Small Cavity Filling Procedure: 7 Steps from Diagnosis to Aftercare

1. Examination & Diagnosis

• Visual/tactile inspection with explorer.
• Bitewing/periapical radiographs to assess depth, interproximal involvement.

2. Local Anesthesia

Infiltration or block (e.g., IAN for mandibular molars) if decay approaches dentin/pulp. Topical gel precedes needle.

3. Caries Removal

High-speed handpiece (round bur) for enamel; low-speed/large round bur or spoon excavator for infected dentin. Caries detector dye may aid.

4. Cavity Preparation

• Remove unsupported enamel.
• Create retention form (undercuts, dovetails for amalgam; bevels for composite).
• Pulp protection: liner/base (glass ionomer, calcium hydroxide) if deep.

5. Filling Placement

• Amalgam: Condensed incrementally, carved, burnished.
• Composite: Etch (37% phosphoric acid), bond, layer (2 mm increments), light-cure each layer.
• Glass Ionomer / RMGI: Condition, mix, place; fluoride-releasing.
• Porcelain (inlay/onlay): Indirect; requires impression/temporization.

6. Finishing & Polishing

Occlusal check (articulating paper), adjust, polish (composite: discs/paste; amalgam: next-day polish).

7. Post-Op Instructions

• Numbness warning (avoid biting lip/tongue).
• Sensitivity to cold/pressure may occur transiently.
• Oral hygiene, fluoride, recall schedule.