Caries treatment in the early stage
In early stage caries, there are only changes on the surface of the teeth, a hole has not yet appeared. At such an early stage, treatment by the dentist is not necessarily needed. You can try to see if you can remove the caries yourself.
To do this, firstly, you should consume as little as possible sugary foods and drinks. If you often reach for chocolate, pudding, ice cream, sweets, soft drinks, etc., you increase the risk that the caries will spread further. Caution: In addition to normal household sugar (sucrose), fructose, which is found primarily in fruit and baked goods, but also in vegetables, can also damage the teeth.
Secondly, caries treatment (as well as caries prevention) involves thorough oral hygiene. It is best to brush your teeth after every meal. If that is not possible, you can alternatively chew gum (without added sugar, but with xylitol). This will at least restore the pH value in the mouth to normal and stimulate the flow of saliva (food debris is thus more easily removed from the teeth).
In order to be able to cure incipient caries, regular professional fluoridation measures should be carried out as a supplement. To do this, the dentist first removes any plaque that has accumulated on the teeth. A fluoride varnish is then applied to the affected areas. In some cases, antibacterial treatment is also carried out. For this purpose, special rinsing solutions or gels are prescribed to reduce the amount of bacteria in the mouth.
After this caries treatment, regular check-ups should be carried out by the dentist to keep an eye on further progress. In the best case, caries has been stopped by these measures and the previously degraded minerals are replaced over time by components of the saliva. However, it is equally possible for caries to progress.
Caries treatment in advanced stages
In most cases, the drill is used. In the case of sensitive teeth, this caries treatment is performed under local anesthesia. During drilling, the dentist removes the destroyed tooth substance. He then cleans the drilled hole and closes it with a filling, which is sealed from the outside with a sealant.
If much of the tooth substance has already been lost, the shape of the tooth is restored from the outside. So-called matrices are used as a template to restore the tooth to its natural shape as far as possible and to prevent any chewing difficulties with the opposite side of the tooth.
If caries is located very close to the tooth nerve, special therapy is required. If the nerve tissue is already damaged, it must be protected with a root filling. For this purpose, the tooth bone is filled with a substance containing calcium hydroxide. This is to stimulate the tooth bone to form new substance. Only then can the normal tooth filling take place.
Root canal treatment
For a lasting good result, bacteria and dead tissue must be completely removed from the root canal. Later, the canal is tightly sealed with a filling material.
Root canal treatment can be performed on a living, inflamed or already dead tooth nerve.
Caries treatment: fillings
In principle, there are various materials available for tooth fillings in caries treatment (more detailed information on the individual filling materials can be found below):
- Ceramics
- Plastics (compomer / composite)
- Metal alloys (e.g. gold)
- Amalgam
Which filling is suitable in your case depends on various factors. On the one hand, the different materials have different properties (service life) and are suitable for different problems with the tooth. Last but not least, the costs also vary depending on the filling material. And not all fillings are paid for by the health insurance companies (e.g. gold hammer filling).
The fillings mentioned above all belong to the so-called plastic fillings. This means that they are placed in the tooth in a liquid state and can thus adapt precisely to the drilled hole before they are cured.
Alternatively, there are also inlay fillings (so-called inlays). These are made in the laboratory from a previously cast model of the hole in the tooth. Inlay fillings are very expensive and are therefore of little importance in the treatment of caries.
Caries treatment with composite
Composite is an artificially produced material consisting of about 80 percent silica salt and about 20 percent plastic. It is very dimensionally stable and extremely durable. In addition, depending on the application scheme, it matches the natural tooth color very well. In the case of minor caries damage, it is often sufficient to prepare the hole, apply composite in a single step and cure with a special light.
Caries treatment with compomer and glass ionomer cement
Caries treatment with amalgam
The treatment of caries with amalgam is widespread, but sometimes controversial. This is a metal mixture of silver, copper and tin as well as toxic mercury. The latter is bound in its crystallized (i.e. solid) form in these dental fillings and is therefore harmless. However, it cannot be ruled out that traces of it may dissolve and then be present freely in the oral cavity – especially if the fillings need to be replaced or processed.
Nevertheless, amalgam is still permitted as a dental filling. Mercury intake from amalgam-containing dental fillings is estimated to be about the same as mercury intake from diet. And this amount is considered harmless by international standards. The use of mercury-containing fillings is restricted only in children and pregnant and lactating women.
Caries treatment: Gold hammer filling
Newer methods of caries treatment
Is it possible to treat caries without drilling? Yes, with the help of laser technology. The caries bacteria are removed with the help of laser beams. This method has the advantage of being less painful than drilling. However, the cost of caries treatment with a laser is not covered by statutory health insurance.
Another new method of caries treatment without drilling, which is already used by dentists, is infiltration with plastic (also called the Icon method). In this method, the hole in the tooth is not drilled out, but filled with plastic from the outside. The bacteria are thus virtually enclosed and rendered harmless.
After caries treatment
Toothache for two to three days after caries treatment is therefore usually normal. However, if the pain does not subside afterwards, you should visit the dentist again. Cooling and/or painkilling medications help against the pain. In the case of the latter, the following applies: Painkillers should not be taken for longer than three days after caries treatment – otherwise, off to the dentist!
You have had your caries treated and now feel safe? Wrongly thought – a single caries treatment does not protect against caries recurring. You should therefore follow the dentist’s recommendations exactly afterwards and pay attention to careful oral hygiene and a tooth-friendly diet – especially in the initial period after caries treatment, but also in the long term.