A filling can be placed on the side of a tooth, which is a common location for dental decay. The term “side” refers to surfaces other than the flat biting area, and these areas require restoration to prevent further damage. Dentists treat cavities on these non-chewing surfaces using specialized techniques. The complexity of the procedure depends on the specific surface involved and the extent of the decay.
Defining the “Side” of the Tooth
The anatomical sides of a tooth are divided into two main categories where decay frequently develops. The first is the proximal surface, the area where one tooth touches its neighbor (interproximal areas). These surfaces are highly susceptible to decay because food debris easily becomes trapped and they are difficult to clean effectively. X-rays are often necessary to detect decay in these tight spaces.
The second location is the cervical surface, near the gum line or the neck of the tooth, where the crown meets the root. Lesions here can be caused by acid erosion, aggressive toothbrushing (abrasion), or a combination of factors. When gums recede, the softer root structure becomes exposed, making it more vulnerable to decay.
Categorizing Non-Chewing Surface Lesions
Dentistry uses a standardized system to categorize decay based on its location, which dictates the appropriate treatment approach. Side fillings most commonly involve the contact points between teeth (proximal) or the smooth surfaces near the gums (cervical).
When decay affects the proximal surfaces of back teeth (molars and premolars), the restoration is complex because it requires recreating a precise contact point with the adjacent tooth. Decay on the proximal surfaces of front teeth (incisors and canines) is generally less complex, provided the decay does not reach the biting edge.
A third category covers lesions located exclusively on the smooth cervical third of any tooth, near the gum line. These lesions do not involve the biting surface or the contact point with another tooth. The specific location helps determine the necessary preparation, material, and technique to ensure the restoration is functional and aesthetically pleasing.
The Restoration Process
Placing a filling on a side surface presents unique challenges because the dentist must rebuild a missing wall of the tooth. For a proximal filling (the surface between teeth), a matrix system is required to temporarily replace this wall. This system uses a thin metal or plastic band wrapped around the tooth to contain the restorative material.
A small wedge is inserted firmly between the teeth at the gum line margin. The wedge secures the matrix band and slightly separates the teeth. This temporary separation accounts for the band’s thickness, ensuring the finished filling creates a tight, natural contact point with the neighboring tooth. Without this tight contact, food could become trapped, leading to gum problems.
Before the filling material is placed, the tooth must be isolated from saliva and moisture, often using cotton rolls or a rubber dam. A bonding procedure is performed, involving etching the tooth surface with an acid gel and applying a liquid adhesive. This creates microscopic pores for the tooth-colored composite resin to mechanically lock into, forming a strong bond.
The composite resin is placed into the prepared area in small increments, which are individually hardened using a specialized curing light. Layering ensures complete setting of the material and manages shrinkage stress. For lesions near the gum line, glass ionomer cement may be used, as it releases fluoride and does not require the tooth to be perfectly dry. The final step involves shaping and polishing the restoration to mimic the natural contour of the tooth.