Introduction: DIY Dentistry
PLEASE READ THEORY BEFORE DOING ANYTHING
I do not expect that many people will try that, but if someone is so desperate better do not repeat stupid mistakes.
In my case that was just temporary fix for few weeks and i mostly use usual dentist service.
Not everybody can afford professional tooth repairs, and free goverment subsidized service is usually so bad that they do more damage than repair.
My father lost few good teeth because dentists considered them to much damaged to repair cheaply.
I had problems with my wisdom teeth so since there was nothing to loose I decided to repair them myself. It is just temporary repair, until I will find some dentist to extract them properly.
It appears to be not so impossible as you may expect. however wisdom teeth are very hard to reach and so work is complicated so quality is questionable.
There are 2 options for tooth repair, fillings or crowns, dentists especially cheap ones are in love with fillings. They don't last long and each repair does irreversible damage.
Crowns are best solution but somehow quite expensive even if there is no reason for them to be so.
Surprisingly, crowns are not so hard to make as you think, you can find instructions how to make vampire teeth for Halloween and without modifications these methods are usable for tooth repair too.
Only difference is that you need to glue them permanently.
Big filings are much harder to do for yourself. And also you risk to be unable to remove them in case of emergency.I would not recommend permanent DIY filings unless you have dental drill. It is best to avoid them because even professional doctors cant make them properly.
tiny filings are easy to do and are worth trying.
DISCLAIMER: this looks like medical procedure, but technically it is not since none of these instructions involve any work with living flesh(I only recommend very minor repairs). However it is possible to do some damage, and I am not responsible for that. especially if you try to repair heavy damage there is big chance that something will go wrong.
I am not a doctor and I will gladly accept suggestions or critic from any dentist.
Step 1: Materials and Tools
If you intend to do permanent repairs, then you need good quality materials. (even then it is quite unlikely to have great success.)
Crowns can be made of fiberglass+epoxy or acrylic resin. almost all materials are ok, if you are satisfied with color and strength.
most or stuff can be obtained from medical supply shops
If you want to do filings you need something that cures fast, so epoxy is bad choice, or be prepared to walk with open mouth for 3 hours or find some fast epoxy.
Cheapest solution is acrylic resin.
For temporary filings you can use simple plaster, it is great while you are waiting for appointment of just currently do not have time to visit dentist.
To do job properly you need to prepare tooth surface somehow, cheap dremel is OK for that, but it is better to buy dental handpiece from ebay if you intent do do more repairs.
Simple sharp rod will do the cleaning job because decayed bone is very weak and easy to scrap.
But only diamond burs can defeat enamel without shaking your head too much.
Most vital tool in dental repair business is air blower, without it do not even try to do anything.
big fish tank compressor will work fine, refrigerator compressors may also be suitable but some oil filter may be necessary.
Blunted hypodermic needle will make fine nozzle.
Also you will need big syringe with blunt needle as water squirter to wash tooth surface.
Step 2: Some Theory
Learn tooth anatomy at first.
In short tooh is piece of relatively soft bone(dentin) covered with natural crown which is called enamel, this enamel is hard like epoxy, but it cracks easily. Enamel is dead like nails and hair so it cant repair itself. dentin is not so absolutely dead, but still cant repair itself.
Tooth also has blood supply system which is called nerve, its purpose is to provide water to the tooth bone and enamel without nerve tooth will crack and disintegrate easily.
Dentists like to remove nerve because it my cause problems sometimes, but in reality it is not that dangerous if timely help is available. Without nerve tooth will crack for sure if not protected by crown.
Tooth structure is quite interesting, it is not like other bones but lots of small parallel tubes coming from the nerve to the edges of tooth, because of that tooth has very high tensile strength but it is prone to cracking.
To repair tooth you mostly need to restore missing enamel. However if decay progressed for long enough dentin is usually badly damaged, decaying bone spreads and makes pressure to the nerve, in some cases infection may happen.
If you feel dental pain it means that somewhere you have decaying dentin which makes pressure on the nerve.
So before beginning repair works it is necessary to remove damaged dentin. or else decay will spread. Also damaged dentin cause lots of pain for no visible reasons just cleaning it is enough to relieve dental pain.
Damaged dentin is quite soft and it is easy to scrape with some sharp tool. Usually there is no pain unless you reach healthy tooth surface.
Also it is quite easy to see if everything is ok , because decaying bone becomes darker. It is necessary to scrape away all dark spots until everything is clean and hard.
In case of open nerve work becomes more complex because inflammation may happen.
usually dentist will perform root canal procedure then, but it is also possible to save nerve by cleaning it up and placing CaOH on it. Pulp has one interesting unknown feature: it can regrow tooth. Under stimulation pulp will turn into dentin, however if there are lots or bacteria around that will not work and inflammation will happen instead
CaOH can do that stimulation and somehow kill bacteria too.
The big problem with dental work is that you work in very wet area so it will be hard to glue something to wet surfaces.
And even worse is that dentin is something like calcium reinforced fabric made of tiny threads of collagen. Cleaning will mess up that surface and make it into something like greased chalk. Obviously it is nearly impossible to glue something to such surface properly.
thats why most of DIY dentistry will fail.
lots of people try to use super glue or epoxy to glue back pieces of tooth but that is quite useless. they will fall off even under minimal load. gluing teeth is about same as trying to glue Teflon
Currently pharmacists invented new materials to fight with that problem. for example Clearfil SE bonding agent seems to be good but very expensive. one pack costs about 200$
Another problem is that all epoxies will shrink, simple epoxy will shrink about 1-3% and so it will detach from tooth surface and let contaminants enter inside.
Usage of costly filing material with quartz particles will help a little. Seems ebay sells one for about 75$
Cheap DIY dentistry without these exotic materials is quite primitive. All attempts to use pure epoxy filings will fail. Amalgam is quite worthless to because it needs special preparation which scraps away too much bone. Even if filling will not fall out decay will start again.
Gluing crowns is another story, because you can glue them to enamel (however dentists prefer to scrap enamel way to make crown smaller.)because of little amount of glue there is no shrinkage.
and bonds to enamel are very strong and can be made even stronger if you etch it with some acid.
Before doing any of filings or gluing it is vital to dry surface.
and in case of epoxy application it is good idea to scrap surface with small hadrd steel brush to mix collagen threads with your epoxy. It may increase bonding strength quite much and aslo it will clean away some of remaining bacteria and decayed cells
Even if job is done perfectly there are some more dangers. crown shape must be correct. in the lower area of tooth some gap between teeth must exist bigger gap = better, top surfaces sides must touch nearby teeth and have as little gap as possible.
Without proper gap , food particles will go down and there will be no way to clean them, finally they will be pushed between gums and tooth which will cause decay, inflammation abscess or other nasty things. so that must be taken into account during repair.
If there is no gap between teeth like often happens with wisdom teeth it is nearly impossible to do repairs
Primitive gluing may cause closing of gap between teeth and some of glue may enter between gums ant tooth what may cause inflammation.
it is quite hard to remove that glue, because unlike dentin bonds to enamel are stronger and it is possible to cause damage to the bone while trying to scrub excessive hardened epoxy away and you may accidentally implant contaminated piece of glue between bone and tooth, which probably will cause some problems.
To avoid these problems rubber barrier is used sometimes so that you protect gum line from contamination and damage
So my recommendation is to leave all heavy damage repair to dentist. And only work on light cracks that do not reach gums or pulp.
Also remember that faulty work will do lots of damage.
Step 3: Procedure
It is extremely hard to repair your own teeth, it is like making haircut to yourself.
but it can be done.
Because you feel pain you can properly scrape damaged dentin without damaging healthy surface.
that procedure is relatively simple and similar to tooth picking with one difference that you use sharp tooth pick and watch your work in the mirror.
If you are sure that all surface is free of decayed stuff wash it with warm water syringe. until it is completely clean with no dark spots.
It may be necessary to trim edges with dremel to remove unnecessary enamel. It is incredibly hard and only diamond burs can do the job
Now it is time to make crown using any of well known methods for making vampire teeth.
make it big and strong or else it will break.
I suggest you to wait for one day to be sure that there is no pain anymore if damage is extensive or you have open nerve pain may become permanent and if you have damaged nerve it may rot and cause infection, so be sure that nerve is healed. In case of open nerve it must be nice pink color.
to avoid infection and start recalcination you need to place some "poison" on the nerve to induce necrosis of surface. I used very small amount of silver nitrate solution for that.
Now you need to dry surface, use air compressor for about 1 minute until you are sure that surface is absolutely dry.
Finally you can fill cavity with some filling material of glue the crown
if you closed open nerve it is good idea to remove your crown after some time for example 2 weeks and reexamine surface for signs of decay and check if nerve recalcinated its surface. if everything is ok you can glue crown back
This procedure is mostly suitable for extremely damaged molar teeth, when dentists just refuse to fix then and suggests extraction. However it is not so hard to make crown and save your tooth for some more time.
Unfortunately some complications may happen. However this procedure will prolong tooth's life for some time.
Tooth extraction that is quote popular DIY procedure, but I advise never attempt to do it by yourself
if tooth it erupted enough to grip with pilers you can still fix and save it.
attempts to extract tooth may end in smashing other teeth into pieces, or at least cracking them.
If you relay need to extract some tooth(for example there is heavy abscess under its root and you are in the wilderness with no dentist available in 100km range ) do not ever try to do that in one step, flex tooth from one side to another many times until it loosens and easily falls out. if you try to pull tooth out with force you pilers will impact teeth that are around and shatter them.
there are even cases when professional dentists don't know that and cause extreme damage to patient.
Step 4: Results
Currently I performed one such procedure on extremely damaged wisdom tooth which which tortured my for some time.
Strangely enough that primitive crown is working quite well. There is no more pain even if tooth has open nerve and tooth appearance is quite good too, doctor has no comments about it and suggested extraction of another wisdom tooth this time which is in much better shape.
Not sure why doctor acted so strangely, because that tooth is definitely not going to last long.
Probably I will fix it tooth too, since it takes to long to wait. its primaty purpose is to let me chew without pain.
Once again this is only temporary fix until extraction will be performed by surgeon.
however it let me to learn about problems of dentistry.
Step 5: Some Scientific Tests (will Be Updated Regularly)
After my wisdom teeth were extracted I decided to evaluate some materials.
Dentin is extremely hard to glue something and to make matter worse tooth produces collagen enzyme which is responsible for breaking collagen layer below filings and so they fall of.
Now I tested these materials.
1 WAVE: Medical material which is designed to paint teeth to prevent then from decay.
it costs bout 6$ for 1g . cures under UV light. and also contains some fluorine to protect tooth.
RESULT: unfortunately that is total failure. it peels of with little effort, may be good for very tiny cavities or can be used as designed just to paint tooth surfaces to remove groves and stop that nasty decay before it ever started.
Looks perfect, impossible to see.
Should be good cosmetic material for whitening and reshaping front teeth instead of these nasty bleaching procedures, in case of dissatisfaction easy to peel of.
2. Cheap acrylic 2 component system resin from dealextreme.com cost 2$ for about 20g has very strong smell until cured.
Acrylic resins are clinically tested, and should be safe to use.
RESULT: surprisingly good adhesion, impossible to remove in any way except crapping piece by piece, however relatively soft when cured. and takes few minutes to harden.
should be perfect for gluing crowns. and may be usable for small cavities.
3. Epoxy resins: cures too slow to be usable. Will test bonding strength later for comparison
4. Superglue: too fast to do something usable but again will be tested for comparison.
5. G-bond: medical primer designed to adhere to dentin and enamel, easy to use, costs a fortune(150$ for 2-3g), my dentist uses it as primer to attach filings.
If she will not object maybe there will be chance to compare that material to to others.
(unfortunately she have no clue what the hell is that and what does it do)
Tooth surface preparation methods:
To glue something to enamel it must be etched at first with some acid.
I found easiest to use moderately concentrated nitric acid. It works fast and has not so bad taste.
(That stuff is extremely corrosive and will cause burns if left on living flesh. And will eat holes in your clothes instantly)
Any moderately strong acid should be suitable.
Gluing to dentin is much harder. so i tested another method.
first t I attempted to etch it with concentrated almost fuming nitric acid (if I drop piece of copper in that acid it starts to boil violently releasing brown fumes)
Hoverer for my surprise it has almost no visible effect on dentin. That was strange, we expect that acids should eat tooth materials quite easily.
Next, I tempted to remove collagen with sodium hydroxide (which is more known as drain cleaner) again quite dangerous stuff, which can dissolve flesh and turn it into soap.
Once more no effect on extracted tooth surface.
There was no visible changes under microscope. However, after few attempts, polished surface of dentin changed color a little, so that should be some kind of success.
Probably highly concentrated acids and bases can eat tooth surface enough to clean smear layer, and remove collagen, but that requires further investigation.