Re: caries question




The most important thing to keep in mind is when to place [or I should say
"if to place"] the first filling.  We don't have any filling material that
duplicates natural tooth structure, and once the initial filling is placed,
the usual scenario is that the filling breaks down and needs to be replaced
in 5 or 10 years.  Each time the filling is replaced, the "hole" gets a bit
larger, and the tooth gets more irritated by the drilling/filling.
Eventually, a crown is needed, and sometimes root canal treatment as well.


I have been using sealants and PRR's to some degree for many years. I
don't have 20 year studies, but I do have 26 years of anecdotal observation. I think the early intervention with very small restorations to eradicate the caries will save a lot of tooth structure
over time.

I believe this idea was more true of the days with GV Black preps and
amalgam use than with todays techniques. Even with the medium sized
Class I amalgams, the 5 year replacement theory does not often turn into
reality. I do see a lot of 40-60 yr.-olds who need a few crowns. Most of these were not due to an intitial occlusal amalgam. They may have
had occlusal decay treated with an amalgam in 1964, but new areas of decay led to an MO, then an MOD, and then cusps began to fracture. It is rarely continued replacement of one filling that leads to a crown.

Fawks

.

Relevant Pages

  • Re: Crown replacement/Core buildup
    ... a filling is patching a hole using the existing structure ... A build-up requires extensive and careful cleanout ... | of caries followed by meticulous preparation to preserve tooth structure ... | and straight enough for crowning, would be okay for billing as a core. ...
    (sci.med.dentistry)
  • Re: Crown replacement/Core buildup
    ... My interpretation on filling vs. build-up. ... would be okay for billing as a core. ... >> enough tooth structure is missing that you need to create some wall ...
    (sci.med.dentistry)
  • Re: Sensitivity after mixed amalgam/composite filling
    ... and then the depth of the decay must also be factored ... >recurrent decay (so the filling gets deeper and wider), ... dentist but due to lack of tooth structure! ... >difference between dentists when treatment is rendered (water spray, ...
    (sci.med.dentistry)
  • Re: Whats it called when material from a filling procedure is embedded in the gum?... and theres a p
    ... or abrasion in the soft tissues during a filling placement or removal. ... Common sense dictates that a tatto, even if it is mostly amalgam ... material into the tissue which may be relatively inert, ... If its the gums next to a silver filling, ...
    (sci.med.dentistry)
  • Re: OT: Fun things to do with Mercury - Any?
    ... process assures that Hg moving from the amalgam to the surroundings is ... I thought that once the mercury was amalgamed with silver to make ... > a filling it would be trapped there forever. ... > in a landfill are stronger than wot's in yer mouth. ...
    (rec.crafts.metalworking)