How is a dental filling (dental sealant) made?

The process of making a dental filling varies depending on the type of filling and the specific needs of the patient. The following is a general procedure for making a dental filling:

• First, the dentist will examine the affected tooth to determine the extent of the damage. This may include a visual examination, palpation, and X-rays.
• For greater comfort and to reduce pain during treatment, the dentist may apply local anaesthesia to numb the affected area.
• Using special instruments, we remove the affected tissue and clean the area of decay and other debris.
• For some types of fillings, it is necessary to prepare the tooth so that the filling holds better. This may involve cutting away a small amount of healthy tooth around the edge of the hole.
• The dentist may isolate the tooth with a rubber band or other material (rubber dam) to ensure that saliva or other fluids do not flow into the working area.

Application of dental fillings (plugs):

• For composite fillings, the dentist first applies a thin layer of adhesive and then applies the composite material. The material is shaped to match the natural shape of the tooth and then hardened with a special light.
• For inlays/onlays (ceramic or gold fillings), the dentist takes an impression of the tooth after removing the decay and sends it to a laboratory where the filling is made. After a few days, the patient returns to the dentist to have the filling attached to the tooth.
• Grinding and adjustment: After the dental filling has been applied, it needs to be polished and adjusted to match the shape and bite of the natural tooth as closely as possible.
• Check: After completing the procedure, we check the correct placement of the filling and also the occlusion (closing of the teeth).
• If the tooth decay has infected the pulp, endodontic treatment of the root canal is necessary.
• After the filling has been made, it is important to maintain proper oral hygiene and have regular preventive check-ups.

Preparation of a photocomposite (white) filling

The fabrication of a photocomposite filling takes place in several steps:

• Before starting treatment, the area around the affected tooth is isolated, often using a rubber dam to prevent saliva and other contaminants from entering the working area.
• First, the affected part of the tooth is removed, cleaning the area of decay and creating space for the new filling.
• A thin bonding agent is applied to the clean, dry area to help the composite adhere better to the tooth.
• The composite resin is applied in layers to the prepared area. Each layer is carefully modelled to fit properly and restore the natural shape of the tooth.
• After each layer of composite is applied, a special UV light (sometimes called a curing light) is used to quickly harden and strengthen the material.
• Once the filling is completely cured, it is further adjusted and shaped to achieve the correct shape and alignment of the upper and lower teeth. The filling is then smoothed and polished to make it as similar as possible to a natural tooth.
• Bite check: After the filling has been made, it is necessary to press the teeth together to verify the correct position and comfort of the new filling in relation to the other teeth.

It is important to note that although composite fillings can be aesthetically attractive and functional, they require proper oral hygiene and regular check-ups by a dentist to last as long as possible.

Treatment of a broken tooth with a composite filling

A photocomposite filling can also be used to rebuild a broken tooth, where a special composite material is applied to the damaged tooth layer by layer. After each application, the material is cured with a special light to give it strength. Finally, the photocomposite tooth reconstruction is adjusted and ground to match the original shape of the tooth.

When is it necessary to replace a dental filling?

A dental filling can last from several years to decades, depending on the type of filling material and dental care. Replacement of a dental filling is necessary especially when the filling cracks, loosens, or tooth decay appears underneath it.

A filling needs to be replaced in the following cases:

• Cracked or fallen out filling: Fillings can crack, break off or fall out completely, creating a place where bacteria can accumulate and new tooth decay can develop.
• Damage to the tooth around the filling: If new tooth decay develops around an existing filling.
• Separation of the filling from the tooth: Sometimes a small gap (microscopic leak) can develop between the tooth and the filling, where bacteria can accumulate and cause decay.
• Wear and tear of the filling: Over time, fillings can wear down, especially those on the chewing surfaces of teeth that are exposed to constant pressure and friction.
• Aesthetic reasons: Old amalgam fillings can darken or discolour the surrounding tooth tissue over time, which may lead some people to decide to replace them with more aesthetic materials such as composite or ceramic.

Is amalgam harmful?

Amalgam fillings are a mixture of mercury and other metals and have been used in dentistry for a long time. According to most health organisations, including the World Health Organisation, the amount of mercury released by amalgam fillings is considered safe for most people.

Amalgam fillings are sometimes not recommended for aesthetic reasons (they are silver and may be visible), potential allergies to the components of this dental filling, and environmental concerns associated with the mercury in amalgam.

However, if the amalgam filling is still in good condition and the patient has no aesthetic or health concerns, it may be unnecessary to replace it.

If you feel that your filling needs to be replaced, it is important to consult your dentist. Even in the case of dental fillings, regular check-ups are important to identify and address potential problems before they become serious.