Dental fillings have been around in various guises for hundreds of years. There is some debate as to when the first dental filing was placed, but research suggests that ancient civilisations used natural ingredients to strengthen teeth and remedies to heal pain caused by decay and gum disease.
Fillings are a form of restoration, which are used to strengthen the teeth, prevent further decay and patch up holes in the teeth known as cavities. Fillings help to prevent the spread of infection in a tooth and strengthen the tooth against injury; if a tooth is left untreated, the cavity can get bigger, leaving the tooth weak and exposed to bacterial infection. Signs of decay include tooth pain, increased sensitivity to hot and cold and pain when you bite down or chew.
The Etruscans are credited by many as the founders of Restorative Dentistry; between the years 300 and 500 BC, Aristotle and Hippocrates wrote about dental procedures and references were made to gold dentures, fillings and dental bridges. The writer, Cornelius Celcus also noted thorough information about oral hygiene and treating dental woes in Roman times. In the East, there is evidence to suggest that metal amalgam fillings were used as early as 200 BC.
During the 1800’s a variety of metals was used to fill teeth, with varying levels of success. There are records of tin, gold and lead. Tin was an affordable option for people who did not have much money and gold was first used in 1800, with gold foil becoming the material of choice in the 1850’s. Dentists also experimented with aluminium, asbestos and lead, which was later abandoned as a result of harmful heath effects.
From 1850 onwards, metal amalgam fillings, which were made of silver, tin and a tiny amount of mercury, became very popular. At the time, some dentists were concerned about the health effects of mercury and this debate has simmered through the ages. Modern amalgam fillings are made from silver, liquid mercury, tin, copper and zinc.
Amalgam fillings are still used today. However, they have become less common, as more people choose aesthetically pleasing composite fillings. There are also concerns, both for human health and the environment, surrounding the use of metal amalgam fillings and several countries, including Denmark, Sweden and Norway, have already decided to ban the use of mercury amalgam fillings.
A growing number of dentists is pledging to offer amalgam-free dentistry and many dentists offer a service to replace metal fillings with composite filling. Many people believe that amalgam fillings can have detrimental effects on the body and people are more conscious about the environment these days, which has promoted a move towards clean or green dentistry.
Composite fillings, also known as white fillings, have become incredibly popular and are now the first choice material for most patients who need a filling. Composite material is usually composed of a resin-based chemical, such as bisphenol A-glycidyl methacrylate (commonly known as BISGMA) and non-organic filler, which is usually silica; glass ionmers are also added. The beauty of composite fillings is that they blend with the natural tooth structure, meaning that the filling is indistinguishable; filling material is also versatile and can be used to repair chips and build up worn surfaces to improve the aesthetic of the smile. This is said by some to be a cosmetic dental procedure but is more functional and for health than anything.
Composite fillings have become increasingly durable over the course of the last decade in line with advances in science and technology; they can now be used in most teeth, for most patients and they are expected to last around 10 years.
The dreaded dental drill has been documented in history and appears to be ever-present through the ages; drills have become increasingly sophisticated over the ages and the modern filling procedure is fairly straight-forward and involves very little pain.
Traditionally, the filling procedure involves drilling into the tooth to remove decayed tissue; however, recent developments mean that air abrasion and laser technology can be used to do this, which eliminates damage to the healthy tooth structure, as well as making the procedure less daunting for nervous dental patients. Once the cavity is clean, the filling material is poured in and then set hard using a curing light; the material sets and it can then be trimmed to ensure a perfect fit in the cavity.
The future: the end of the dental drill?
Recent developments in research may be even better news for nervous patients, as scientists in Brazil are currently trialling a gel derived from the leaves and fruit of the papaya tree. Initial findings show that papain gel can be used to break down decayed tooth tissue in a matter of seconds without any pain, paving the way for drill-free dentistry. Papain is a protein, which is derived from papaya fruit and leaves; papaya trees grow in tropical climates. Papain is already used in laboratories to break down proteins, clean wound sites and treat bed sores and it could soon have a new role.
Papain gel is currently being trialled at Nove de Julho University in Brazil and early indications are very positive. Dental experts in the UK claim that the discovery is very exciting, especially for children and nervous dental patients. It is hoped that the gel will be available for use by the end of next year if it successfully passes clinical trials. The dental drill is a major source of anxiety for many people and with dental decay one of the most common preventable health conditions in the world, papain could make a real difference to dentistry as we know it.