Due to insufficient care there might be soft plaque on the teeth which contains bacteria that produces acid. This acid is responsible for the demineralisation (softening) of the enamel and other dentine substances. The result is a “hole” in the tooth. The first appearance often is a calcareous white or dark spot at the surface of the tooth. With continuous demineralisation the transition from partial to total enamel decalcification will take place. This coincides with loss of surface structure, invasion of bacteria, increase of bacteria, reaching the enamel-dentine-limit and its undermining. In case of a further invasion the deep dentine layers will be softened and caries will advance to the pulp (tooth nerve). At this stage the patient often suffers from toothache which forces him to go to the dentist. Every defect of a tooth requires a restauration.

At the front of the teeth, which are visible when speaking and laughing, dental coloured resin restaurations are possible. Health insurance requires usual treatment with amalgam in the side cutters. Up to a certain size defects in the incise areas can also be restored with dental coloured resins. Patients have to observe that they have to pay a part of this treatment himself, as this provision is more complicated and exceeds the provision with amalgam that is required by health insurance. If the caries has proceeded very deeply and is entrained with pain, generally an inlay with an anodyne medicament and a temporary closure of the tooth are carried out.

After a recommended healing time of approx. 3 weeks the tooth receives its definite provision. If the tooth nerve has died off or inflamed that the nerve has to be removed from the tooth root canal, the canal will be disinfected by irrigations and several inlays. In this transition phase the tooth also receives a temporary closure. After healing and disinfection now also the tooth root canal will be filled and the tooth crown will be restored. If too much substance of the tooth crown is lost due to caries, often a restauration with filling materials is not sufficient. For stability reasons a cast filling produced in a dental laboratory is more suitable. This can be produced from several materials: e. g. silver alloys, gold alloys or dental coloured cast ceramics. The cast filling will be inserted as a whole into the tooth and either fixed with cement or by means of a special gluing technique. It offers a high chewing stability and long-term functionality. The patient receives a fixed partial payment from his health insurance, but has to pay a remaining own contribution himself. Your dentist will consult you in this respect.
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