What's wrong with dental excess?

 Often when dentists place a filling or cement a restoration, excess filling or cement can remain adjacent to a newly placed restoration. This "flash" is what I am referring to. Although this excess can be difficult to detect to a patient or a dentist looking at a new filling or crown, it creates a hiding place for plaque that will cause gingival inflammation and can even cause eventual bone loss.

Often this excess is not visible because it is sub gingival and only can be detected with a sharp explorer, positioned at the correct angle. After I place a restoration, I always use a piggy tail explorer to seek out any possible "flash" and if I detect it, I will either clean it off with a curette, scaler or use a tiny fine diamond to smooth the interface so that no flash remains. Where dental restorations are concerned, smooth "margins" ( the termination of a dental restoration) are clearly more biocompatible than rough ones. Some really great looking restorations can be flawed because the dentist creating them did not take the time to remove excess composite or cement.

Part of my examination of new patients involves an inspection of all the margins of existing dental restorations. Sometimes a review of a patients radiographs show evidence of cement flash from a previously cemented crown or any interproximal "overhangs" on existing fillings. Part of my new patient exam involves taking my patients on a tour of their radiographs since I have a large screen video monitor that allows patients to view their x-rays while seated in the dental chair. While I don't always replace restorations with slight over hangs, I do point them out to my patient during the exam and we discuss the possible problems they may cause in the future ( possible recurrent decay or periodontal disease).

from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2019/02/whats-wrong-with-dental-excess.html - http://lspindelnycdds.blogspot.com/

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