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Los Angeles Times
02-07-2025
- Health
- Los Angeles Times
What to Know About Dental Fillings: Materials, Techniques, and Long-Term Results
Tooth decay doesn't go away on its own—and when it's not caught early, a filling is often the answer. In the early stages, dental caries may be asymptomatic and reversible, but if not detected, they can progress and require more extensive treatment. As common as fillings are, there's more to them than just plugging a hole in the tooth. Advances in dental materials and techniques have made these restorations more efficient, longer-lasting and even more patient friendly. For both kids and adults, choosing the right method and material can make a big difference in comfort and long-term outcome and the choice is best determined with a dental professional. When treating cavities in children—especially in early childhood caries (ECC)—durability is key. Kids are more prone to recurrent decay due to diet, developing oral hygiene habits and anatomy. Paediatric dentistry focuses on early diagnosis, prevention and tailored dental treatment for young patients, managing conditions like ECC effectively. A 2014 study in Clinical Oral Investigations followed children treated under general anesthesia, often necessary for severe dental caries that can't be managed with routine care and found that composite resin fillings had a success rate of 81.5% over about 31 months [1]. That's a good track record especially for high risk pediatric cases. Composite fillings bond to the tooth itself which makes them cosmetically appealing and conserves more of the natural tooth structure. For children needing treatment under anesthesia, a long lasting option like composite reduces the chances of repeat procedures. In cases where restoration is not possible due to extensive decay or severe dental caries, tooth extraction may be necessary to prevent further complications. Taking care of baby teeth is important to ensure healthy development of permanent teeth and to prevent future oral health issues. Not all filling methods are created equal. Traditionally dentists place composite in small increments, curing each layer with a special light—a process that ensures strength but takes time. Bulk-fill techniques speed this up by allowing more material to be placed and cured all at once. Both methods are forms of dental restoration to repair tooth structure damaged by caries. A 2023 randomized controlled trial in the Journal of Dentistry found that the bulk-fill base technique reduced procedure time by almost 60% and had better surface quality right after placement [2]. And these benefits didn't depend on how experienced the dentist was—so it's a win-win for both seasoned pros and newer clinicians. For patients this means quicker appointments and less chair time which can be especially helpful for those with dental anxiety or limited time. These advances in fillings contribute to better patient comfort and outcomes. Whether you're getting a filling in a baby tooth or an adult molar the material matters—but maybe not as much as you'd think. A 2009 Cochrane Review found there wasn't a clear winner among the most commonly used filling materials for kids [3]. More recent data backs this up. A 2023 meta-analysis published in JADA found only moderate to very low certainty evidence for any meaningful performance differences among direct restorative materials [7]. So what does this mean for patients? While certain materials may have advantages in specific cases (like glass ionomer in fluoride rich applications or composite for aesthetics) restorative materials are designed to mimic the properties of natural tooth enamel and halt further caries formation. Technique and context matter more than the brand name on the label. And the use of fluoridated toothpaste is a key preventive measure that helps protect tooth enamel and reduce the risk of caries formation. Long term studies help dentists estimate how long a filling will last. A 2012 study in Statistics in Medicine used advanced modeling to evaluate survival probabilities of fillings in primary teeth, accounting for real world follow up challenges like missed appointments or dropouts [6]. Similar modeling approaches are used to assess the longevity of restorations in permanent teeth. Knowing caries prevalence in different populations helps dentists anticipate treatment needs and outcomes as rates of caries can vary widely due to sociodemographic and environmental factors. These models give dentists valuable guidance when planning treatment especially for patients who may have limited access to follow up care or need a longer lasting option upfront. There's a trend to do less—at least when it comes to removing healthy tooth structure. Minimally invasive dentistry is about early detection, preserving natural enamel and using techniques that cause the least disruption with an emphasis on preserving dental hard tissues and monitoring the enamel surface for early lesions. Two 2023 studies—one in the International Journal of Dentistry and another in Frontiers in Oral Health—highlight this shift [5] [10]. The latter looked at natural antimicrobial agents like pomegranate extract that could reduce bacterial activity that causes decay. Combined with preventive strategies like fluoride treatments, sealants and improved brushing habits this approach stops cavities before they start and limits how much drilling is needed when they do. Dental sealants are applied to the pit and fissure areas of posterior teeth to prevent dental caries especially in high risk patients. Preventive measures should target all tooth surfaces as caries can develop on any tooth surface especially in patients with multiple risk factors. Regular dental checkups and good oral hygiene are key to preventing dental caries and identifying early signs of decay. Risk factors like poor oral hygiene, dry mouth and dietary habits contribute to rampant caries especially on the tooth surfaces most susceptible to decay. It's easy to think of cavities as isolated issues—just a hole to be filled. But dental caries is a chronic disease with deep roots in diet, bacteria, hygiene habits and even general health. The disease process of dental caries occurs when dental plaque a biofilm harboring cariogenic bacteria metabolizes dietary sugars leading to acid production and caries formation [8]. This process results in caries destruction which can manifest as carious lesions. These lesions can be classified as coronal caries, root caries or occlusal caries depending on their location on the tooth. As caries progresses the dental pulp may become involved potentially resulting in dental pain, infection or the need for root canal treatment. If left untreated carious lesions can ultimately result in tooth loss due to the advanced disease process. A 2017 Nature Reviews Disease Primers article and a 2021 report in the British Dental Journal both state that caries should be treated as a non-communicable disease like diabetes or heart disease [4] [9]. This confirms that fillings alone aren't enough. True oral health comes from addressing the cause—not just the symptom. Early intervention is key to identifying and treating carious lesions before they cause irreversible damage. Educating patients on sugar intake, oral hygiene routines and regular checkups is as important as the clinical procedure itself. Modern dentistry has many tools and techniques to treat dental caries effectively but the best outcomes come from combining clinical evidence with patient centered care. Here's what we know from current research: Caries is a chronic condition—not just a cavity—empowers patients and clinicians to work together for long term oral health. [1] Bücher, K., Tautz, A., Hickel, R., & Kühnisch, J. (2014). Longevity of composite restorations in patients with early childhood caries (ECC). Clinical oral investigations, 18(3), 775–782. [2] Leinonen, K. M., Leinonen, J., Bolstad, N. L., Tanner, T., Al-Haroni, M., & Johnsen, J. K. (2023). Procedure time and filling quality for bulk-fill base and conventional incremental composite techniques-A randomised controlled in vitro trial. Journal of dentistry, 138, 104725. [3] Yengopal, V., Harneker, S. Y., Patel, N., & Siegfried, N. (2009). Dental fillings for the treatment of caries in the primary dentition. The Cochrane database of systematic reviews, (2), CD004483. [4] Pitts, N. B., Zero, D. T., Marsh, P. D., Ekstrand, K., Weintraub, J. A., Ramos-Gomez, F., Tagami, J., Twetman, S., Tsakos, G., & Ismail, A. (2017). Dental caries. Nature reviews. Disease primers, 3, 17030. [5] Warreth A. (2023). Dental Caries and Its Management. International journal of dentistry, 2023, 9365845. [6] Joly, P., Gerds, T. A., Qvist, V., Commenges, D., & Keiding, N. (2012). Estimating survival of dental fillings on the basis of interval-censored data and multi-state models. Statistics in medicine, 31(11-12), 1139–1149. [7] Pilcher, L., Pahlke, S., Urquhart, O., O'Brien, K. K., Dhar, V., Fontana, M., González-Cabezas, C., Keels, M. A., Mascarenhas, A. K., Nascimento, M. M., Platt, J. A., Sabino, G. J., Slayton, R. L., Tinanoff, N., Young, D. A., Zero, D. T., Tampi, M. P., Purnell, D., Salazar, J., Megremis, S., … Carrasco-Labra, A. (2023). Direct materials for restoring caries lesions: Systematic review and meta-analysis-a report of the American Dental Association Council on Scientific Affairs. Journal of the American Dental Association (1939), 154(2), e1–e98. [8] Mathur, V. P., & Dhillon, J. K. (2018). Dental Caries: A Disease Which Needs Attention. Indian journal of pediatrics, 85(3), 202–206. [9] Pitts, N. B., Twetman, S., Fisher, J., & Marsh, P. D. (2021). Understanding dental caries as a non-communicable disease. British dental journal, 231(12), 749–753. [10] Rafeie, N., Salimi, Y., Aghamir, Z. S., Amini, A., Taheri, H., Sadreddini, S., Kamali, F., Akbarian, G., Azizi, N., Bagherianlemraski, M., Valizadeh, M., Alimohammadi, F., Sedighnia, N., Qadirifard, M., & Naziri, M. (2025). Effects of pomegranate extract on preventing dental caries: a systematic review. Frontiers in oral health, 6, 1484364.
Jordan News
14-05-2025
- Health
- Jordan News
Vitamin D Deficiency: The Silent Killer of Children's Tooth Enamel? - Jordan News
One of the recently identified conditions in the field of dentistry is Molar-Incisor Hypomineralization (MIH). This disorder was officially recognized in 2001 by Professor Henrik Weerheijm and his research team at the Academic Centre for Dentistry Amsterdam (ACTA) in the Netherlands, through their groundbreaking study that described the condition for the first time. This marked the beginning of growing awareness around the issue of enamel hypomineralization in children. اضافة اعلان Understanding the Possible Causes Since then, MIH has become a major subject of interest in medical and scientific circles. Researchers are striving to uncover its potential causes—ranging from environmental to genetic factors—while also working on effective treatment strategies for its associated symptoms, such as severe tooth sensitivity and increased risk of cavities. This ongoing research is helping to shed light on the mechanisms of the condition and how to prevent it. Is Vitamin D the Main Culprit? Recent studies suggest that vitamin D deficiency during childhood is a key risk factor for developing MIH. Vitamin D plays a crucial role in regulating the absorption of calcium and phosphorus—two minerals that make up more than 90% of tooth enamel. Evidence from Labs Around the World: Saudi Arabia, Japan, Switzerland Switzerland: A 2024 study from the University of Zurich, led by Professor Benjamin Sluska and published in BMC Oral Health, found that vitamin D deficiency increases the risk of MIH by up to 43%. Saudi Arabia: A 2023 systematic review published in Children – MDPI, led by Dr. Ahmed Al-Ali from King Abdulaziz University, confirmed that low vitamin D levels at birth are associated with a higher risk of developing MIH. Australia: In a 2025 study published in Clinical Oral Investigations, Dr. Sophie Hammond showed that sun exposure during a child's first two years reduces the risk of MIH by 38%. Japan: A 2024 study from Osaka University, led by Dr. Yamamoto and published in the Paediatric Dental Journal, warned against the early use of antibiotics, which can negatively affect vitamin D levels and increase the incidence of MIH. USA: A 2023 study by Columbia University, published in BMC Oral Health, found that children with vitamin D deficiency are 22% more likely to suffer from dental caries, especially in primary teeth. A Global Epidemic: Alarming Numbers A global study led by Dr. Wenjundong Zhao from Anhui Medical University in China (2017), published in the International Journal of Paediatric Dentistry, revealed that 12.9% of the world's children are affected by MIH, with rates as high as 20% in parts of South America. The author of this article suspects even higher prevalence in the Arab world, pending a major upcoming study by King Saud University's College of Dentistry on MIH epidemiology in Gulf Cooperation Council countries. The devastating effects of this condition are not just cosmetic—it can affect nutrition, mental health, and cause dental fear from an early age due to the need for intensive dental treatments at a very young age. The Rescue Plan: Protecting Children's Teeth Starts Today In its 2025 annual report for World Oral Health Day (March), the World Health Organization recommended the following steps to protect children from MIH: Early diagnosis: Visit the dentist before age 6 and before the eruption of permanent teeth. Sun exposure: 15 minutes of daily sunlight (under medical advice). Vitamin D screening: Test and supplement if deficient—particularly important in Arab countries, where despite abundant sunlight, up to 90% of people are deficient due to sun avoidance. Preventive care: Regular fluoride use and periodic dental checkups. Advanced treatments: Use of resistant fillings or crowns (ceramic or metal) for advanced MIH cases. Final Word Molar-Incisor Hypomineralization is not merely about white spots—it may be an early indicator of a serious vitamin D deficiency that threatens bone development and overall health. Prevention starts from day one of a child's life, through proper nutrition and consistent exposure to sunlight.
