A filling can absolutely be placed on the side of a tooth, which is a routine procedure in dentistry. Decay frequently begins on surfaces that are difficult to clean thoroughly, making the sides of the teeth particularly vulnerable. These areas include the tight spaces between adjacent teeth and the surfaces near the gum line. Dental fillings are the standard treatment for restoring these decayed areas, preventing damage and preserving the tooth’s structure.
Defining Cavities on the Side of a Tooth
When people refer to decay on the “side” of a tooth, they are typically describing one of two locations. The first is interproximal decay, which occurs directly between two neighboring teeth. This area is shielded from toothbrush bristles, allowing plaque and acid to erode the enamel. Because these cavities are hidden, they often go undetected until they are visible on an X-ray or cause the tooth structure to collapse.
The second common area is the cervical region, the smooth, outer surface of the tooth right at or slightly below the gum line. Decay here results from plaque accumulation combined with factors like aggressive toothbrushing causing abrasion or acid erosion. The enamel layer is thinner closer to the gum line. If the gums recede, the softer root surface is exposed, making it highly susceptible to decay.
Preparing and Restoring Side Cavities
Restoring decay on the side of a tooth, especially the interproximal surface, is technically more demanding than working on a chewing surface. The dentist must first gain access to the decayed area, often by removing a small portion of the tooth structure from the top surface to reach the cavity. All infected material is carefully removed to prepare a clean base for the filling.
A specialized tool called a matrix system is then used to create a temporary wall for the filling material. For interproximal decay, a sectional matrix band is placed against the adjacent tooth. A small wedge is inserted from the side to secure the band tightly at the gum line. This system seals the bottom margin and slightly separates the teeth to compensate for the matrix band’s thickness.
The goal is to ensure the new filling has a natural, tight contact point with the neighboring tooth once the matrix is removed. Recreating this contour helps maintain the health of the gum tissue and prevents food from getting trapped. Without a properly shaped contact point, food impaction can occur, leading to gum irritation or further decay. The filling material is layered into the preparation and cured, rebuilding the lost side wall.
Material Choices for Lateral Restorations
The choice of filling material for a side cavity is influenced by the tooth’s location, aesthetic concerns, and the chewing force the restoration will endure. Composite resin, a tooth-colored plastic and glass mixture, is the most frequently used material today. It is favored for cervical lesions and visible interproximal decay because it can be matched precisely to the natural tooth color, offering an aesthetically pleasing result.
Composite resin chemically bonds to the tooth structure, which helps strengthen the remaining tooth and requires less removal of healthy material during preparation. For large interproximal cavities on back teeth where chewing forces are highest, amalgam, a silver-colored metal alloy, may be considered for its durability. Another option is glass ionomer cement, often used for cervical lesions or root surface decay because it releases fluoride, offering an additional protective benefit.
Preventing Decay on Tooth Surfaces
Preventing decay on the sides of the teeth requires techniques that go beyond standard toothbrushing. For interproximal areas, daily mechanical cleaning of the space between the teeth is necessary, most commonly achieved with dental floss. Flossing removes the sticky bacterial plaque film from the side surfaces where toothbrush bristles cannot reach.
For some individuals, using interdental brushes or a water flosser may be more effective for cleaning larger spaces or around complex restorations. To protect the cervical areas near the gum line, a soft-bristled toothbrush and proper brushing technique are important to prevent abrasion that can expose the softer root structure. The use of fluoridated toothpaste is also effective, as fluoride helps strengthen the enamel, making surfaces more resistant to acid attacks.