Cavity fillings, also called dental fillings, are popular methods used for restoring the appearance and functionality of damaged teeth. When a part of the teeth becomes damaged, small holes called cavities gradually develop in these areas. These cavities cause mouth pain and toothache if left for too long.
Regular dental cleaning and checkups are necessary to maintain optimum dental health. That is because it helps the dentist to identify caries before they do much damage to your teeth. The most common use of dental fillings is to fill cavities. They are used to restore part of a broken tooth. And to repair teeth damaged by excessive grinding (bruxism).
The dentist starts the cavity filling process by administering a local anesthetic. The anesthetic numbs your teeth and gums to reduce the pain and discomfort during the cavity filling process. The affected portion of the tooth is then drilled out and replaced with a filling.
Tooth fillings are necessary for several reasons.
• They seal up holes in the teeth. If these holes aren’t closed quickly, there is a high probability that food particles and bacteria will accumulate and cause tooth decay.
• They help to restore fractured, cracked, and discolored teeth.
Classes of Cavities
The current system of caries classification by an American dentist, Dr. G.V. Black, classifies caries based on two factors; Location on the tooth surface and type of tooth affected.
G.V. Black’s Classification identifies six classes of carious lesions. They are as follows:
Class I
These cavities are also called pit-and-fissure lesions. This class includes caries on the occlusal surfaces of molars and premolars, occlusal two-thirds of the buccal and lingual surfaces of molars, and the lingual surface of maxillary incisors.
The occlusal surface is the part of the posterior teeth used for chewing, while the buccal surface is the part of the teeth that faces the cheeks. The lingual surface is the part of the teeth that is closer to the tongue. Class I cavities are easily seen with the human eye.
Class II
These cavities develop on the proximal surfaces of the posterior teeth (Premolars and molars). Proximal surfaces are tooth surfaces that follow each other. This class of caries is not visible to the human eye.
Class III
Class III cavities occur on the proximal surfaces of the front teeth (Incisors and canine). Class III cavities do not include those that develop on the cutting edges of the anterior teeth. This class of caries is also not visible to the human eye.
Class IV
These cavities develop on the proximal surfaces of the front teeth (incisors and canines). Class IV includes caries that build on the cutting edges of the anterior teeth.
Class V
These cavities form on the surfaces of all teeth near the gum line.
Class VI
Class VI cavities form around the cusp tips of premolars and molars, as well as the cutting edges of the incisors and canines.
Symptoms of Cavities
Cavities do not usually cause any symptoms in their early stages. Yearly x-rays are necessary to detect them at this stage. Symptoms begin to develop when small caries become larger.
Some of the symptoms caused by large cavities include:
• Recurring toothache – This is pain or inflammation around the tooth.
• Tooth sensitivity – The teeth become easily stimulated by cold, hot, or sweet substances.
• Teeth stains – Carious lesions leave white spots on the teeth.
Why do Cavities form?
Tooth decay gives rise to cavities. When carbohydrate foods like cereal, bread, milk, rice, soda, cookies, or candy stay on your teeth for an extended period, they cause decay. These food substances are converted into acid in the mouth by bacteria. The bacteria then combines with the food remains, saliva, and acid to form plaque.
Plaque is sticky, and it clings to your teeth. The acid in plaque begins to attack the enamel and dissolve it. This results in the formation of holes in the teeth called cavities. Therefore, eating lots of sugary and high-carb foods puts you at a higher risk of getting cavities.
After wearing away the enamel, plaque moves on to attack the next layer of the teeth called dentin. When the dentin is exposed, the sensitivity of the teeth increases. That is one of the symptoms of a cavity.
As the tooth decay continues, the bacteria and acid continue to make their way through the layers of your teeth. After passing through the dentin, they reach the next layer of the teeth that contains the nerves and blood vessels, the pulp. The pulp becomes irritated and begins to swell, compressing the nerves in the teeth and causing pain.
Everyone that has teeth is at risk of developing cavities. However, some factors can increase your chances of having them:
• Sticky foods and beverages: Since we need to eat and drink to survive, there’s no way to avoid this. However, it is possible to minimize the chances of developing cavities. Foods that stick to your teeth increase your risk of caries. After eating or drinking, you must brush to remove all the food that remains on your teeth.
• Dry Mouth: Saliva helps prevent the build-up of plaque by washing them from the teeth. Saliva also helps to buffer the acid contained in the plaque. Therefore, if there is a reduction in the amount of saliva produced in the mouth, plaque and tooth bacteria will build-up more quickly.
• Poor Oral Hygiene: Brushing your teeth has many advantages, one of which is the washing away of plaque. Brushing reduces your chances of developing cavities by removing plaque that can damage your teeth.
Cavity Filling Types
There are two varieties of Cavity filling; Direct and Indirect cavity fillings. Direct cavity fillings are usually faster, and they require only one visit to the dentist. Indirect cavity fillings require two appointments with the dentist.
Direct Cavity Fillings
Direct Cavity fillings are of three types.
• Composite Fillings: They are the most popular cavity filling materials. They are tooth-colored and can be used to fix broken and cracked teeth. Composite fillings have a distinct advantage because they blend in naturally with the teeth. That makes composite fillings aesthetically pleasing. Composite fillings may last for up to five years.
• Silver Amalgam Fillings: Of all the available cavity fillings, silver amalgam fillings are the cheapest and most durable. This filling consists of metals such as; mercury, tin, silver, and copper. Silver amalgam fillings are safe to use because the mercury they contain is non-toxic and poses no danger to your health. Silver amalgam fillings are not as aesthetically pleasing as composite fillings.
• Glass Ionomer Fillings: Glass Ionomer fillings are of two types; Conventional Glass Ionomer fillings and Resin-Modified Glass Ionomer fillings.
Conventional Glass Ionomer fillings are similar to Composite fillings because they are tooth-colored. They contain ion-leachable glass particles and polymerizable acids. These fillings have an additional function, as they help prevent future cavities by releasing fluoride.
Resin-Modified Glass Ionomer fillings are tougher than Conventional Glass Ionomer fillings. They contain an additional component, acrylic resins. These filings are used mainly for cavities in baby teeth.
Indirect Cavity Fillings
When cavities can’t be corrected using cavity fillings, indirect cavity fillings are appropriate. They are of two types; Porcelain Cavity fillings and Gold Cavity fillings.
• Porcelain cavity fillings: These fillings blend very well with natural teeth. They are strong and are also aesthetically pleasing.
• Gold cavity fillings: These fillings aren’t as aesthetically pleasing as composite and porcelain fillings. They give protection to teeth cusps weakened by cavities.
Process of Cavity Filling 
The first step in the cavity filling process is the administration of local anesthetic by the dentist. The anesthetic numbs the area around the damaged tooth. And the dentist uses a drill, laser, or air abrasion instrument to remove the decayed part of the tooth.
After the removal of the decay, the dentist cleans the cavity and prepares it for the filling. Once the filling is in, the dentist finishes and polishes it. Tooth-colored fillings require several additional steps. A special light is applied to harden each layer of the filling. After placing the layers of the tooth-colored filling, the dentist then trims off excess material on the filing and shapes it. The final restoration is then polished.
Caring for Cavity Fillings
To maintain cavity fillings, you must practice good oral hygiene. You must brush regularly with fluoride toothpaste, visit your dentist for checkups, and use an antibacterial mouthwash. X-rays can assess the cavity fillings for cracks and leaks. Remember to call your dentist if you feel any pain or discomfort with your cavity fillings.
Cavity Filling Cost
The cost of a cavity filling depends on the filling material and the dentist’s location. The cost of a cavity filling procedure is usually covered by dental insurance except in some cases.
• Composite fillings cost $90-$300 per tooth without dental insurance.
• Glass Ionomer fillings also cost $90- $300 per tooth without dental insurance.
• Indirect Gold or Porcelain fillings are more expensive than composite and glass ionomer fillings. They cost $500-$4500 per tooth.
