Procedure for restoring a tooth filling. How a filling is made on a tooth. Types and methods of filling teeth

Until it was found suitable material, there was no way to restore the functions and external forms broken tooth. Our ancestors tried to use the resins of trees, pieces, parts of pebbles. But they did not hold well in places lost or partially damaged teeth. Therefore, until the middle of the 19th century, the main way dental treatment had a tooth extraction. Hairdressers did this, in the same place where they cut and shaved clients. Everything changed in 1948, when a certain physician Arculanus invented and first used a relatively durable and functional filling made of gold.

filling

This method of restoring a partially destroyed tooth crown has become indispensable in saving teeth from caries. If not for him, the loss of teeth would be one hundred percent. Get rid of carious lesions can only be done in the following way.

1. Remove caries-affected dental tissue.
2. Scrub the infected area down to healthy tissue.
3. Fill the empty space with a filling.

By the way. By clogging the areas through which bacteria can enter the tooth tissue, filling not only restores the shape of the tooth surface, restores the ability to fully chew, but also prevents the development of recurrent caries.

Today, the following materials are used for filling:

• porcelain;
• cement;
• amalgam (alloys of non-ferrous and noble metals and mercury);
• gold;
• composites;
• ceramics.

They may also be needed if, due to mechanical damage a piece of dental tissue was chipped off.

Which type is preferred?

There is no ideal type that suits everyone. The choice depends on four positions.

1. The scale of the required restoration.
2. The presence of an allergy to the incoming components.
3. The location of the tooth to be filled in the mouth.
4. The total cost.

When is it time to bet?

This can only be determined by a dentist, but it is necessary to go to his appointment at the first suspicion of caries (or regularly, once every six months, undergo a preventive examination).

What are the fillings

In addition to the types of filling components used, they are divided into two large groups- permanent and temporary.

Temporary

It is installed during the treatment of the tooth, when it is not yet finished. The indication for installing a temporary filling is not accurate diagnosis. For example, a dentist assumes the presence of caries in the dental nerve, but cannot detect it without destroying the top of the dental crown. In this case, a filling is placed for the time it takes caries to manifest itself as pain. If the pain has not started, then the nerve is not affected by caries. You can leave a healthy nerve alone and close it with a permanent filling.

A temporary filling is necessary when a medicine is placed in the tooth. If the dentist decides to remove the nerve, arsenic is placed in the root canal for several days to "kill" the nerve. A temporary filling in this case is placed for one to two weeks. After fulfilling its function - protecting the medicine from falling out - it is replaced by a permanent one.

Table. Comparison of temporary fillings from different materials

Constant

Classification of permanent seals is carried out according to the materials of manufacture.

Table. Comparison of permanent fillings from different materials

By the way. If too damaged most of tooth surface tissue, the filling will not hold. You will have to install a crown. For both fillings and crowns, there are two treatment options. If the root nerve is affected by damage, it is removed. If healthy, kept under cover.

Sealing stages

The procedure, no matter what material will be used, begins with anesthesia.

Stage one - anesthesia

Using a syringe, an anesthetic is injected into the gum to anesthetize the periodontal tissue and temporarily remove the sensitivity of the nerve endings. It will take some time for the painkiller to work.

Stage two - cleansing

When the freeze begins to take effect, the dentist proceeds to clean and prepare the cavity for filling. All remnants of dead or damaged, infected tissue are removed. The surface is completely cleaned from the darkened enamel, the remnants of the old filling material, if the previous filling fell out. To fill with filling material, a cavity of the required size is prepared.

Stage three - checking the pulp

The condition of the pulp is very important. If it is not affected by caries and has no signs of damage, case easy, you can disinfect your mouth special antiseptic and start filling. If the pulp is inflamed, it will have to be removed.

Important! Only after the complete extraction of the affected pulp from the body of the tooth and the cleaning of its remnants does the filling take place first. root canal, and then the cavity of the apex of the tooth.

Stage four - drying and disinfection

A fully cleaned and prepared tooth must be dried. An antimicrobial pad is placed in a dry cavity, which, being under the seal, will serve as a barrier to the penetration of bacteria.

Stage five - filling

After passing through all the previous stages, a filling material is placed in the tooth cavity, selected in accordance with the indications. If necessary, the canals are sealed first. Then, when the filled channel hardens, the composition is applied to the part of the crown to be filled.

Step six - polishing

It remains only to adjust the bite, grind, polish, give the patient instructions on the hardening time and use of the filled tooth.

Installation of various types of permanent fillings

Installation methods, as opposed to general description filling process, differ when using different filling materials.

Cement

Modern cement fillings make them special types this material - silicate cement, phosphate or glass ionomer. Their specificity during installation is that the cement filling does not harden by itself (this would be too long process), but due to a chemical reaction that occurs when cements are mixed with a liquid.

Important! When working with filling cement, the dentist does not have much time to model the filling and its relief. The material quickly loses its plasticity, although the final hardening occurs after two hours.

Depending on which cement is used, the quality of the filling is higher or lower.

metal

Metal alloy fillings have many advantages. Modern filling alloys (amalgam) are not subject to corrosive changes, are very durable, and are not afraid of moisture. However, the mixture of metals with mercury is toxic, so metal fillings are not suitable for everyone and are not completely harmless.

The second significant disadvantage of amalgam is its ability to expand. The expansion happens after installation. Before, at large cavity filling, there could even be a split in the dental tissue if the wall remains thin. Now the risk of this is minimized, but due to the ability to expand, patients often experience pain after filling for a long time.

The disadvantage is also that the color of the amalgam is very different from the tooth enamel. Most often, this filling material is used under crowns.

It is difficult to place an amalgam filling. She hardens for a long time. But the service life is several decades.

By the way. Gold, which is also a metal, is considered by many qualified dentists to be the ideal filling material. But, in addition to toxicity, it has all the disadvantages of fillings from other metals and alloys.

Composite

Not so long ago, this composition was recognized as a breakthrough in dentistry. Composite fillings are, as it were, glued into the tooth cavity, pre-treated with an adhesive, in layers. Each layer is cured with ultraviolet lamp within 20-30 seconds. After laying the last layer, the top is turned and polished.

Important! Sometimes setting composite filling leads to increased tooth sensitivity in patients.

Composites tend to change color (darken) under the influence of dyes contained in coffee and tea. But dentists have learned to protect patients from losing aesthetic characteristics by covering the surface with a special transparent film.

Ceramic

A real salvation in a situation where the tooth has large surface damage. In terms of color, characteristics, strength, texture, and light reflection indicators, ceramics are identical to natural tooth enamel.

They are made according to casts, in the laboratory, in the form of special tabs that almost completely imitate the restored tooth surface.

The tabs are attached to the cavity on special glue. Irregularities are ground and polished.

Porcelain

They are similar in terms of installation methods and time, as well as in their properties to ceramic ones. Ceramic lasts a little longer than porcelain. The dentist, after cleaning and preparing the cavity for a porcelain filling, takes an impression and sends it to the laboratory. Then the patient comes to try on the finished liner, which is finally adjusted and installed on the glue.

Video - Ceramic tabs

One of the main occupations of dentists is filling teeth. The procedure is familiar and ordinary for both the dentist and the patient. But few people think about what biological sense enclosed in a tooth filling. Why don't fillings last forever? How long can fillings last? Why under the seal toothache after treatment? Why do fillings fall out? Let's try to understand these issues. There are several reasons for placing seals, consider the three most important:

caries treatment

caries treatment- the most frequent and most important reason put a seal. It is interesting to note that caries occurs only in humans, other types of mammals do not suffer from this disease. Caries can be induced in animals, such as rats in the laboratory (they are fed a cariogenic diet containing a large number of sweet foods). Caries, pain in the tooth- This is a kind of human payment for eating processed foods. And, first of all, we are talking about foods containing sugar and other carbohydrates.

Salty, marinated, spicy, fatty food do not apply great harm teeth. Tooth decay occurs from sugary foods and drinks. Carbohydrates are the best "food" for microorganisms that live in the oral cavity and produce acids that destroy tooth enamel. In addition, speaking about the occurrence of caries, one should not forget about the nature and diet of a person, about the quality of salivation, about the amount of fluorine entering the body, and also about genetic predisposition to caries and general condition health.

After eating, part of the food remains on the teeth: at the junction of the tooth with the gum, in the natural depressions between the tubercles of the lateral teeth (fissures) and in the interdental spaces. These are the most typical places where caries occurs on the teeth. Pieces stuck in these places sweet food serve as an excellent food for some types of bacteria that quickly form colonies on the surface of the enamel.

Inside bacteria, carbohydrates are processed, and their decay products become quite active. organic acids. These acids are secreted in large quantities bacteria dissolve tooth enamel. In place of the destroyed enamel, voids are formed, which are filled with bacteria that release even more acid. The voids increase, and over time, a carious cavity forms in the tooth, literally teeming with bacteria. The process is irreversible - a person needs dental caries treatment. Pain in the tooth appears later, when the carious process reaches the nerve of the tooth.

Caries looks like a brown or black stain on the tooth. AT advanced cases a hole in the tooth is clearly visible or even felt with the tongue. Caries - insidious disease! The fact is that the enamel is strong and dense, but the tissue lying under it - the dentin - is less durable and undergoes destruction much faster. Therefore, the manifestations of caries on the surface of the tooth can be very different from what is happening inside. Under a small, barely noticeable speck on the enamel, there may be a huge carious cavity.

caries treatment consists in removing all softened tooth tissues with a drill to a clean, healthy layer. The missing tooth fragment is replaced with a filling.

What to look for in the treatment of caries

As an endodontist, caries treatment I advise you to pay attention to the following points.

First, don't neglect preventive visits see a dentist, see a doctor even if you notice a slight discoloration of the tooth enamel or change in tooth sensitivity. The best way to diagnose caries can be a specialist with the help of X-ray diagnostics. Treat caries in time, without waiting for the complete destruction of the tooth or the appearance of pulpitis.

Secondly, when choosing a clinic for dental treatment, be guided by the presence of an endodontist with special skills in the staff. root canal treatment and performing dental treatment under a microscope. Endodontic treatment of a tooth relieve you of the problems associated with poor quality treatment caries. Every second visitor to my office complains - “ toothache after treatment" or " aching teeth". This means that the work performed in another clinic was performed poorly, the carious cavity was not completely cleaned and properly disinfected. The inflammatory process after such treatment begins with new force and, as a rule, leads to inflammation of the nerve or pulpitis. Pulpitis treatment- a more traumatic and expensive procedure than.

Treatment of non-carious lesions of the teeth

Less often than caries, dentists have to treat non-carious lesions of the teeth. Over the past decades, these lesions have been increasingly diagnosed among the population of developed countries. The causes and mechanisms of the onset and development of this disease are not fully understood, there are many theories and hypotheses on this score.

These lesions represent the destruction of the enamel without noticeable carious inflammation. As a rule, they are located in the gum part of the tooth and look like enamel chips. In some patients, these defects are sensitive and painful, in others they appear imperceptibly.

In the photo: a tooth with a non-carious lesion, the closure of the defect with filling material and the appearance of the same tooth six months after treatment.

Treatment of non-carious defects is similar caries treatment The missing part of the tooth is restored with a filling. If the tooth is left untreated, the defect increases over time, and can also be aggravated by the inflammatory process.

What to look for in the treatment of non-carious defects

First of all, pay attention to the sensitivity of the teeth, perhaps it was caused by a non-carious defect invisible to your eye. Maintain regular oral hygiene and visit the dentist twice a year to diagnose dental problems in time.

Tooth restoration after canal filling

As a rule, canal filling is carried out with treatment of pulpitis. AT this case one more essential requirement is imposed on the seal: it must be absolutely hermetic. ABSOLUTELY. If there is no tightness, then sooner or later the microbes of the oral cavity will penetrate into the channels again, and a sluggish inflammatory process. The reason for the infection of the canals is that the material used to fill the canals is not as strong as a dental filling.

What to look for when restoring a tooth

First, choose a clinic with an endodontist in the state. Only this doctor can guarantee a correctly performed root canal treatment, which will not be complicated subsequently by inflammation. Secondly, check with your doctor what options for tooth restoration he can offer you. If you are offered to restore a badly damaged tooth, then you should know that there are three methods of tooth restoration. The first - restoration with filling material directly in the mouth (filling) - is used when small cavities. The second one is the restoration of a tooth made in a dental laboratory according to casts with a dental inlay made of ceramics - it is used in case of severe tooth decay, when the crown part is missing or thin walls remain after caries treatment. Third - filling and subsequent coating of the tooth artificial crown- applies to chewing tooth with its significant destruction, and especially after canal filling, when the filling cannot perform the tasks of restoring the tooth relief fully. The doctor will always explain which method is most suitable for your case.

Choose a clinic that has its own dental laboratory, and whose doctors own the most different methods restoration of damaged teeth, this will help to quickly and reliably cure teeth.

Quite often, patients dental clinics appoint dental filling. But not every patient thinks about how this procedure is carried out, and what the doctor does during it.

Haste in the treatment of a diseased tooth leads to rash actions. For example, a patient may not say that he is allergic to any component. This can lead to negative consequences of such treatment.

Incorrectly selected material by a doctor without taking into account anatomical features oral cavity the patient can also lead to poor quality filling tooth. Therefore, you need to understand How is a tooth filling done?.

Most of us have forgotten that the only right decision to cope with a diseased tooth is to remove it. Dentistry does not stand still and constantly comes up with new methods that allow you to treat teeth and eliminate damage. To date effective way To cure caries and a damaged tooth is a filling.

It is worth noting that quality partial treatment damaged area will directly depend on the quality of the material and the professionalism of the doctor.

Pain in this variant is inevitable. Since the root of the tooth contains nerve endings, which gradually transmit their signals to the brain about the manipulations that the dentist performs. But a few decades ago, it was impossible to cure caries for the reason that painkillers were not used. Today, without them, it is impossible to imagine any manipulation that is carried out in the oral cavity. Thus, the patient has the opportunity to cure everything imperceptibly and painlessly.

Tooth filling process

The technology of filling the damaged area consists of several manipulations. In time, it can take up to an hour, depending on the clinical picture of the patient. As a rule, it consists of the following procedures:

1. an anesthetic injection that removes any pain;
2. the oral cavity is carefully treated. At the same time, the affected areas of the tooth will be cleaned. During the inflammatory process, the pulp can be removed. Then the tooth is disinfected. At this stage, it is important that no areas of affected tissue remain under the filling. Otherwise, the inflammatory process will be characterized by relapse;
3. in the event that the damage on the tooth surface is not severe, a medical pad can be installed. But if not, then the pin will be installed during the filling of the affected area;
4. when choosing a material, the doctor pays attention to the location of the damaged tooth, as well as other factors;
5. to make sure the quality of his work, the dentist makes a control X-ray;
6. to eliminate discomfort and cover the seal with varnish, grinding of the composite is performed. Thus, there are no problems with chewing food and when closing the jaw.

In some cases, the standard process - filling - may not be suitable for the patient due to serious lesions and anomalies. They should include:

• canal curvature;
• sealing with a pin and tab;
• resection of the root apex.

In these cases, the dentist performs a retrograde filling, which allows for further inflammation and hermetically sealing the canals.

Tooth filling: materials

AT modern dentistryfilling materials are varied. Their purpose is not only to close the hole in the tooth. They are aimed at recovery processes, physiological and anatomical functions. Thus, the material must be selected at the appropriate load and its location.

At serious injuries, in case of damage to the structure itself, polymers are used as a filling material. They are able to withstand heavy loads to be shown on the front designs. In addition, light-curing composites can be used. With the help of them, it becomes possible to reproduce the natural color of the filling, like a tooth. If damage has affected the incisors, then silicophosphates or silicate cements can be used.

As with any other material, there are special requirements. For canal filling to be successful, the material must meet the following requirements:

1. it must perform a complete sealing of the canal root;
2. he should be missing chemical reaction, which changes the color of the structure;
3. it should not seat fillings;
4. the material should be easily removed from the oral cavity in case re-treatment is required;
5. the material should not dissolve in soft tissue.

According to all these requirements, filling can be carried out using gutta-percha. However, this material does not meet all the requirements. Gutta-percha cannot block the life of microorganisms in the sealed cavity.

The cements that are used for filling, on the contrary, prevent this process. But at the same time, they do not have such a high level of strength. Thus, they are fully compatible with dental tissues and release fluoride, which will help strengthen the dentin and shrink. This material is the most durable and does not negative consequences. The only drawback is the high level of acidity. For proper installation, dentists use a calcified pad.

Tooth filling: does it hurt?

Every second person who is faced with a filling problem is interested in how painful it is. If earlier this process was performed without anesthesia, now going to the dentist is not at all scary. After all, tooth filling is carried out under the influence of painkillers.

The doctor at the clinic will not ask you questions about anesthesia. Since such manipulations are carried out only under the influence of painkillers. In this case, the only thing you should do is choose a drug. Today there are many of them. Even diabetics and allergy sufferers can treat their teeth without suffering. Anesthesia is done with several injections into the gum. During the procedure, the patient does not feel anything. After the filling procedure is completed, there may be a slight sensitivity. It goes away in a few days.

Quite often you can see caries in the front row. The emergence of this is not only poor nutrition and lack of proper care, but also poor heredity. Caries is a stain dark color, which is formed on inside tooth or between them, which is quite difficult to notice. But due to the fact that the protective layer on the front teeth is too thin, this stain will grow rapidly. The main thing is not to miss it initial stage process and cure it in time.

It should be noted that the filling of the front row has only aesthetic indicators. Since these teeth are minimal chewing load. To not have discomfort while chewing food or while smiling, light-curing fillings are installed, which allow you to restore the natural color of the enamel.

It is possible to restore the front teeth with the help of ceramic fillings. They are almost identical to natural teeth. Only up close you can see that this is just a filling, and not a real tooth. But this material will take a long time to produce. And also it is used for serious damage to the front teeth. But at the same time, it is resistant to external influences.

Tooth filling: application of paste

Quite often, when filling canals, dentists use pastes. They are needed to seal the void after the inflamed pulp is removed. To date, there are three types of pastes:

1. paste "Endametoson" is the best option. It does not dissolve or dissolve. In addition, it does not irritate the tooth tissue. Always remains unchanged. The powder for making pasta comes in two shades. It can be pink or ivory;
2. pasta "Forfenan" widely used in dentistry. During polymerization, it overheats greatly. As a result, formaldehyde is released. It turns into a solid antiseptic. The disadvantages of using forphenan include a long period of hardening;
3. formalin paste used to be quite common in dentistry. To date, it is rarely used, as it can affect the color of the tooth. In terms of basic properties, it is not inferior to the previous two. It is recommended to use it on any molars, except for the anterior ones.

To date, pastes are used in all dentistry. But there is no universal one. Each of them has a drawback - these are difficulties in unsealing when re-treatment. Thus, the dense material that enters the channel is unevenly distributed. Air pockets may form in the hard paste. But despite all the difficulties, filling with paste is a popular way to cure caries and close the hole in the tooth.

Along with the usual methods of filling, dentistry does not stand still. She constantly invents new ways to treat the dentition. We propose to consider innovative, modern ways tooth filling.

1. Canal sterilization filling them with depophoresis. Cracks and cavities will be filled special tool. It can be applied in difficult cases, for example, the curvature of the channels. Applied using medicinal product and special tool.
2. Application of hot gutta-percha for filling teeth is a reliable way for filling. Can be used with the injection method. In this case, to problem area adjoins gutta-percha and seals the canal. With the vertical condensation method, when a three-dimensional filling is performed. Can be used with the continuous wave method, which is similar in performing vertical condensation. With syringe injection, heated gutta-percha is also used. Such methods can only be used by a dentist who has high level qualifications.
3. Tooth filling with cold gutta-percha. Can be used when installing one pin. And also with the help of lateral condensation, when gutta-percha and a pin will be used when filling the channels. They are also used at the risk of a tooth fracture or loose canal filling. Can be used for thermomechanical condensation. With this option, the channel is filled using a special rotating tool.
4. Another way is channel mummification. In this case, the pulp can be treated with more antiseptics. Then the blocking of the inflammatory process will be achieved.
5. Retrograde filling is a procedure using modern equipment. This requires a special nozzle from injection pistols. Initially, the root is filled with the selected material. And then, according to the schedule of movements, the doctor performs the following filling.

There are many ways to fill a tooth. But each of them has both advantages and disadvantages. Choosing this or that method, it is necessary to consult with the attending dentist. Since many of the options may not be suitable for an individual clinical picture patient. In general, tooth filling is successful and does not require additional restoration. It is especially important that the procedure is safe, effective and painless. To restore chewing functions, aesthetics, it is necessary to apply tooth filling.

As you know, the most common materials for filling teeth are light-curing composites. Considering this fact, we will consider the technology of setting a photocomposite filling.

The method of filling a tooth directly depends on the volume and depth carious process. By depth carious cavity caries is classified as: superficial, medium and deep. At superficial caries, the carious defect is located within the enamel. With an average - the enamel is affected and the dentin is affected. At deep caries- the enamel is affected and a significant layer of dentin is destroyed by caries.

Superficial caries

Medium caries

deep caries

After the carious cavity is prepared for filling, the tooth must be isolated from saliva. Failure to comply with this requirement can lead to wetting of the prepared cavity with saliva and, as a result, cause a violation of the tightness of the seal to the tooth. This leads to caries at the border of the filling and the tooth, and can also cause "fallout".

Cotton rolls or more are used to isolate teeth from saliva. reliable way– insulation with rubber dam. A rubber dam (or rubber dam) is a thin sheet of latex rubber. With a special technique, a rubber dam sheet is put on the tooth, creating a dry working field. Saliva is removed from the oral cavity with a saliva ejector.

Figure 1: Rubber dam sheet.

Fig 2: Clasps - metal clips for fixing the rubber dam on the tooth.

Fig 3: Tooth isolated with rubber dam.

Then acid etching of the prepared cavity is carried out using 37% phosphoric acid. This is done in order to remove the so-called "smear layer" and increase the contact area between the surface of the tooth cavity and the filling. When etched, the acid dissolves the inorganic components of the tooth tissue, creating a rough surface. After 20 - 60 seconds, the acid is washed off with water and the tooth is dried with air.

The next step is to introduce the so-called “bond” into the cavity - its function is to create an “adhesive” layer for reliable “sticking” of the filling to the tooth tissues.

Applying the bond to the walls of the prepared cavity

After "bonding" the walls of the cavity are covered with a special special fluid composite. Due to its fluidity, it penetrates into all microcavities, creating a thin and smooth "adaptive" layer. This layer contributes to the removal of mechanical stress from the walls of the cavity of the tooth. Then the flowable composite introduced into the cavity is cured by the light of a special dental lamp.

Dental curing lamp

Light curing fillings

The filling material is directly introduced into the cavity in portions and evenly distributed in it. Then it is cured by lamp light. So, layer by layer, the entire cavity is filled. It is very important that the thickness of each layer does not exceed 2 mm. This requirement is due to the polymerization shrinkage of the photocomposite (volume reduction during curing) and the inability to polymerize the "thick" layer of the composite with lamp light. If this rule is not observed, a micro-gap may form between the filling and the tissues of the tooth, which leads to the occurrence of recurrent caries. Also, this mistake can cause pain after the filling.

So, "set". Now it should be processed, i.e. make the restored tooth correct anatomical shape and polish the filling. Preliminary processing fillings are carried out using diamond or carbide burs. Excess filling material is removed, sharp edges are smoothed out, the relief is given to the seal, characteristic of this tooth. Carbon paper is used to control full contact between the restored tooth and the antagonist (similar to the tooth of the opposite jaw). When the teeth are closed, the paper leaves an imprint on the filling in the place where the contact is excessive. This point is ground. This operation is repeated until the optimum contact of the antagonists is reached. Polishing gums, abrasive discs and strips are used for the final processing of the seal. After that, the filling is polished with a special polishing paste and covered with a protective varnish.

Clinical example with heliocomposite

A: initial situation(amalgam fillings requiring replacement).

B: Fillings removed, resulting cavities etched and bonded.

C, D, E: Stages of restoration of the second upper premolar.

View of the completed restoration of teeth

Features of the treatment of medium and deep caries

With medium and, especially, deep caries, a layer of tooth tissue that separates the bottom of the carious cavity from the pulp chamber ( inner part the tooth where the "nerve" is located) can be very thin. As a result, after the filling, a complication may occur - (inflammation of the nerve of the tooth). Pulpitis, in this case, can be provoked by chemical irritation of the pulp. dental preparations used to treat a carious cavity.

Also, a significant area of ​​the exposed (internal tooth tissue containing nerve endings) can cause pain after tooth filling. In order to prevent these undesirable consequences before placing a filling inner surface prepared cavity is covered thin layer glass ionomer cement. The cement layer promotes the regeneration of tooth tissues and isolates sensitive dentin from irritant pickling acid.

With deep caries, a special medical pad is applied to the bottom of the cavity. It contains calcium hydroxide, which contributes to the restoration of dentin from the side of the pulp chamber. Then, a layer of glass ionomer cement is applied over the medical lining, after which a filling is placed.

A “good” filling will be obtained if the above principles of caries treatment are observed. Otherwise, the filling will most likely not be "good" enough.

Seals are different: cement, metal, plastic, etc. In addition, they are permanent and temporary. Temporary fillings are placed when they are placed in a carious cavity medicinal substance, permanent - when the tooth can be cured at one time. The latest peep of modern dentistry: large "holes" in the tooth are closed with so-called tabs.

Many patients believe that the “hole” is simply enough to close up with filling material. They are very wrong. It is better to start with anesthesia. This will anesthetize the treatment, and will not leave bad memories.Now from the carious cavity you need to remove damaged tissue tooth (dark and softened dentin). By certain rules need to form a carious cavity.

Then this cavity must be washed and disinfected with antiseptic solutions. In no case should live teeth be treated with alcohol or ether - this can lead to nerve death. Dry the cavity. At deep cavities it is necessary to apply a medical pad containing calcium, which will help relieve inflammation and finish off the remaining microbes. Such a pad stimulates the formation of replacement dentin (increases the distance from the carious cavity to the nerve), thereby reducing the chances that the tooth may become sick.

Followed by medical pad(or in its absence) an insulating gasket must be applied. It can be phosphate cement or glass ionomer cement. This pad isolates the nerve of the tooth from toxic action modern aesthetic filling materials. After applying the gaskets, you can put a seal. The scheme of setting each seal is individual. After the filling is placed, it must be properly sanded and, if possible, polished. As a result, the treated tooth will not cause discomfort in the mouth, and the filling will not darken.

A good filling should fill the entire space of the carious cavity; do not interfere with chewing; be as smooth as possible don't stick to adjacent teeth; repeat the anatomical shape healthy tooth(if there are no contraindications to this); After setting the seal, the tooth should not hurt. If you experience pain after caries treatment, contact your doctor.

Possible causes of pain : Ppost-polymerization pain - rarely occurs after tooth filling composite materials; allergic reactions on the filling material - it is required to replace the filling with another, not causing allergies; complications of caries; the occurrence of pulpitis (damage to the nerve of the tooth) is characterized by acute paroxysmal pain, pain from cold or hot, severe night pains. In this case, it is necessary to remove the nerve from the tooth and refill it.

So, what to do if it is already 12 at night, and the tooth suddenly grabbed:

First of all, until you have visited the doctor, no warm compresses and lotions - this procedure can significantly worsen the situation and make it difficult further treatment. This recommendation also applies to widely practiced "methods" like: "Put a cotton swab with cologne on the gum." As a result, the patient receives severe burn gums, from which he will still have to suffer even after the tooth is cured.

The first thing to do is to try to gently, with a needle, remove all food debris from the cavity in the tooth. Next, it is advisable to rinse the tooth with a warm solution of soda (1 teaspoon per glass warm water). The absence of any residue in the tooth should be constantly maintained.

You can take various painkillers (analgin, baralgin, sedalgin ...). The only thing I would like to warn against is aspirin, since its analgesic effect is not great and you will be forced to take it in large quantities that are unsafe for health. Painkillers should be stopped no later than 3 hours before a visit to the doctor, as this can distort the picture of the disease and make it difficult to make a diagnosis.

It is strictly forbidden to take antibiotics without qualified consultation and doctor's prescription. In general, taking antibiotics for any disease is a very responsible procedure. These drugs are taken according to a special scheme, and not 1 tablet 3 times a day, as patients often think. Taking one pill "just in case" will bring nothing but harm.

If a problem occurs, you should immediately consult a doctor. Preferably with a friend who has recommendations. However, do not be afraid of the clinic on duty, because in most cases you can remove acute phenomena without removing a tooth and without putting a permanent filling.