What it covers
Restorative dentistry deals with a tooth that is damaged but can still be saved. That means removing decay and replacing the lost part of the tooth with a filling, and, when the damage has reached the pulp, root canal treatment, also known as endodontics.
The boundary with prosthetics is simple: as long as there is enough healthy tooth tissue to hold a filling, the work is restorative. Once there is not, it is time for a crown or a replacement.
When to come in
- Sensitivity to cold, heat or sweet food that lasts longer than a few seconds.
- A visible dark spot, small hole or rough patch on a tooth.
- Food catching between the same teeth every time.
- Pain when biting, particularly on one tooth.
- An old filling that has come out or cracked.
Early decay usually does not hurt. That is why a routine check-up every six to twelve months finds what does not announce itself, while the repair is still a small one.
What repairing a tooth is like
An examination and, if needed, an X-ray show how far the damage has gone. The work is done under local anaesthetic. The decayed tissue is removed, the tooth is isolated so it stays dry, and the cavity is filled with a material that sets in layers. Finally the filling is shaped to the bite and polished.
For visible teeth we use a composite, white filling, shade-matched to the tooth. An amalgam filling is still in the price list and has its place in back teeth and under heavy loads. We described the difference in detail in the article about white fillings.
Root canal treatment
Once bacteria reach the pulp, a filling alone is no longer the answer. The canals are cleaned, shaped and filled with a material that seals them. The tooth loses its nerve but stays in the jaw and goes on carrying the bite.
The number of visits depends on the number of canals and on whether there is infection. A single-rooted tooth is often finished in one or two visits; a multi-rooted one takes more. Between visits a medicament sits in the canal and the tooth carries a temporary filling.
After root canal treatment a tooth is more brittle than a healthy one, so it is often built up with a post and covered with a crown. That is not an upsell but a way for the tooth to withstand chewing for years to come.
How long it takes and what follows
One filling usually fits into an appointment of thirty to forty-five minutes. The anaesthetic wears off within a few hours; while it lasts it is better not to eat, so you do not bite your cheek. A composite filling sets immediately, so you can eat normally the same day.
Mild sensitivity to cold for a few days after a deep filling is not unusual. If the pain grows, throbs or wakes you at night, get in touch — that is a sign it needs looking at again.
Price
Prices for fillings and root canal treatment are in the “Restorative dentistry” group of the price list, together with posts and build-ups. What exactly is needed is seen after an examination and an X-ray, and we tell you before we start.
- Does repairing a tooth hurt?
- The work is done under local anaesthetic, given before it starts. A sense of pressure and vibration remains; sharp pain does not. If you feel more than pressure during the work, say so at once and the anaesthetic is topped up.
- How long does a filling last?
- It depends on its size, the position of the tooth, and habits in diet and hygiene. A filling is not for life and changes over time; a check-up is where that is noticed before it becomes a problem.
- Can I keep a tooth that needs root canal treatment?
- Usually yes — that is the point of root canal treatment. The decision depends on how much healthy tissue is left and on the state of the bone around the root, which is seen on the X-ray.
- Do old amalgam fillings have to be replaced?
- Not in themselves. They are replaced when they fail, when decay appears underneath, or when the tooth cracks. Replacing them for appearance is your decision, not a medical requirement.
