Learn Everything You Need To Know About Posterior Tooth Treatment.

When is one technique chosen over another? Mainly, it depends on how big the restoration needs to be compared to the size of the tooth. Generally, the materials used for the direct technique are structurally not as strong and, hence, need to be used in situations where they can be kept small in order for them to have the best chance of lasting. If the tooth restoration needs to be larger to cover more of the tooth, it will also need to be stronger. The materials used for the indirect technique would then be required.

Direct Technique

The direct technique consists of fabricating and placing the filling directly on the tooth. This procedure only requires a single office visit, where the old filling or cavity will be removed followed by the placement of the new filling. In this category, there are mainly two options available: amalgam -- a silver-colored filling material, or composite -- a tooth-colored filling material.

Dental Amalgam

An amalgam is a tooth restoration that has been around for many years and is considered a very durable and long-lasting material. It is not being used as often today for one main reason: esthetics.

Many people do not want to have the appearance of metal in their mouth. Another possible reason why the use of amalgam is on the decline is the fact that it contains mercury, although the amount of mercury leaching out of the material once it is in the mouth is still questionable.

One of the advantages of amalgam is that it is the strongest direct filling material available. Since the material itself is so strong, it can be used in a variety of situations, especially with regards to size. Because of its strength, amalgam can be used predictably in situations that would normally require indirect techniques.

Composite Dental Filling

A composite is a tooth restoration that is a plastic tooth-colored filling material. It is the most common direct filling material used today and its use is continually growing, as more people are concerned about esthetics. Since it relies on a "bond" with the tooth structure, it can be used in a manner that is more conservative, in that the amount of tooth structure that needs to be removed is less than with amalgam. To ensure the most predictable long-term result, this material needs to be used for smaller fillings. Composite is not as strong as amalgam and is more prone to wear over time.

Indirect Technique

The indirect technique requires more than one appointment. This technique involves removing the old filling or decay; but rather than immediately placing the new filling, an impression is made of the tooth so that the final restoration can be made outside of your mouth on a model of your tooth. A temporary filling is then placed until the final restoration is finished and can be placed at the second appointment.

There are also many options available to restore teeth utilizing the indirect technique. These include gold or tooth-colored materials. Again, the advantages of this technique are an increase in strength and the ability to better control the function, contour and esthetics of the final restoration. These restorations can vary in size from an "inlay," which fits within the confines of the tooth, to an "onlay," which covers the top half of the tooth, to a "crown," which covers the entire tooth. Ideally, the restoration of choice will be the one that satisfies the requirement of why the tooth needed a restoration in the first place while only removing as much tooth structure as necessary. Typically, an inlay is more conservative than an onlay, which is more conservative than a crown. All of these restorations are then either bonded or cemented to the tooth.

Gold Inlay/Onlay

Gold has been used for tooth restorations for many years. It is extremely strong, resistant to wear, and can achieve an excellent fit. Also, since it is metal, it is very resistant to fracture. However, as with amalgam, the problem is with the esthetics in that most people do not want to show the gold.

Tooth-Colored Inlay/Onlay

The materials used in this category can vary from porcelain to resin, both of which can be used with a high degree of success. These restorations have superior esthetics and are able to blend naturally with your own teeth. Porcelain is by far a stronger material and less likely to wear than resin. Due to the nature of these materials as compared with gold, they are at a higher risk for fracture. However, if designed well, these restorations are very durable.

Dental Crown

A crown is a tooth restoration that is used to help cover and contain teeth that are in need of structural support. They can be used in any situation and can be fabricated out of either gold or porcelain with a metal substructure. Also available are all-ceramic crowns, which do not have any metal. All-ceramic crowns are primarily indicated in the front of the mouth, as they have an increased risk of fracture when used on the back teeth. If a tooth-colored crown is indicated for restoring a back tooth, a better choice is a porcelain crown with a metal substructure. Its strength and fracture resistance make it more durable in the back teeth where there are more forces from chewing.

Bad breath, or halitosis, is a signal that something is not right inside your mouth. It may be as simple as the need to pay more attention to your daily oral hygiene, or it may indicate tooth decay, gum disease, or another medical problem. Whichever it is, bad breath is a red flag: take another look at your mouth!

Bad breath is a social problem; if you have bad breath, you may notice that people actually back away as you talk to them. Mouth odors are embarrassing, and they tell other people that you aren't taking care of yourself. Sometimes people are not aware that their breath smells bad; be alert to how other people react when they're close to you, and be grateful if a friend or family member lets you know about the problem.

Commercial products claim they will make your breath fresher, but the only way to make sure your breath permanently fresh is to practice good oral hygiene. In fact, too many breath mints and hard candies with sugar will lead to tooth decay. If you are constantly using breath mints, breath sprays, or mouthrinses in an effort to cover up your bad breath, realize that you may have a dental or medical problem that needs addressing.

There are a number of reasons you may experience a bad taste in your mouth, and even be able to smell your own breath. Food may be lodged between your teeth if you are not brushing at least twice daily and flossing regularly. Food particles can be very tiny and can wedge themselves between teeth and below the gum line; brushing after meals is important and flossing is imperative to get at the particles that the brush can't reach. Brush your tongue or use a tongue scraper. As odd as it will feel at first, bacteria collects on the tongue and can contribute to bad breath. If you wear removable dentures, take them out at night and clean them thoroughly before you wear them again.

If you neglect your daily hygiene over time, bad breath can become a symptom of more serious dental problems. Teeth that are not cleaned properly become a place for bacteria to reside as food particles stay in your mouth and decay. Bacteria attack your teeth and gums and cause cavities and gum disease. If this is happening, gum disease will cause an unpleasant odor.

Perhaps you believe that you are brushing and flossing on a regular basis, but are still experiencing bad breath. If you have teeth that are crooked or crowded, it may be hard for you to clean between them. If you wear dentures that are not fit properly, they may be trapping food or irritating your mouth. Or perhaps your bad breath is caused by another medical problem: drainage from your sinuses, gastrointestinal problems, kidney or liver problems, or other medical conditions.

Here's what you can do to "investigate" on your own. Write down what you're eating and notice whether your breath smells bad because of certain foods. Garlic and onions actually cause odor, but the odor is coming from your lungs as you breathe, not from your mouth itself. The odor from these foods is temporary, and will be gone once the food is out of your bloodstream.

Are you dieting? Hunger can contribute to bad breath, because of the chemical changes as your body turns fat and protein into the energy it needs. Taking prescription or over-the-counter medications? Add these to the record of what you're eating to see whether there's a relationship between your medications and your bad breath. And don't forget to tell your dentist if there's been a change in your overall health since your last visit.

Suffering from dry mouth? Saliva provides constant rinsing in our mouths and washes away food particles. Your dentist may recommend more liquids, sugarless candy to stimulate natural saliva, and perhaps some of the commercial products that are available to combat dry mouth.

If bad breath continues after you have done your best job of regular brushing and flossing, start with your dentist. He or she can tell you whether the odor is caused by an oral problem; if it is not, then your dentist will suggest you see your doctor for a physical check-up.