How Dentists Fill A Cavity, Part 1, by Justin K. Hillock, D.D.S.

March 17, 2011 § Leave a comment

Dental office

Cavities, or more correctly, dental caries, form the most common disease discovered and treated at the dentist’s office. A dental caries is simply an area of tooth that has decayed, as a result of acid created by bacteria in the mouth. Caries can be exceptionally painful if left untreated, and they can also lead to tooth loss and further, more serious health complications later on.

The standard diagnostic procedure for identifying cavities involves the use of a visual examination, x-rays, and tactile evaluation with a probe. The dentist pokes at the teeth with the probe to identify damaged areas, which may be indicated by pits, softer tissue, or discoloration.

Most of the time, the treatment for a cavity involves filling the tooth’s eroded area. First, the dentist numbs the area of the mouth using a local anesthesia such as Novocain. The numbing is not medically necessary but it makes the procedure much more comfortable for the patient.

Next, the dentist will remove the decayed area of the tooth with a drill. A number of drill types are available to patients today, and dentists employ the tools they are more comfortable with and are most appropriate to the job.

Traditional rotary dental drills (called handpieces by dentists) may be air-driven or electric, and they are outfitted with specialized burs, made either of tungsten carbide, diamond, or stainless steel. Most dentists also employ a stream of water and suction along with these drills in order to keep the tooth cool and to remove debris, respectively. The dental laser forms an alternative to the rotary drill. Many types of laser drills now exist, and dentists will choose specific bandwidths for the types of tissue being drilled.

Both rotary drills and lasers have advantages and disadvantages. A rotary drill in many cases allows the dentist to make a more precise excavation of decayed tooth tissues. The goal in filling a cavity is to preserve as much of the tooth as possible, but if any decay remains after it is filled, the cavity may continue to fester within the tooth, causing further problems.

Using a rotary drill, dentists judge the depth that they need to go by feel; diseased tooth reacts differently to the drill than healthy tooth. With a laser, this isn’t possible. However, one of the advantages of a laser drill is the ability to sterilize the tooth as it is drilled. Therefore, absolute precision becomes less of an issue. In addition, laser dentistry can be performed without anesthesia, as the laser doesn’t cause any pain. This is a major bonus for many patients.

In the next installment of my discussion on filling cavities, I will discuss types of fillers. Stay tuned!

Justin K. Hillock, D.D.S., practices general dentistry in Guthrie Center, Iowa. Dr. Justin Hillock also belongs to the local chamber of commerce.


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