Question Details	Asked By	Asked On
Fillings	sallie00	01/14/05
I am just curious, I am told by my dentist that I need a filling. When do they think it's necessary to do a filling, for example do they start filling tiny holes or midsize holes, etc. Any info would be appreciated. Thanks in advance.
Answered By		Answered On
agentledentist		01/15/05
Tooth decay refers to lost of calcium from the tooth structure. As the very surface enamel is well protected by fluoride and has high resistance to decay, decay usually starts under the surface (sub-surface demineralization) and can get bigger and deeper inside a tooth even without a hole being actually seen or felt. Dentist can check whether there is decay on a tooth by various means such as visual examination, translumination (passing a bright light through the tooth), x-rays and even with the use of lasers. Once decay is detected, whether to watch or to fill purely depends on the dentist¡¦s opinion and the choice of filling material. In general there are two approaches ¡V a conservative approach and a minimal invasive approach. The conservative approach is more applicable to conventional amalgam (silver-mercury) fillings and the minimal invasive approach is more applicable to composite (white) fillings. For amalgam fillings, even the smallest decay will require a relatively large cavity form to fulfill all the cavity preparation requirements. Therefore, when a small decay is detected, a conservative approach would tend to leave and watch and hopefully, with fluoride and optimal oral hygiene measures, would allow the decay to be re-calcified. However, whether re-calcification will occur is always an uncertainty. The minimal invasive approach on the other hand does not allow for this uncertainty and, because of use if composite filling material as opposed to conventional amalgam, there is no specific requirement for cavity form and the prepared cavities could be just big enough to remove the decay. Hence the minimal invasive approach would tend to put a filling on even the smallest decay detected, or sometimes for high risk sites, even before decay is detected. As a conclusion, to put a filling or to watch is basically determined by the size of the decay and the opinion or approach the dentist employs.

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