Restorative dentistry is the art and science of removing decayed surfaces on the teeth and replacing it with a filling material. The filling material may be an amalgam (silver material) or a composite (tooth-colored material).
These decayed surfaces are called caries. Four factors interplay in the formation of dental caries. These factors include- microorganisms present in dental plaque, substrate, susceptible areas of the teeth and time. Substrate serves as food for the microorganisms on the dental plaque which then releases acidic by-products that demineralizes susceptible areas of the teeth through time. Dental caries may be prevented by intervening in these four factors. By brushing and flossing properly, one can disturb the maturation of dental plaque; by decreasing the frequency of eating in between meals and eating sugary foods, one can deprive microorganisms of its “food”; and by using fluoridated toothpastes or intake of beverages and food with fluoride and having pit and fissure sealants on teeth, one can strengthen and reduce the likelihood of developing caries.
When caries and a cavitation is already present, the carious lesion has to be removed and the missing surface of the teeth is then replaced by a material. During the removal of caries, the patient may feel sensitivity that may be referred to as pain. When the carious lesion is large, the dentist may put a liner and a base prior to the filling procedure. When a composite material is to be used, the tooth should be dry during the procedure. The dentist will put a rubber dam around the tooth to prevent it from getting wet prior and during the filling of the tooth. The composite is then light-cured, trimmed and polished. On the other hand, if amalgam is to be used, it is directly placed on a dry tooth, carved and burnished. Patients are advised not eat or bit on the side of the newly restored tooth since amalgam is not strong enough in the first 24 hours to receive load or biting forces. The polishing of amalgam is done at least 24 hours after the filling procedure.
After restoration or filling of teeth, the patient should be aware that restorations are not forever and that he/she should maintain good oral hygiene to prevent the recurrence of caries. Amalgam fillings generally last longer than composite fillings.