Dental Sealants

What are dental sealants?
Dental sealants are plastic coatings that are usually placed on the chewing (occlusal) surface of the permanent back teeth — the molars and premolars — to help protect them from decay.

Why are dental sealants placed on teeth?
The chewing surfaces of the molar and premolar teeth have grooves — "fissures" — that make them vulnerable to decay. These fissures can be deep, are difficult to clean, and can be narrower than even a single bristle of a toothbrush. Plaque accumulates in these areas, and the acid from bacteria in the plaque attacks the enamel and cavities can develop. Fluoride helps prevent decay and helps protect all the surfaces of the teeth, dental sealants provide extra protection for the grooved and pitted areas by providing a smooth surface covering over the fissured area.

When are dental sealants placed?
The first dental sealant to be placed is usually on the fissure of the first permanent molar tooth, once the chewing surface of the tooth has erupted completely beyond the gum. This tooth grows in behind the baby teeth. If the chewing (occlusal) surfaces of these teeth are sealed, the dental sealant will help protect the tooth. Except for the wisdom teeth, which come through much later, the molars and premolars continue to erupt until eleven-thirteen years of age and the chewing surfaces of these teeth can be sealed after they have erupted beyond the gum.

What Is A Filling?

What is a Filling?
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material. By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Which Type of Filling is Best?
No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

• Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

• Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

• Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

• Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.
If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which nerve damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

What Happens When You get a Filling?
If your dentist decides to fill a cavity, he or she will first remove the decay and clean the affected area. The cleaned-out cavity will then be filled with any of the variety of materials described above.

How Do I Know if I Need a Filling?
Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth. Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also X-ray your entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.

What is a Root Canal ?

Root canal treatment is the removal of the tooth's infected pulp, a small, thread-like tissue in the center of the tooth. Once the damaged, diseased or dead pulp is removed, the remaining space is cleaned, shaped and filled. This procedure seals off the root canal. A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory -- to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Years ago, teeth with diseased or injured pulps were removed. Today, root canal treatment saves many teeth that would otherwise be lost.

The most common causes of pulp damage or death are:

• A Broken or cracked tooth
• A deep cavity that reach or close to the Pulp
• An injury to a tooth, such as a severe knock to the tooth, either recent or in the past Once the pulp is infected or dead, if left untreated, pus can build up at the root tip in the jawbone, forming an abscess. An abscess can destroy the bone surrounding the tooth and cause pain

How is a Root Canal Done?
Root canal treatment consists of several steps that take place over several office visits, depending on the situation. These steps are:

• First, an access opening is made through the back of a front tooth or the crown of a molar or pre-molar.
• After the diseased pulp is removed (a pulpectomy), the pulp chamber and root canals are cleaned, enlarged and shaped in preparation for being filled.
• If more than one visit is needed, a temporary filling is placed in the crown opening to protect the tooth between dental visits.
• The temporary filling is removed and the pulp chamber and root canal permanently filled. A tapered, rubbery material called gutta-percha is inserted into each of the canals and is often sealed into place with cement. Sometimes a metal or plastic rod is placed in the canal for structural support.
• In the final step, a crown is usually placed over the tooth to restore its natural shape and appearance. If the tooth is very broken down, a post may be required to build it up prior to placing a crown.

How Long Will the Restored Tooth Last?
Your treated and restored tooth/teeth can last a lifetime with proper care. Because tooth decay can still occur in treated teeth, good oral hygiene and regular dental exams are necessary to prevent further problems.

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.

To determine the success or failure of root canal treatment, the most relied-upon method is to compare new X-rays with those taken prior to treatment. This comparison will show whether bone continues to be lost or is being regenerated.