Why Do Teeth Decay?
Bacterial plaque, which consists of bacteria found in the mouth, can form acid from the remnants of sugary and starchy foods left in the mouth. These acids dissolve the mineral tissue of the teeth, causing the enamel of the tooth to deteriorate and ultimately leading to the onset of tooth decay and the cavities that dentists call “cavities.” These are usually cavities seen with dark discoloration. Since cavities form as a result of the meeting of sugary and starchy foods with bacteria, there is a danger for everyone. However, those whose diet has a very high proportion of carbohydrate and sugary foods are at a much greater risk of decay, especially if the fluoride content in their water is also very low. Although saliva creates a natural defense mechanism against the acid produced by bacterial plaque, it cannot prevent decay on its own. Diseases or medications that reduce saliva flow and amount also accelerate the formation of decay. For this reason, dentists often recommend sugar-free gums because they increase saliva flow.
What Should Be Done to Prevent Tooth Decay?
Brushing teeth after breakfast and before going to bed in the evening, and regular daily use of dental floss is the most effective way. Since food residues accumulate mostly in the indentations on the chewing surfaces of the teeth and in the interproximal surfaces where the teeth touch each other, toothbrushes with small heads should be chosen. The inner surfaces, outer surfaces, chewing surfaces, and the top of the tongue should be brushed, and dental floss should be used in the interproximal surfaces. Brushes should have medium-hard or soft bristles and should be changed at certain intervals. The brush bristles should not be worn out and should be stored in a way that does not carry bacteria. Never use someone else’s toothbrush. By using a fluoride toothpaste during brushing, the role of fluoride in preventing tooth decay should be utilized. Fluoride mouthwashes, which also eliminate bad breath and give a feeling of freshness and cleanliness, can be used as an adjunct to fluoride toothpastes. Trying to consume sugary foods during main meals and trying not to eat anything between meals is another precaution. There is no cure for decay, so visiting the dentist at regular intervals is the best way to prevent or catch decay early. In addition, in cases such as teeth sensitive to hot and cold, painful teeth, or initial decays that are chalky in color, brown discoloration, and cavities, a doctor should be consulted without delay, as this will change the form of treatment and reduce its difficulty.
What Materials Are Used in Decay Treatment?
- Zinc-containing substances generally used for temporary purposes,
- Calcium-containing substances with tooth-healing properties,
- Durable substances containing silver, tin, zinc, and gold,
- Aesthetic substances that are a mixture of glass, aluminum, phosphate, and artificial resins,
- Substances consisting of aluminum silicate glass particles used for a wide variety of purposes,
- Block materials prepared outside the mouth and glued to the tooth.
What is Amalgam Filling (Metal Filling)?
Amalgam fillings are also defined as silver fillings. Amalgam is obtained by mixing an alloy of silver, tin, and copper with mercury. Mercury, which constitutes 45-50% of the mixture, binds the metals together, creating a durable filling material. Amalgam fillings have been developed and used for more than 150 years. Amalgam is still the most harmless, longest-lasting, and cheapest filling material. It has been calculated that more than one billion amalgam fillings are made annually. They can be applied much faster and easier than other filling materials. Filling materials such as porcelain, gold, and white fillings are both more expensive and require more time and attention. Moreover, except for gold, they are not as long-lasting as amalgam. Amalgam should only not be used in those with a definitively diagnosed allergy to mercury, which is a probability much lower than one percent. Amalgam fillings should not be removed unnecessarily because they both incur unnecessary costs and increase the possibility of damaging the tooth.
Is Mercury in Amalgam Harmful?
The mercury in amalgam filling is not toxic. When mercury combines with other metals, its chemical structure changes and it becomes harmless. The amount of mercury released in the mouth as a result of chewing and grinding is much smaller than the amount taken in through water, air, and food. All scientific research has concluded that mercury is harmless. Although it has been claimed that some diseases thought to be caused by mercury improve when amalgams are removed, this has not been scientifically proven.
What Should Be Considered After Amalgam Restoration?
The side where the application was made should not be used for at least one hour, and care should be taken not to chew hard things in that area for the following 24 hours. The physician should give a second appointment for polishing 24 hours after the procedure. This application will allow the physician to both improve the metallic properties of the amalgam and review the restoration anatomically and functionally after use. A short-term hot-cold sensitivity may occur after amalgam fillings, and this disappears over time. However, although rare, some people may experience sensitivities caused by electrification when various metals are present in the mouth or when another metal such as a fork enters. In cases of persistent sensitivity, replacing the restoration with a non-metallic restorative material may be the solution after making sure that the sensitivity is only due to this reason.
How is Composite Filling (Tooth-Colored Filling) Applied?
Composite resin is a plastic mixture containing silicon dioxide particles. Since they are tooth-colored, they are defined as white fillings. Although they were only used on anterior teeth in the 1960s, with the advanced development of the material, they can now be successfully applied to posterior teeth as a filling material that is resistant to chewing pressures and less prone to wear. Composite fillings are placed layer by layer into prepared cavities, and each layer is hardened with a special light. Once this process is complete, the composite fillings are shaped and adjusted according to the tooth. All these procedures take longer than the amalgam filling procedure. However, they are at least twice as expensive as amalgam. The retention period of composite fillings in the mouth is also 7-10 years, which is close to the lifespan of amalgam. However, the situation is in favor of amalgam in very large fillings. The biggest advantage of these fillings is their aesthetics. In addition, since these fillings bond well to the teeth, they support tooth tissues, prevent fractures and temperature transmission. Composites can be used not only to restore decays but also for cosmetic effects by changing the color and shape of teeth. The most important disadvantage is the occurrence of post-operative sensitivities. The colors of the fillings can also change slightly with staining foods such as coffee and tea.
What Should Be Considered After Composite Restoration?
Polishing can now be done in the same session with composites as well. However, in very large restorations or serial restorations done for many teeth, the patient may need to go for a check-up once more. Very large losses in anterior teeth can be restored with these materials, so patients should be careful during biting. Especially after applications made on the facial surface, even if good polishing has been done, staining foods and drinks can change the color of the fillings. In restored teeth due to abrasion, the things that need more attention are using non-hard toothbrushes and making corrections in brushing methods.