Caries treatments, obturation, amalgam removal, canal treatments
CONSERVATIVE TREATMENTS
Molars, teeth of the smile, teeth of milk or definitive ... caries strike everywhere. But the age of "filling" is over and the dentist now has materials and techniques adapted to each case.
Avoid nibbling and sweet and sour products, brush your teeth after every meal ... Even with good dental hygiene that limits plaque, rare are those who will never have decay ... This is one of the ten most common chronic diseases. To treat it, the tissues affected by the bacteria are removed first and then the hole is filled to restore the shape and function of the tooth. Depending on the size and location of the decay, different solutions may be proposed. The choice will be based on the quality of filling, durability, aesthetics, and of course the cost and reimbursement, very variable from one method to another.
SMALL CARIE ON MOLAR: COMPOSITE ... OR AMALGAM?
Initially reserved for the front teeth, composite resins of enamel color are increasingly used for posterior teeth. This paste based on quartz particles, silica and zirconium, fits perfectly to the recess cavity. The new composites are more resistant, nevertheless they sometimes age badly and can be infiltrated and change color.
Should we be wary of amalgam mercury?
Some dentists still use a gray amalgam. Amalgam, also called "sealing", is made of a combination of silver, tin, copper and zinc combined with mercury mixed to produce a gray paste. It has the advantage of being very resistant and having anti-carious properties. The mercury it contains is potentially harmful for the body ... But the risk threshold is difficult to assess. As a precaution, it should not be used in pregnant or breastfeeding women and in people who are sensitive or allergic to any of its components, or near other metal fillings or crowns to prevent electrochemical corrosion.
We advise our patients to have them removed because they not only contain mercury that is toxic to the body, but in addition they make a mercuroscopic expansion that causes cracks and fractures teeth after several years in the mouth. But as it is especially during the break and the removal that the mercury dust diffuse the most, we use special masks and a very powerful suction specifically adapted for the removal of dental amalgam.
BIG CARIE ON MOLAIRE: INLAY OR ONLAY
When the hole is larger (recurrence of caries, etc.), the dentist can reconstruct the tooth using a small composite block, ceramic or gold, made to measure in the laboratory, then glued or sealed. This requires an impression and two sessions. The inlay is a small room that is encrusted. The onlay is a "partial crown". It is used when it is necessary to cover part of the damaged tooth.
CARIE UNDER A CROWN: NEW CROWN OR EXTRACTION
Bacteria can sneak at the junction with the gum and cause caries under a crown, usually insensitive since the tooth is devitalized. It is then necessary to remove the crown to evaluate the damage, to treat the caries then to put back a crown. It may be the same if it is still suitable, otherwise you have to ask a new one. If the tooth is too damaged, we have to extract it. An implant fixed directly into the bone can then replace the root to support a prosthesis.
CARIE TOUCHING THE NERVE: DEVIATION AND COMPOSITE / CROWN
When caries reaches the "nerve" of the tooth, devitalization is required. The practitioner eliminates the pulp, disinfects the root (s) and then closes the canal with a waterproof material. Nine times out of ten, it is necessary to crown the weakened tooth. The metal crowns, nickel chrome, chrome-cobalt or yellow gold are the least expensive. The ceramic crowns on a metal support or ceramic support, more aesthetic, have the same lifespan and minimize the risk of allergy.
CARIE ON A TOOTH MILK: IONOMER GLASS
Recent alternative to the composite, glass ionomer cements continuously release fluoride, which promotes the prevention of cavities. Their life is limited, they are used mainly for baby teeth.
A fluoride toothpaste (dosage <600 ppm before 6 years, then 1000 to 1500 ppm) can prevent cavities. In case of high risk, the dentist may prescribe mouthwashes as well as gels, varnishes or fluorine tablets.
CARIE ON A FRONT TOOTH: COMPOSITE AND FACET ... OR CROWN
When decay is small, a composite is used to fill it, which must be replaced after a few years if its color changes. A larger caries on a living tooth will be filled, then we can stick a ceramic facet (lifetime 10-12 years) and find a beautiful smile. When the root is touched, the tooth must be devitalized and a crown may be needed.
DID YOU KNOW? WE CAN SEAL THE SILLONS IN PREVENTION
80% of caries originate in the grooves of the upper surfaces of the molars and premolars. As soon as the first and second final molars (around 6 years old and 12 years old) are released, it is advisable to seal these furrows with a protective fluororesin. Protection that can be renewed if necessary.
