Bacteria and food remnants may settle on the tooth over time, building a thin coat of plaque. Food containing carbohydrates is broken down by these bacteria, producing acids. These, in turn, break down the hard tooth enamel, enabling microorganisms to enter the tooth and destroy it from inside. This is the cause of cavities.
Because there are no nerves in the dental enamel, the breakdown process caused by the acid does not cause any pain. However, once tooth decay has reached the dentin, which is underneath the tooth enamel, toothache begins. If left untreated, decay can spread rapidly, right down to the nerve of the tooth. This results in severe pain and inflammation of the nerve. What is known as deep-reaching tooth decay, often requires root canal treatment.
Due to the fact that tooth decay does not cause pain until it reaches an advanced stage, you should see a dentist twice a year. The earlier a cavity in your tooth is discovered, the lower the risk of deep-reaching tooth decay because we can take action. To locate decay we use liquids that change colour where it exists. Should a cavity be identified, x-rays clarify how far the decay has advanced and how this can best be treated.
Tooth decay is removed with small drills under local anaesthetic. It is vital that as much of the tooth as possible is kept, which is one of the reasons why we do not use silver fillings (amalgam). These require the removal of much more tooth substance, while the amalgam material itself releases toxic mercury. Composite fillings and inlays are much easier on the tooth substance.
Depending on the size of the cavity in your tooth, different fillings may be used. The filling that is best for you is something we will decide together after a detailed explanation of your options. We will be transparent about any costs — we want you to have all the information required before you make a decision.
Composite fillings, also known as plastic fillings, tend to be used mostly for small dental defects. These fillings are made of tooth-coloured, plastic material that is applied to your tooth in layers. Once applied, the material is hardened with a special light. It is advisable to put a rubber surgery cloth around the tooth prior to inserting the composite filling. This keeps the adhesive surfaces saliva-free and ensures an adhesive bond that is about 30% stronger between the plastic filling and the tooth. Finally, the composite filling is polished.
Modern ceramic fillings keep their colour for a long time. Depending on their size they last between five to 10 years on average. In contrast to this, some ceramic fillings and gold inlays may last 20 years.
How long an inlay or a filling will last also depends on its position and size. In addition, your oral hygiene is an important factor in the durability of your inlay or filling. Please use floss and a small brush to clean the area around your inlay or filling. We will be pleased to give you more advice on how to care for your filling or inlay.
Fillings cost between £150 and £400 depending on the size and the time we have to spend to restore the cavity. Inlays are much more expensive because the treatment takes double the time and a dental laboratory has to be involved. However, most dental insurance policies will cover part or all of the cost of ceramic fillings, plastic fillings and inlays.
Recognising, removing and preventing caries in the interdental space. Interdental caries are barely visible with the naked eye. Tooth decay in the interdental space can, therefore, go unnoticed for a long time. As a result, some of the tooth substance may already be damaged when you come to visit us. To prevent that from happening in the future we take x-rays regularly, mostly at two-year intervals.
Interdental caries are barely visible with the naked eye. Tooth decay in the interdental space can therefore go unnoticed for a long time. As a result, some of the tooth substance may already be damaged when you come visit us. To prevent that from happening in the future we take x-rays regularly, mostly at two year intervals.
How we spot interdental caries
Since the caries occur between two adjacent teeth, it is often difficult to see from the outside. Also, at the beginning, typical whitish or brownish discoloration escapes a superficial check in the bathroom at home. Symptoms of decay can be bad breath and sensitivity of the teeth to hot, cold and sweets. Strong toothache, however, indicates a more advanced stage of tooth decay.
How we diagnose tooth decay in the interdental space
First, a visual inspection using dental mirrors and high magnification glasses is performed. Subsequently, individual teeth can be checked for their sensitivity by cold. In addition, superficial roughness or cavitations of the enamel can be checked for with a dental probe. In two year intervals we take x-ray images to check for decay between the teeth and to evaluate the bone level and check for gum disease. The x-rays give us a detailed insight into the interdental spaces, and if the border between the dental enamel and the dentine has been breached we will need to remove the decay and place fillings, partial crowns or crowns.
Treatment of tooth decay: remineralisation, fillings, crowns
The treatment of caries depends on the location and the size of the cavity. If the dentin is not damaged, fluoride gels can help to remineralise the enamel. In the case of major damage, we must remove the affected parts of the tooth mechanically with a drill. Thanks to anesthesia this causes no pain, but the sound of drilling might be uncomfortable for some patients. Distracting music can help here. Subsequently, we treat the tooth with a corresponding filling, partial crown or crown. While the fillings are made with tooth coloured composites, partial crowns and crowns are made from full ceramic.
If the caries decay has caused pain already, the tooth nerves may have been affected, indicating that a root canal treatment might be necessary. Due to modern treatment methods and precise planning, the success rate of root canal treatment is now very high (around 90 per cent). In addition, root canal treatment is always performed under local anesthesia, so patients need not be afraid of pain. A final crown protects the treated tooth from breaking. Tooth-coloured full ceramic materials also provide aesthetic solutions.
To prevent tooth decay: what you can do yourself
The interdental spaces cannot be reached with a toothbrush. This is why dental floss and interdental brushes should be used in daily dental care. These prevent the settling of harmful bacteria between the teeth. In addition, fluoride toothpastes protect the enamel from acids. In addition to domestic dental care, you should attend two check-ups a year at the dentist and dental hygienist. This allows abnormalities to be detected quickly and treated if necessary.
For more information regarding this treatmentBack to Saving Teeth
Seal Holes in Your Teeth for Good
“Prof Mehl and Dr Harder are accredited dentists and specialists by the German Society of Prosthodontics (DGPro) and the General Dental Council (GDC). For you, this means an optimal supply of high quality and desirable filling materials, so that cavities can be treated in the best possible way."