To place a cement filling, follow these 5 steps:

1. Keep the cavity dry.
2. Lift out the soft decay.
3. Mix the cement.
4. Press the cement into the cavity.
5. Remove the extra cement from around the cavity and the tooth.

What is a tooth filling?

What is a filling? – A tooth filling is a type of dental restoration which repairs damage caused by tooth decay and prolongs the life of the tooth. Fillings are an effective way to repair damage from tooth decay Fillings are a very common dental procedure – as many as 80% of adults end up with at least one filling during their lifetimes, and most people have several. In the year 2017-2018, NHS dentists in England performed over 10.2 million filling treatments for adults and 3.3 million for children, according to,24% of adult treatment courses included fillings during this time.

1. To treat a tooth with dental caries (tooth decay) in this way, a dentist first drills out all the decayed material and cleans the cavity.
2. They then fill the hole in the tooth with one of a number of filling materials.
3. Once the filling is complete, the tooth can function as normal for many more years.
4. If left untreated, tooth decay will continue to erode the tooth, leading to cavity pain.

An abscess may eventually form somewhere around the tooth, requiring more drastic treatment like root canal work or, You may not relish the idea of having a filling, but it’s really the best way to stop decay in its tracks and preserve the tooth for as long as possible.

How do you put cement between teeth for fillings?

How to Place the Cement Filling – Hesperian Health Guides Lay out on a clean cloth:

• A
• B
• C
• D
• E

A: your syringe, needle, and local anesthetic (in case a tooth hurts) B: your instruments: mirror, probe, tweezers, spoon, filling tool, mixing tool C: oil of cloves (eugenol) and zinc oxide D: lots of cotton: cotton rolls, gauze, or cotton wool E: smooth glass to mix cement

1. Keep the cavity dry. The cavity and the area around it must be dry so you can see what you are doing. Just as important, cement stays longer inside a dry cavity. Place cotton between the cheek and gums to keep the area dry. Put some cotton under the tongue when you work on a lower tooth. Use whatever kind of cotton you have: gauze, wool, or even rolls. Change the cotton whenever it becomes wet. Keep the cavity dry while you work. Wipe the inside of it every now and then with a bit of cotton. Then leave a piece of cotton inside the cavity while you mix the cement.
2. Lift out the decay. You do not need to remove all of the decay on the bottom of the cavity. If you try to clean out all of the decay, you might touch the nerve. However, you must remove all of the decay from the edges of the cavity. Otherwise, germs and food can go between the cement and the cavity and keep the decay growing inside. For, it is especially important to remove all the decay from the edges so the filling will stick well. Use the spoon tool to scrape clean the walls and the edge of the cavity. If you find that the part of the tooth at the edge of the cavity is thin and weak, break it deliberately. That makes for stronger sides to hold onto the cement. You can use the end of your filling tool to break the edge but it is much easier with a dental hatchet, which is less likely to bend. CAVITY NERVE Use the spoon tool to lift out soft decay from inside the cavity. Be careful not to go too deep and touch the nerve at the very bottom of the cavity. This takes practice. If the tooth hurts when you do this, stop and inject some local anesthetic. Use cotton gauze to collect the bits of decay so that the person does not swallow them. Use your mirror and look closely around the edges of the cavity for any decay that you may have missed. Put some cotton inside the cavity and leave it there to keep the area clean and dry while you mix the filling. These first two steps are also used in placing a,
3. Mix the cement on a piece of smooth glass. Place separately onto the glass a pile of zinc oxide powder and a few drops of eugenol liquid. Pull a small amount of the powder to the liquid with the mixing tool and mix them together. Add more powder in this way, until the cement mixture becomes thick.
   

   Suggestion: Practice with the cement ahead of time. You can then find out the time it takes to become hard.

   Cement is much easier to use when it is thick and not too sticky. Roll a bit between your fingers. If the cement sticks, it is not yet ready. Add more powder and then test again. Now take the cotton out of the cavity. Check to be sure the cavity is dry. If the cotton around the tooth is wet, change it.

4. Press some cement into the cavity. If a cavity goes down between two teeth, you need to first take care that the cement does not squeeze and hurt the gum.
   

   	space left for the gum
   before	after

   Before you apply the cement, place something thin between the teeth. You can use the soft stem from a palm leaf, a toothpick, or a tooth from a comb. Be sure it has a rounded end to prevent damage to the gums. To apply the cement, put a small ball of cement on the end of your filling tool. Carry it to the cavity. Spread it over the floor of the cavity and into the corners.

   Then add another ball of cement, pressing it against the other cement and against the sides of the cavity. If a cavity goes down between two teeth, one other step is necessary. You need to take care that the cement does not squeeze and hurt the gum. REMEMBER: Decay stops growing only when the cement covers it completely and tightly.

5. Remove the extra cement before it gets too hard. Press the flat side of the filling tool against the cement and smooth it towards the edge of the cavity. As you smooth the cement, shape it to look like the top of a normal tooth. This way, the tooth above or below it can fit against the filling without breaking it. If you have placed something between the teeth, remove it and, Gums are easier to clean, and stay healthier, when the cement beside them is smooth. Cement that sticks out and is not smooth can hurt the gums. It can also later break off. When that happens, spit and germs are able to go inside and start the decay growing again. It is also important to look closely around the tooth for loose pieces of cement and to remove them before they make the gums sore. Use the end of your probe. Gently reach into the gum pocket and lift out any pieces of cement caught there. Wipe off your probe with cotton gauze each time. Now remove all the cotton and ask the person to gently close the teeth. The teeth should come together normally and not hit first against the cement filling. Too much pressure against the cement filling will crack and break it. If you do not have carbon paper, darken some paper with a pencil. Always check to see if part of the filling is high:
   1. lf the cement is still wet, you can see the smooth place where the opposite tooth bit into it. Scrape the cement away from this place.
   2. If the cement is dry, have the person bite on a piece of carbon paper. If there is too much cement, the carbon paper will darken the cement. Scrape away that extra cement.

   The person must not leave your clinic until the filled tooth fits properly against the other teeth This page was updated: 21 Jan 2021

: How to Place the Cement Filling – Hesperian Health Guides

What are tooth cement dentistry procedures?

How does it work? – The basic concept of using cementation starts with mixing a dry ingredient with a wet one and then working quickly to apply the mixture to the area that needs adhesion. It usually does not take very long for the cement to set, unlike other adhesives.

Therefore, the procedure can be done quickly and with minimal downtime before the patient can eat or drink. The curing and adhesiveness actually do not happen because of the cement “drying out” but instead is the result of a chemical reaction between the wet and dry elements. When the cement cures, it hardens and bonds with the surfaces that it is touching, so if two different surfaces have a layer of cement between them that cures, they then adhere.

Some resin-based cement types will have the curing process helped along at the dentist office with the use of a light-curing tool. These are usually halogen or LED lights that emit light which is on the visible blue light spectrum. The purpose of this light is to act as a catalyst for the curing chemical reaction.

Before this procedure was discovered, resins were subject to quick and uncontrolled curing times and were rarely used. This is why metal materials used to be the go-to for fillings. The development of light-activated resin allowed dentists to have much more control over when and where the resin would set.

For this reason, resin-based cements are extremely popular. For more on the physics of how this works, take a look at this article, Tooth cement shares some similarities with the kind of cement you might find outside your home, but there are certain key properties that have been developed specifically for use in oral applications.

It must not be irritating to the mouth tissues or the pulp of the tooth. Cement tends to be slightly acidic which is understandably irritating. However, tooth cement is made of polycarboxylate which rises in pH after setting, reducing the acidity and becoming tolerant to the various biological surfaces found in the mouth. It must be strong enough to resist the forces of chewing. It must be aesthetically pleasing, so most cements tend to be translucent or close to the same color as enamel. It must have the proper opacity to show up on X-rays and radiographs.

There may be other desirable properties depending on the brand, such as being antibacterial, hypoallergenic, and able to create a reliable seal. There are also special cases where a particular cement might be used for a specific property. For example, some tooth cements are made only for temporary use.

These might be formulated to either be more brittle and therefore easy to break off when the time comes or they might have a specific liquid solubility property. If there are other materials being used in the procedure then the dentist will want to use a tooth cement that is made specifically to bond well with it, such as when attaching a metal appliance or when needing to bond to a composite material.

These are the most common procedures in which tooth cement may be used: 1. Cavities – When a cavity needs to be filled, the dentist will first drill out any decay that might be present. Failure to remove all the decay will result in the tooth continuing to deteriorate underneath the filling and may lead to serious nerve and jaw damage.

The opening is then filled with tooth cement. If the bond between the cement and tooth breaks down the cavity may reoccur.2. Braces – Individual brackets are affixed to the teeth with tooth cement and a wire is run through and attached to them. This wire is then replaced regularly to encourage teeth to shift in a way that produces a straighter smile.

Sometimes a bracket can pop off, at which point it will be reattached with more cement,3. Appliances – There are several types of dental appliances which may be installed for a period of time to move the teeth around. They are attached to the teeth with cement and include an adjustment mechanism that will change the jaw in a way that the dentist is targeting, such as widening it.4.

Tooth Replacements and Repairs – If a tooth becomes damaged or needs to be removed, the subsequent repair or replacement is done with the aid of tooth cement. It can hold crowns, bridges, and implants in place by bonding the material with the underlying tooth or bone. Tooth cement is one of the most versatile tools in a dentist’s arsenal and is one of the most important advancements we have made in modern dentistry.

Without it, seemingly simple problems like cavities and chipped teeth would be much worse and we would all be in a lot of pain.

How to fill a cavity with a filling tool?

How to Place the Cement Filling – Hesperian Health Guides Lay out on a clean cloth:

• A
• B
• C
• D
• E

A: your syringe, needle, and local anesthetic (in case a tooth hurts) B: your instruments: mirror, probe, tweezers, spoon, filling tool, mixing tool C: oil of cloves (eugenol) and zinc oxide D: lots of cotton: cotton rolls, gauze, or cotton wool E: smooth glass to mix cement

1. Keep the cavity dry. The cavity and the area around it must be dry so you can see what you are doing. Just as important, cement stays longer inside a dry cavity. Place cotton between the cheek and gums to keep the area dry. Put some cotton under the tongue when you work on a lower tooth. Use whatever kind of cotton you have: gauze, wool, or even rolls. Change the cotton whenever it becomes wet. Keep the cavity dry while you work. Wipe the inside of it every now and then with a bit of cotton. Then leave a piece of cotton inside the cavity while you mix the cement.
2. Lift out the decay. You do not need to remove all of the decay on the bottom of the cavity. If you try to clean out all of the decay, you might touch the nerve. However, you must remove all of the decay from the edges of the cavity. Otherwise, germs and food can go between the cement and the cavity and keep the decay growing inside. For, it is especially important to remove all the decay from the edges so the filling will stick well. Use the spoon tool to scrape clean the walls and the edge of the cavity. If you find that the part of the tooth at the edge of the cavity is thin and weak, break it deliberately. That makes for stronger sides to hold onto the cement. You can use the end of your filling tool to break the edge but it is much easier with a dental hatchet, which is less likely to bend. CAVITY NERVE Use the spoon tool to lift out soft decay from inside the cavity. Be careful not to go too deep and touch the nerve at the very bottom of the cavity. This takes practice. If the tooth hurts when you do this, stop and inject some local anesthetic. Use cotton gauze to collect the bits of decay so that the person does not swallow them. Use your mirror and look closely around the edges of the cavity for any decay that you may have missed. Put some cotton inside the cavity and leave it there to keep the area clean and dry while you mix the filling. These first two steps are also used in placing a,
3. Mix the cement on a piece of smooth glass. Place separately onto the glass a pile of zinc oxide powder and a few drops of eugenol liquid. Pull a small amount of the powder to the liquid with the mixing tool and mix them together. Add more powder in this way, until the cement mixture becomes thick.
   

   Suggestion: Practice with the cement ahead of time. You can then find out the time it takes to become hard.

   Cement is much easier to use when it is thick and not too sticky. Roll a bit between your fingers. If the cement sticks, it is not yet ready. Add more powder and then test again. Now take the cotton out of the cavity. Check to be sure the cavity is dry. If the cotton around the tooth is wet, change it.

4. Press some cement into the cavity. If a cavity goes down between two teeth, you need to first take care that the cement does not squeeze and hurt the gum.
   

   	space left for the gum
   before	after

   Before you apply the cement, place something thin between the teeth. You can use the soft stem from a palm leaf, a toothpick, or a tooth from a comb. Be sure it has a rounded end to prevent damage to the gums. To apply the cement, put a small ball of cement on the end of your filling tool. Carry it to the cavity. Spread it over the floor of the cavity and into the corners.

   Then add another ball of cement, pressing it against the other cement and against the sides of the cavity. If a cavity goes down between two teeth, one other step is necessary. You need to take care that the cement does not squeeze and hurt the gum. REMEMBER: Decay stops growing only when the cement covers it completely and tightly.

5. Remove the extra cement before it gets too hard. Press the flat side of the filling tool against the cement and smooth it towards the edge of the cavity. As you smooth the cement, shape it to look like the top of a normal tooth. This way, the tooth above or below it can fit against the filling without breaking it. If you have placed something between the teeth, remove it and, Gums are easier to clean, and stay healthier, when the cement beside them is smooth. Cement that sticks out and is not smooth can hurt the gums. It can also later break off. When that happens, spit and germs are able to go inside and start the decay growing again. It is also important to look closely around the tooth for loose pieces of cement and to remove them before they make the gums sore. Use the end of your probe. Gently reach into the gum pocket and lift out any pieces of cement caught there. Wipe off your probe with cotton gauze each time. Now remove all the cotton and ask the person to gently close the teeth. The teeth should come together normally and not hit first against the cement filling. Too much pressure against the cement filling will crack and break it. If you do not have carbon paper, darken some paper with a pencil. Always check to see if part of the filling is high:
   1. lf the cement is still wet, you can see the smooth place where the opposite tooth bit into it. Scrape the cement away from this place.
   2. If the cement is dry, have the person bite on a piece of carbon paper. If there is too much cement, the carbon paper will darken the cement. Scrape away that extra cement.

   The person must not leave your clinic until the filled tooth fits properly against the other teeth This page was updated: 21 Jan 2021

: How to Place the Cement Filling – Hesperian Health Guides