Tooth Filling
To treat a cavity, first your dentist will use a local anesthesia to numb the area around the tooth to be filled. Next, a driller or laser will be used to remove the decayed area. Once the decay has been removed, the dentist will prepare the space for filling by cleaning the cavity of bacteria and debris.
If the decay is near the root, your dentist may first put in a liner made of glass- ionomer, calcium hydroxide, or other material to protect the nerve.
Generally, after the filling is in, your dentist will finish and polish it.
Today, several dental filling materials are available. Teeth can be filled with Gold; Porcelain; Silver Amalgam or tooth-colored, plastic, and material called composite resin fillings.
There is also a material that contains glass particles and is known as Glass ionomer, this material is used in ways similar to the use of composite resin fillings.
The location and extent of the decay, cost of filling material, your insurance coverage, and your dentist’s recommendation assist in determining the best type of filling for you.
In the past, gold was known to be the best material to require teeth but it was later dropped due to its yellow color and high price.
Advantages:
-Durability – lasts at least 10 to 15 years and usually longer; doesn’t corrode
-Strength – can with stand chewing forces
-Aesthetics – some patients find gold more pleasing to the eye than silver amalgam filling
Disadvantages:
-Expense – gold filling cost up to 10 times higher than amalgam.
-Additional office visits – requires at least two office visits to place.
-Galvanic shock – a gold filling placed immediately next to a silver amalgam filling may cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur.
-Aesthetics – most patients dislike metal “colored” fillings and prefer fillings that match the rest of the tooth.
The most widely used and trusted material was amalgam (which consist of mercury mixed with Silver, Tin, Zinc, and Copper) which has high strength and durability due to its metallic properties.
Today, despite the good properties of amalgam, the use of this material in tooth restoration has been restricted because its silver color and mercury in amalgam composition.
However, amalgam is still the best material in Terms of physical properties and in difficult cases it is better to use it for dental protection.
Advantages:
-Durability – silver fillings last at least 10 to 15 years and usually outlasts composite fillings
-Strength – can withstand chewing forces
-Expense – may be less expensive than composite filling
Disadvantages:
-Poor aesthetics
-Destruction of more tooth structure – healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling
-Discoloration – amalgam fillings can create a grayish hue to the surrounding tooth structure.
-Cracks and fractures – amalgam material in comparison with other filling materials, may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fracture.
-Allergic reactions – a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations.
In the end it should be noted that studies have found no link between the amalgam fillings and health problems and the FDA considers them safe for adults and children ages 6 and above.
Composite resin fillings or white fillings are the most common used fillings at our office. White fillings can be used to restore a tooth to function and integrity. White fillings enable you to maintain your beautiful white smile even if you require treatment.
Tooth-colored fillings make your teeth appear whiter and brighter than before with strength even better than metal restorations.
White fillings are not only limited to new dental repairs, older restorations may also be replaced. These esthetic materials will help give your smile a new lease on life.
Advantages:
-Aesthetics – the shade/ color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth.
-Bonding to tooth structure – composite filling micro-mechanically bond to tooth structure, providing future support.
-Versatility – in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth
-Tooth- sparing preparation – sometimes less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
Disadvantages:
-Lack of durability – composite filling wear out sooner than amalgam fillings.
-Increased chair time- these fillings can take up to 20 minutes longer than amalgam fillings to place.
-Chipping – depending on location, composite materials can chip off the tooth.
-Expense – composite filling can cost up to twice the cost of amalgam fillings.
These filling are made most often of porcelain and are more resistant to staining than composite resin material. This material generally lasts more than 15 years and can cost as much as gold.
Glass ionomer is made of acrylic and a specific type of glass material. This material is most commonly used for fillings below the gum line and for fillings in young children (drilling is still required).
Glass incomers release fluoride, which can help protect the tooth from further decay.
However, this material is weaker than composite resin and is more susceptible to wear and prone to fracture. Glass ionomer generally costs comparable to composite resin.