Dental Questions: Why would a dentist place a temporary filling?

A filling is a filling, right? Then why would a dentist send you home with a "temporary" filling? What makes it any different from the permanent fillings you have on your other teeth? Do you need to worry about it falling out? Read on to see how and why dentists use temporary fillings to save and protect teeth!

A temporary or sedative filling is a type of dental procedure performed on a tooth with an uncertain prognosis or as an intermediate measure before further treatment. Imagine a patient who comes in for an emergency appointment with a large, painful cavity. While definitively saving the tooth may require a few different lengthy treatments, a dentist can remove decay and provide a temporary filling that same visit. This allows a tooth to be stabilized and desensitized so the patient can continue to function until a more definitive plan can be made. Many times, it is simply too early to determine the status of the tooth's nerves or gums and thus a temporary filling acts as a good interim measure. 

The most common material used in temporary fillings is a tooth colored compound called glass ionomer. This product bonds to tooth enamel, reacts well with moisture and has a natural calming effect on aggravated tooth nerves. Additionally, it enhances the effects of fluoride to provide extra defense against decay. The trade off is that glass ionomer is much weaker than permanent filling materials and does not stand up against tooth brushing, eating or chewing over time. Still, it's properties make it an ideal material to be used in temporary situations. 

How long will your temporary filling last? That question is impossible to answer without knowing the condition of the remaining tooth. In general, you should always end your temporary filling appointment with a plan for a permanent solution in the future. If you would like to know more about fillings, crowns, root canals or other dental procedures, please give our office a call!

Do you need to get numb for every filling?

If you've had a dental filling placed recently, chances are you had to get numb before the procedure began. Local anesthetics, like lidocaine and septocaine, make modern dentistry relatively painless and easy for the patient. However, there is a chance you got to skip the shot for your most recent filling. Why didn't you need to get numb? Was there really a cavity there? Read on to find out. 

Inside of every tooth is a nerve chamber that transmits sensations of pain, cold and vibration to the brain. This, coupled with the pressure sensors in the tooth ligament, give you input on the current status (and any potential harm) of the tooth. The sensation of pain is largely dependent on input from cells called odontoblasts relaying information to the dental nerve. Odontoblasts live within the inner dentin layer of the teeth, with long arms that extend to the interface between the dentin and enamel. Enamel, by contrast, is 95% mineral and contains no cells. If your filling is limited to enamel, there is no biological mechanism to transmit pain directly to the tooth nerve. Thus, there is no absolute need to numb the tooth for these procedures. 

We perform fillings on shallow areas of decayed enamel to prevent them from getting deeper. Once the bacteria pass from enamel to dentin, their growth spreads exponentially due to the higher concentration of organic matter. If we can remove and stop the decay while it is limited to enamel, there is no need for anesthesia and a much lower risk of post-operative complications. 

Other reasons for not needing injections during fillings include working on teeth with root canals or dead nerve tissue. Without a living nerve to transmit pain information, the is usually little benefit from providing the anesthesia. If you would like to know more about dental filings, how they are performed and why we place them, please give our office a call!

Smile Repair Using Bonding and Emax Crown

Today's patient came to us with complaints of mismatched central incisors. The patient's right incisor had a large composite (tooth colored) filing that had become worn and stained over time. Their left incisor had a crown that was too light and opaque compared to the surrounding teeth. Both of these esthetic problems are very common, as teeth tend to age differently from the materials we use in dentistry. Composite fillings pick up stain and erode more quickly than enamel while crowns do not respond to color changes like surrounding teeth. The result is that restorations in the front of the mouth gradually become more obvious and less natural over time. 

Dr. Kari Ann Hong set out to repair this smile by placing a new filling on the left incisor and using an Emax Lithium Disilicate crown on the right. The new restorations add natural coloring, opacity and shape back to the patient's smile. In the before picture, the existing dental work is fairly obvious. The new crown and filling blend naturally and bring harmony back to this smile! If you would like to know more about crowns, fillings or other cosmetic procedures we perform at our office, please give us a call!

Case Presentation: Polishing an Existing Filling

Over time, dental fillings tend to pick up stains from the foods and beverages we consume. This isn't a big concern with the posterior teeth, where restorations are generally hidden during daily activities. However, discoloration can become a  genuine cosmetic concern in fillings on anterior teeth.

This patient had a filling placed years ago by a different dentist to correct for abfraction, or the loss of enamel near the gum line due to stress and clenching. This type of restoration is very common and usually affects the canines and premolars (both visible in a typical smile). They were dissatisfied with the dark line around the filling that drew the eye towards that tooth. With a 10 minute appointment to polish and recontour, the filling looked brand new! 

It is important to note that we checked the seal and fit of the filling first, to make sure we weren't just polishing a defective restoration. Many times, discoloration is a sign of recurrent decay, where the entire fillings needs to be replaced. If you would like to know more about fillings, their lifespans and how to care for them, please give our office a call!