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What happens when the dentist gives you a filling?

Just about everyone will have a tooth filled at some point. Yet most people have no idea of what is actually going on inside of their mouth while the tooth is being filled. Let's take a look at what is really happening when a dentist performs a filling.

Preparing for the Filling

Dentists ensure patient comfort throughout the filling process by applying a local anesthetic before the procedure occurs. It functions to temporarily block pain messages sent from the tooth's nerves to the brain. The dentist then “preps” the mouth by placing a rubber dam along the tooth that will be filled. Some dentists also place a soft triangular shaped piece of rubber called a "bite block" between the lower and upper teeth to keep the jaw open.

Eliminating Tooth Decay

Once your mouth is prepared for the filling, the dentist will begin the process of removing tooth decay. He might use a variety of tools to clean out the decayed section of the tooth. A high-speed handpiece, commonly called a dental drill, sprays water as the dentist operates. It quickly glides through the decayed section of the tooth to eliminate the damaged portion. As this happens, the dental assistant applies a high volume suction to remove water and tooth debris. Another suction device called the "saliva ejector/low-volume suction" removes excess water in the mouth so that you do not swallow it. Any remaining decay is removed with a slow-speed handpiece along with various hand instruments.

Filling the Tooth

Once the tooth decay is eliminated, the dentist will proceed to apply a filling to the resulting hole, meaning you have a complete tooth once again. He will use either amalgam or composite to restore the tooth. If the cavity is not positioned smack dab on the middle of the tooth's biting surface but in between the teeth, the dentist will apply a metal “matrix” band around the tooth to allow the tooth's walls to rebuild themselves. He'll also use a wedge in between the two teeth so the neighboring teeth do not touch the filling. This prevents bits of food from catching in between the teeth as you chew. When the amalgam is mixed and ready to go, the dentist will place it inside of the tooth with an amalgam carrier. He presses it down to make it compact and carves it to make it look like a natural tooth.

If your dentist uses a composite resin filling, not much will change except the band will be clear rather than metal. A clear band is used to allow the curing light to shine through it. When applying the composite filling, the dentist utilizes a blue gel acid on the tooth to create very small holes that permit the composite to bond with the tooth. He then rinses off the acid, dries the tooth and applies a priming/bonding agent to build a solid bond between the filling and the tooth.

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