When a cavity between the teeth occurs, the dentist recommends a suitable treatment to stop it from spreading further. This recommendation depends on the severity of the cavity. Broadly, the various treatment modalities are remineralisation, filling, and root canal treatment, followed by crown placement and extraction.
The first step towards any kind of restoration is the removal of caries or the decayed part of the tooth. A dentist can remove it using various hand instruments, such as explorers, excavators, or conventional airotars. This is followed by a proven approach to restoring the damaged dentinal surfaces and the enamel with various restorative options.
What are the various approaches to filling a cavity between the teeth?
Remineralisation can only be done if the cavity between the teeth is caught very early, and a fluoride application is done to stop the progression. If the cavity extends further into the enamel, the dentist does a restoration to bring its normal function and shape back. In restoration, the dentist removes the decayed part and fills with a suitable filling material. This material is chosen as per the patient’s choice, such as composite, amalgam, gold, etc.
But, in cases where caries has reached the innermost layer of the tooth, i.e., pulp, there is a need for RCT or Root Canal Treatment to save the tooth. The procedure involves the removal of the pulp and the decayed area. After this, the dentist cleans, disinfects, shapes and fills the tooth. Following this, the dentist places a crown over the tooth to cover the filling and support the tooth. The dentist may do the restoration with ceramics, composite resin, metal alloys, porcelain, or a combination.
The last resort to treat it is an extraction, especially if the tooth is beyond restorable. The dentist can fill the space after the extraction with a bridge, a partial denture, or a dental implant later on.
What other approach can be used to fill the cavity?
A controversial approach is conservative or ultraconservative removal of cavity between the teeth. It is also called “partial caries removal”. For this procedure, the dentist removes most but not all of the infected dentin and seals the cavity. The dentist seals the cavity with or without indirect pulp treatment, such as applying protective material like calcium hydroxide or zinc phosphate on the pulpal floor. This proceeds with the restoration. The etiology behind this is that the cariogenic bacteria is left isolated from its source of nutrition. Due to this, it may die or remain quiescent and, thus, given a vital pulp, pose no risk to the health of the dentition.
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