Hello. I am Dr. Richard Gangwisch, and today, I am going to show you how a composite filling is done. I have video right here, so I am going to start that up so that I can watch along with you. Now you notice that the patient has a q-tip in her mouth. That’s for topical anesthetic and that topical anesthetic is going to numb her gum before we give her the injection. Now the injections are very important. We want to make sure that it is as painless as possible. Now you notice that the patient is not flinching or grimacing at all. That’s because they don’t feel anything. Now technique is very important in this case. What we do is inject very, very slowly. If you try to pump it in too quick, what happens is is that the patient feels it. We don’t want that. That’s extremely important. It’s the most important part of the procedure is to make sure that it is totally pain-free. You notice how slow that is. It takes a lot of time. But it’s well worth it. She didn’t feel a thing. So, let’s get started. What we have here is decay in between the teeth. Unfortunately, that means that we have to drill down through the chewing surface to get to it. We use a high speed handpiece with a very small bur to try to keep that as conservative as we can. We try to take no more tooth structure than we have to to get to the decay. So we clean that up. We have a water spray to keep that clean and to keep that cool. So, we’ll go ahead and clean that up. Now, we are going to use a slower handpiece. This will have a small, rotating bur that we will go ahead and get the rest of the decay out. We want to make sure that all of that is cleaned up before we put a filling in it. So, we’ll make sure that we didn’t leave any decay in it. We’ll clean it out one more time. Now we’ll go ahead and show you what a cavity preparation Is like right there. We try to keep it as small as possible. Now, we have a little metal matrix that we are going to put between the teeth. That will confine the composite material that we are going to place in there. It’s to try to keep that from oozing all over when we try to put that in. At this point, we are going to put a bonding agent in. The bonding agent has etchant in it. Now we will go ahead and etch the tooth. And it also has a liquid plastic and that plastic will flow into those little etched areas and it will harden when we put the light on it. This is the actual bond. It is what bonds it to the tooth. There is also a desensitizing agent in there. Now that desensitizer can be very helpful, because many times, they can be quite sensitive, so we want to do everything that we can to make things easy for people. Now the filling material that we use is a composite resin. What that is is microscopic quartz crystals that are bound together with an organic resin. It ends up looking just like tooth, so that makes it really nice. Now, the material that we use is light-cured. You see the intense light there and we put it over the top and it causes that material to harden. It works our great. We place the composite filling material incrementally. That we don’t overstep our bounds on what the light source can get to. So we want to make sure that every layer is properly cured. It takes a little time, but it is well worth the effort. You get a good filling in the end, which is important. As we cure that, we will shorten it a little bit so that you don’t get too bored watching that. So, time to take all of the hardware off. It’s coming along quite well so far. We take the little wedge out. Now, it’s time to take the metal matrix out. You notice that it is going to take a little tug to get that out of there. It’s very important to have good contact between the teeth. It keeps food from getting caught in there. Now, I’ll go ahead and contour the chewing surfaces. We want to make sure that those mimic nature. We want it to have the same contours as the original tooth. It is very important that when you chew on a new filling, that it’s in harmony with the rest of your teeth. That’s what we do here. So, now we go ahead and take the rubber dam out of the way so that we can check the bite. We’ll clean it up a little bit from the rubber dam. Here’s articulating paper. It’s pretty much like typewriter ribbon. We can see any high spots where it is hitting a little bit heavy. It looks pretty good there. So, now we will go ahead and contour the rest of the filling. And it’s looking pretty good at this point. We have to get all of the flash off all of the areas. We want to make sure that there are no sharp areas left. Now, we are going to check with floss. We want to make certain that we don’t give the patient an excuse not to floss. That’s important. So, now we clean it up. Believe it or not, that’s all it takes to get a nice, beautiful filling. That should give the patient many, many years of good service. We all tend to get cavities at times, so if you are next in line to get a cavity filled, then, now you know that there is nothing to get nervous about.
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