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Dental sealants act as a barrier to prevent cavities. They are a plastic material usually applied to the chewing surfaces of the back teeth (premolars and molars) where decay occurs most often.
Toothbrush bristles cannot reach all the way into the depressions and grooves. Sealants protect these vulnerable areas by "sealing out" plaque and food.
The sealant is painted onto the tooth enamel, where it bonds directly to the tooth and hardens. This plastic resin bonds into the depressions and grooves (pits and fissures) of the chewing surfaces of back teeth. The sealant acts as a barrier, protecting enamel from plaque and acids.
Sealants hold up well under the force of normal chewing and may last several years before a reapplication is needed. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
The likelihood of developing pit and fissure decay begins early in life. Children and teenagers are obvious candidates, but adults can benefit from sealants as well.
Fluoride is often called nature's cavity fighter and for good reason. Fluoride, a naturally-occurring mineral, helps prevent cavities in children and adults by making the outer surface of your teeth (enamel) more resistant to the acid attacks that cause tooth decay.
Before teeth break through the gums, the fluoride taken in from foods, beverages and dietary supplements makes tooth enamel (the hard surface of the tooth) stronger, making it easier to resist tooth decay.
After teeth erupt, fluoride helps rebuild (remineralize) weakened tooth enamel and reverses early signs of tooth decay. When you brush your teeth with fluoride toothpaste, or use other fluoride dental products, you are applying topical fluoride.
The fluoride you take in from foods and beverages continues to provide a topical benefit because it becomes part of your saliva, constantly bathing the teeth with tiny amounts of fluoride that help rebuild weakened tooth enamel.
A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material.
By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).
A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed. The area is sterilized and the chamber is sealed. It is sometimes called a baby tooth root canal, but it's not really a root canal. It can be done in some cases in permanent teeth as well.
It is a very common procedure in children and has a reasonably good prognosis of success. It's also fairly easy to do in conjunction with associated procedures.
A cavity that gets really deep into the pulp, either from the side or the bottom, can cause inflammation and tooth pain. When the cavity gets this deep, it is close to the pulp or actually into the pulp. The pulpal tissue becomes irritated and inflamed causing a "tooth ache." Without treatment, the tooth will eventually abscess.
Decay is removed from the tooth and the pulp chamber (the top part, not root canals) is removed usually with a high-speed bur or spoon excavator. A small cotton ball damp with formocresol is placed to "mummify" the pulp stumps and to sterilize the area. After a couple of minutes, the cotton is removed and the opening is sealed, usually with a material called IRM, which is a putty-like material that hardens after a few minutes. It is usually necessary to place a stainless steel crown after a pulpotomy on a baby molar.
Stainless steel crowns are metal caps used by dentists to repair a decayed baby molar (back tooth) and prevent it decaying further. They are made to fit the exact size and shape of a child's molar, and are used to cap teeth with large or deep cavities.
SSC crowns are an alternative to silver and tooth-colored fillings. These strong metal caps cover the entire tooth and are hard to lose or damage. They have a smooth polished surface which makes them easy to clean and most last four years or more.
If your child's tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when the permanent teeth come in. Without a space maintainer, the surrounding teeth can shift and impede the permanent tooth's eruption, which can result in a greater need for orthodontic treatment.
Space maintainers can be made of stainless steel and/or plastic, and can be removable or fixed (cemented).
A removable space maintainer looks like a retainer. It uses plastic blocks to fill the space where the tooth is missing. The dentist may choose this type if your child is older and reliably follows directions.
There are many kinds of fixed space maintainers. A band-and-loop maintainer is made of stainless steel wire and held in place by a crown on the tooth next to the space or an orthodontic-type band around one of the teeth next to the open space. A wire is attached to the band or crown and sticks out on the other side where it rests against the side of the other tooth, keeping it from moving.
A lingual arch is used on the lower teeth when the back teeth on both sides of the jaw are lost. A wire is placed on the lingual (tongue) side of the arch and is attached to the tooth in front of the open space on both sides. This stops the teeth in front of the open space from moving backward.
A distal shoe may be used for a lost second primary molar before the first permanent molar has come in. With this type of space maintainer, the first permanent molar hasn't come in yet, so there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe has a metal wire that is inserted slightly under the gum to prevent the space from closing.