Dental Procedure Blog series
The following series of blogs will cover the different areas of dentistry. The aim is to simplify and explain the jargon that patients encounter in the normal course of dental visit. It is based on the Ontario Dental Association’s procedure categories and descriptions.
Restorative dentistry is the term that describes any procedure that restores a tooth to function and appearance. By this definition fillings, crowns, bridges and implants, dentures fall into the category. However, to keep it simple, the usual meaning is used as it applies to the single tooth.
Dental first aid best describes these procedures. They are used when teeth are severely decayed, fractured or traumatized and causing pain.
This may include temporary fillings of various kinds for deep decay with or without exposed pulp tissues that will attempt to settle down the pulp (nerve), diminish the pain and stop the active decay.
Then in several months time a regular filling may be placed. These fillings may not be able to prevent the need for root canal therapy or other interventions, but it is a conservative attempt at rescuing damaged teeth.
Fillings aka Restorations
A tooth is considered to have 5 surfaces for descriptive purposes: mesial, occlusal (incisal on anteriors), distal, buccal (aka vestibular) and lingual or in short form – MODBL. Fillings are described by the number of surfaces involved. Fees are also calculated by the surfaces restored. Thus, a five surface restoration would involve the entire tooth above the gum line.
Filling materials also come in many forms. Historically gold foil and silicates were used, were as in the last 50 years silver mercury amalgam and composite resins took precedence. Today glass ionomer and glass ionomer composite hybrids are also used along with the composite resins which are slowly phasing out metals.
Filling materials are chosen by the requirements of the specific tooth and the extent of the decay or fracture present. The method for excavating the decay may also vary from high and low speed drills, air abrasion, lasers to hand instruments.
Insurance plans reimburse on the treatment outcome i.e. the number of surfaces of the filling and sometimes the filling material – metal or composite.
When large complex fillings are done pins may be used to help retain the filling material.
One to several pins may be placed. This is similar to wall anchors helping hold screws in walls.
Pins are different from posts. Posts are much longer and are cemented into the root canals of a root canal treated tooth when extra support (like rebar) is needed. They help keep the core or restoration in place. Pins may also be used in conjunction with posts. In many ways this is microcarpentry!
Restorative jargon will be continued in the next blog.