Cosmetic dentistry

Composite fillings clearly have the best aesthetic and functional properties.

The advantage of these materials is a wide range of color shades and degrees of translucency. Thanks to this we are able to faithfully imitate the structure of the natural tooth so that the white filling in the mouth is virtually invisible. The color stability and polishability of the white filling is very high, even the mechanical properties are very similar to hard dental tissue. Thanks to a strong adhesive bonding, which involves the interconnection of the white filling with the tooth, it is not necessary to make any grooves in the tooth, such as in the case of amalgam, in which the filling is wedged so that it does not fall off. Modern dental procedures allow us to maximize the potential of these materials, so we are able to reconstruct extensive loss of dental tissue with a very good aesthetic and functional result.

Unfortunately, everything beautiful has its end, which is also true when it comes to positive properties of composite fillings.

The negative properties of the white filling are in most cases related to failure to stick to the tooth. The white filling is quite demanding regarding the technique of fabrication and subsequent care. Failure to observe the proper procedure of inserting the white filling, or in the absence of proper oral hygiene, the bond with the tooth can easily fail and a crack is created. This is subsequently colonized by dental plaque microorganisms and decay occurs. It spreads relatively quickly because the photoconductive material has no protective effects as in the case of the glass ionomer (see below). In order to prevent the failure, it is essential that the following two conditions are met: meticulous oral hygiene and a well-made white filling, following modern procedures.

All dental caries treatment is naturally painless in local anesthesia. Before the surgery, the dentist chooses the color of the filling material. Then follows the removal of the tooth caries and the provision of a dry working environment. For this purpose, a Kofferdam is used. It is a latex membrane that the dentist uses to isolate a tooth or a group of teeth from the wet environment in the mouth. This ensures that the surface of the tooth does not get covered with saliva or blood, which is necessary for further action. Then comes the preparation of the tooth surface with acidic gel followed by the application of a binding system. It will sift the tooth deeply and thus allow a really strong connection with the white tooth filling. Then, individual layers of composite material are applied, and each is carefully cured with blue light. At the end, the filling is further modelled and polished.

The white filling thus made is highly aesthetic, functional, and long-lasting, provided there is good oral hygiene.

This material is commonly used in pediatric patients to treat dental cavities. Unlike the composite filling, there is no need to provide absolute dryness using a Kofferdam. It tolerates a damp environment better, but that does not mean that the dental filling can be applied on a wet or dirty tooth. A great advantage of glass ionomer cement is its protective effect against tooth decay. The chemical structure of the white filling allows for the continuous release of fluoride ions that suppress the cariogenic (damaging) activity of dental plaque bacteria. After cleansing the teeth, the level of ion in the mouth increases and the denture absorbs the ions again. One could say that the glass ionomer filling works as a reservoir of protective fluoride ions.

However, it is not possible to fully rely on this protective effect. It merely has a supportive function. The dental filling should be kept in a clean environment, free from all dental plaque. Only then can we be sure that the tooth decay will not return.

Glass ionomeric cement is not only used in children but also adults. The advantage is that it forms a relatively strong chemical bond to the tooth, and therefore it is not necessary to weaken the tooth unnecessarily with preparation of a space in which the filling would be wedged.

In adult patients, however, it is mostly used only as long-term provisional material. The negative properties of the glass ionomeric material, in particular the low mechanical resistance and the worse optical properties than the composite material.