taste from the restoration site.
  • Breakage of a piece of material from the restoration.

When someone meets you for the first time, the first thing they notice is eyes. Second is teeth, and third is hair. But people spend way more money on their hair than their teeth. 

Not only do your teeth help you talk and chew, they can make or break your appearance. Here are some tips for keeping your pearly whites in tip-top shape.

• Proper brushing
• Flossing
• Interdental brush
• Preventive treatment
• Regular check-up
• Diet
• Mouthwashes
• Lozenges/strips for fresh breath

During your visit to the dentist, you might have heard him/her suggesting that you need to get ‘scaling’ or ‘cleaning’ done. If you’re wondering what it is and is it necessary that you get it done, then read on. 

Scaling is a common non-surgical treatment for removal of infected deposits – stains, plaque or calculus - from the tooth surface. These deposits if not removed lead to tender, swollen or bleeding gums (gingivitis). If left to progress further, it can lead to further deterioration of the gums and supporting tooth structures. Such a condition is called periodontitis or pyorrhea.

A few minutes after brushing, a very thin layer made up of saliva, proteins, and bacteria (also called the pellicle) is formed on the tooth surface which acts as a base for bacterial attachment and growth. Within a few hours the accumulation of various species of bacteria along with sugar from the food we eat results in formation of a pale yellow or white sticky substance known as Dental Plaque.

Plaque formation on the teeth is a continuous process. If it is not removed within 10-14 hours by brushing, it mineralizes into calculus or tartar. Calculus once formed cannot be removed by brushing and has to be removed professionally - by scaling.

The tendency for these deposits to form depends on various factors like diet, quality/quantity of saliva formed, oral hygiene habits etc. These factors vary from person to person and so, even though you may be brushing twice daily, you may still require regular cleaning.

If there are only superficial deposits, it is not painful. If there are deep deposits, usually a local anaesthetic spray/gel is applied on your gums before the procedure and hence you would not experience any pain.There may be slight bleeding as the plaque and calculus usually cause gum inflammation and touching highly inflamed gums can cause bleeding.

It must be emphasized again that scaling of teeth does not weaken them but prevents gum diseases which bring about bleeding gums and if not checked leading to more serious and extensive gum problems.

Endodontic or root canal treatment (RCT), treats the inside of the tooth. It is necessary when the tissue within the tooth – called pulp, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to swelling or abscess.

During root canal treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. The tooth is then restored with a crown or filling for protection. After restoration, the tooth continues to function like any other tooth.

What Are the Signs That a Root Canal Is Needed?

Sometimes no symptoms are present; however, signs you may need a root canal include:

• Severe toothache pain upon chewing or application of pressure
• Prolonged sensitivity/pain to heat or cold temperatures (after the hot or cold has been removed)
• Discoloration (a darkening) of the tooth
• Swelling and tenderness in the nearby gums
• A persistent or recurring pimple/swelling on the gums

Does it Pain?

• Root canal treatment doesn't cause pain — it relieves it!
• Before starting the treatment your dentist will imperceptibly and very slowly numb the area. Once this is done generally no pain is perceivable. In case of highly inflamed tissue, anaesthesia may take longer to act.
• While opening up the tooth, a handpiece/drill is used which generates vibrations. The level of vibration/pressure sensations is similar to that for a regular filling which may be an unwelcome sensation but is not at all painful.

Is Capping required after root canal?

As there is no longer a pulp keeping the tooth alive, root-treated teeth can become brittle and are more prone to fracture. This is an important consideration when deciding whether to crown or fill a tooth after root canal treatment.

How Long Will the Restored Tooth Last?

With proper care, most teeth that have had root canal treatment can last as long as other natural teeth and often for a lifetime. Because tooth decay can still occur in treated teeth, good oral hygiene and regular dental exams are necessary to prevent further problems. 

Alternatives

• The alternatives to root canal therapy include no treatment or tooth extraction.  
• There are risks to conducting no treatment such as pain, infection and the possibility of worsening dental infection such that the tooth will be no longer restorable (root canal treatment will not be successful). If extensive loss of tooth structure occurs, extraction may be the only treatment option. 
• Following tooth extraction, options for replacement may include dental implant, bridge, or removable teeth. 
• Therefore, having root-canal treatments can save your tooth, restore its function and save you from other more complex dental treatments. 

Post & Core

• Post and core is a type of dental restoration that is utilized when there is inadequate tooth structure remaining to support a traditional restoration. A small rod, usually metal, is inserted into the root space(canal) of the tooth and protrudes from the root a couple of millimetres. This rod is referred to as a post. The post is then used to hold a filling, or core, in place. Without this post there would not have been enough tooth structure remaining to hold the filling required. After the post and core material is set, its properly cut into a crown preparation and an impression is taken for the fabrication of a crown.
• Posts may be pre-fabricated or cast. Prefabricated post and cores take less time to place, as they do not involve any lab work and can be inserted immediately upon the decision to utilize them, once the endodontic therapy has been completed and the post space cleared of gutta-percha. They may be metal or fibre re-inforced (tooth coloured).
• In cases where the post space is not a good match for a prefabricated post, a cast post and core is custom fabricated for the tooth by sending a post pattern to the lab. Cast posts can be of metal or zirconia (tooth coloured).

Technically, ‘tooth whitening’, restores natural tooth colour and ’bleaching ’, whitens beyond the natural colour. However these terms are used interchangeably and require the same procedure to be performed.

You've got two options for bleaching your teeth:

• ICn-office bleaching (which is done by a professional dentist)
• At-home bleaching.

Both tooth-whitening options use peroxide-based bleaching agents. At-home systems contain 3-15% peroxide, whereas in-office systems contain up to 30-45% peroxide.

Though bleaching is meant for whitening your teeth, the paradox here is that overuse or over bleaching can cause more stains and can also dull the surface of teeth/crowns /veneers, thus giving you a lacklustre smile.

Generally, the longer you keep a stronger solution on your teeth, the whiter your teeth become. However, the higher the percentage of peroxide in the whitening solution, the shorter the time for which it should be applied to the teeth, else it will dehydrate the teeth , increase sensitivity and cause dullness.

Whether or not you decide to whiten your teeth, keep in mind that good daily oral health habits like brushing, flossing and cleanings go far in keeping your smile bright and healthy.

Improper brushing habits/technique, irregularly placed teeth, smoking, tobacco chewing, salivary and dietary factors all contribute to repeated formation of plaque and calculus. Thus, some persons may require periodic scaling.

Most dentists recommend a twice a year routine. But, if you maintain your oral hygiene exceptionally well, then you may need to get it done once in a year/s. At Dentedge we monitor your oral hygiene for the first 6 mos.-1 yr after your first cleaning session is completed. Depending on your individual need, you are advised on how often you require scaling to be done. The golden rule is to have a routine dental check up every 6 months.

• In-office bleaching (which is done by a professional dentist)
• At-home bleaching.

While details may vary, a fairly standard routine is followed. Typically, the steps involved are not painful or uncomfortable; in fact, many patients doze off during the procedure.

• A cheek retractor is inserted into the mouth, exposing all the “aesthetic zone" .
• A rubber dam is placed or hardening resin is painted onto the gum tissue to protect against any irritation caused by the bleaching gel.
• A bleaching gel containing hydrogen peroxide is applied to the teeth (aesthetic zone) and kept on for approximately 15 to 30 minutes.
• The bleaching gel is suctioned or washed off, and fresh gel is applied for one or more additional periods of 15 to 30 minutes.
• Some whitening treatments incorporate an intense light that is focused on the teeth and is said to activate or enhance the bleaching process. Opinions vary as to whether this light improves the bleaching outcome.
• Between gel applications, the teeth are checked to see how well they have whitened, and whether more bleach needs to be applied.
• After the final gel application, the cheek retractors are removed, the patient rinses and the immediate post-treatment shade change is measured. The teeth may whiten by as few as two to three shades or as many as eight (out of a total of 16).

Part of the whitening effect is due to dehydration during the bleaching process, which makes the teeth look whiter than their true new color. The new ‘true’ color will emerge after a couple of days.

If a satisfactory level of whitening hasn't been achieved, follow-up in-office bleaching at a future date, and/or a regimen of take-home bleaching trays are advised.

At-home

The best time to begin at-home whitening is soon after a dental hygienist's prophylactic cleaning. This procedure removes the surface layer of plaque and grime that can interfere with bleaching . There are many popular natural ways to whiten one's teeth. Some natural teeth whitening methods can be very gentle on the teeth, while others can lead to enamel damage. One efficient type of natural teeth bleaching is through the use of malic acid (present apples, celery, carrots etc.) or baking soda or hydrogen peroxide mouth rinses.

There are also several commercial whitening products intended for home use such as gels, chewing gums, mouthrinses, toothpastes, among others. The most common include:

Tray-based tooth bleaching systems. 

Home bleaching kits typically contain plastic trays which have to be filled with a bleaching gel or paste and placed over the teeth for one to several hours a day, repeating every few days for several weeks. Most at home bleaching kits come with standard sized trays, but you can also get custom-fitted trays from your dentist.

• Bleeding gums
• Bad breath
• Broken tooth
• Sensitive teeth
• Tooth ache
• Swelling around face or tooth
• Missing teeth
• Decayed teeth
• Discolouration of teeth
• Broken filling
• Flattened teeth (bruxism)
• Mouth ulcers
• Burning sensation on toungue/mouth
• Dry mouth
• Oral cancer
• Difficulty/decreased mouth opening
• White patches in the mouth
• Avulsed tooth
• Periodontitis