Conservative Dentistry

Dental caries starts in the surface layer of a tooth. Unless removed, the tooth decay destroys deeper layers up to the dental pulp (the part in the center of a tooth made up of living connective tooth tissue containing blood vessels and nerves). Unfortunately, dental cavity cannot be healed. Once dental caries has occurred, it can only be removed together with the destroyed part of the tooth. The best way is to prevent the occurrence of dental caries by means of good hygiene. At the dental hygiene, it is necessary to focus on the paces with an increased incidence of caries (the spaces between the teeth and at tooth roots).

At the beginning, dental caries only attacks the enamel. However, such destruction may continue and destroy the dentine. If dental caries reaches the pulp, the destruction of the tooth system occurs that requires endodontic treatment. Dental caries is first shown as white decaltificated zones, then in the form of enamel colouration and subsequently „holes“ in the tooth occur. Developed stages of dental decay may lead to complete loss of the disease-ridden tooth.

According to the location and severity of the dental caries, there are various possibilities of how to re-shape the tooth and make it function again. If possible, the focus of the dental caries is removed with a dental drill. In the case that the tooth cavity is near the nerve, other interventions are necessary (e.g. the removal of the dental nerve and the filling of the root canal).

Filling Materials

Modern filling materials are divided in three main groups:

Amalgam is the oldest filling material (being used for over 100 years). It is an excellent filling material for the teeth at the back of the mouth. Correctly apply amalgam makes a firm filling with a quality junction between the filling and the tooth. The disadvantages of the use of amalgam: low aesthetic effect (the filling is dark) and the need to drill off a considerable part of the tooth due to the need of the making a cone-shaped hole fixing the amalgam filing in the tooth.

Photo composites.When applied, photo composites are put in thin layers and polymerised by means of a UV lamp or they harden spontaneously (by the mixing of two materials). Photo decomposites enable a more considerate way of tooth preparation as only the destroyed tissue is removed. In this manner, the healthy tooth tissue is untouched. The patient can eat immediately after the intervention which is another advantage. At the application of photo composites, the stomatologist must ensure dryness of treated surfaces.

Glassionomer cements have a good capacity to stick to the tooth and excellent preventive effect are the greatest advantages of glassionomer cements because they also release fluorine (fluoride ions)supporting re-mineralisation. The use of glassionomer cements does not require absolutely dry surfaces therefore, it can be used at the places where dry environment cannot be ensured e.g., at root surface caries.

Endodontic

The tooth pulp is tissue containing blood vessels and nerves. It is found inside a tooth and in tooth canals. It keeps a tooth alive and sensitive. In most cases, tooth pulp is damaged by dental caries. If tooth pulp damaged, it responds with inflammation and painfulness.
In some cases, it may necrotise and such necrotised dental pulp may become a cause of inflammation. The purpose of endodontic is to painlessly remove such damaged dental pulp and fill the root canals. Before and during endodontic interventions, the stomatologist uses more modern devices to diagnose the shape and depth of the disease-ridden root canal so that such root canal may be cleaned, treated and filled.

Tooth Sealants.

Biting surfaces of the back the (molars) have narrow pits and groves and may even be porous. These are places susceptible to catching food residues and caries formation. To prevent decay, such grooved surfaces may be filled and blocked up (sealed).

The sealing consist of the cleaning of the back tooth with a special paste, spreading and hardening of the sealant and local fluoridation of the tooth surface. The surface of the tooth treated in this manner is smooth, without any deep groves where food residues may be caught. This is the basic preventive protection principle of dental caries. Stomatologists recommend that sealants should in the first place be applied to deciduous teeth, which will prevent the primary infection of baby teeth with dental caries and its subsequent spreading to the permanent (adult) teeth. Sealants may also be applied to adult patients’ teeth. Now, it is standard treatment in conservative dentistry. The seal lasts 3 – 5 years until it is bitten away. In terms of economy, tooth sealants constitute the most advantageous protection from caries.