Hesperian Health Guides
Permanent Fillings Using a Dental Drill
HealthWiki > Where There Is No Dentist > Chapter 10: How to Fill a Cavity > Permanent Fillings Using a Dental Drill
Some simple dental drills
We use a dental drill to remove all decay from a cavity and to change the shape of the hole in the tooth so it can firmly hold the permanent filling material. The most expensive drills use electricity, but some drills are powered by people instead of electricity.
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| Village dental workers in the mountains of western Mexico use bicycle power to make compressed air, which runs a high speed drill. Local young people or family members volunteer to pump the air while they wait to have their own teeth fixed. |
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| In India and Guatemala, health workers use a foot treadle to power a drill, the same way they operate a sewing machine. This kind of drill is slower than a compressed-air drill, and the grinding produces a lot of heat, so one must take care not to let the tooth get so hot that it kills the nerves. Still, this is one of the simplest and cheapest ways to place a permanent filling. |
How a dental drill works
Even if you have the equipment, it is essential that you learn how to make permanent fillings from a person who has
experience using a dental drill.
The tip of the drill (drill bit) is sharp. Some drills spray water on the tooth to keep it cool. Cooling is especially important with a slower treadle-powered drill. An assistant can spray water on the tooth if the drill does not have a sprayer.
As the drill bit moves slowly back and forth, it opens the cavity further. This makes it easier to see all of the decay. The decay is later removed with a spoon instrument.
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The drill bit also changes the shape of the cavity. The hole in the tooth is shaped so that it will keep the permanent filling material in place.
The filling material, which is made of metal or plastic, must be very strong. It must not break apart when the person chews food or when saliva washes over it.
Do not use mercury amalgam to fill teeth!
For many years, mercury — a shiny, silver-white metal — was used in health care to fill thermometers, blood pressure measuring devices, and as part of metal amalgam to fill teeth. But now the use of mercury has been banned in many countries because it is so toxic (poisonous) to people. Mercury can harm the brain, spinal cord, kidney, and liver, causing tremors (shakiness), sleeplessness, memory loss, headache, nervousness, stomach pain, vomiting, and diarrhea. It is especially harmful to a pregnant person and the child they are carrying.
Carefully read the descriptions of the filling material you use to make sure it does not contain mercury. Other materials, such as composite, glass ionomer, ceramics, etc. may be just as available, affordable, and effective. And they are much safer for you, your patients, and the environment.