Dental patients usually get cavities when they neglect good oral hygiene practices. Cavities can cause weakening of the tooth’s structure and severe pain if left untreated.
Application of a Filling
The dental practitioner will numb the tooth and the nearby area's sensation with a local anesthetic before it’s filled. The decayed area will be removed by a air abrasion instrument, laser or standard drill. The selection of a specific instrument to remove the decay depends on the location and extent of the decay as well as the training, skill level, and dedication to invest in the most effective, advanced dental technologies available. The dentist will double check to see if any decay is still present within the tooth. If none exists, the dentist will clean the cavity from debris and bacteria. A composite resin, ionomer (glass) or other dental material may be used to protect the tooth nerve if the decay is near the root of the tooth.
Extra steps and time are required for tooth-colored fillings applications once the dentist cleans the decayed tooth. Applying the tooth-colored material in thinner layers is recommended to minimize shrinkage. Next, a special light hardens or "cures" each layer applied. This process basically rebuilds the tooth to make its structure stronger. Lastly, the dentist will blend, trim and polish the composite material so that its fusion to the natural tooth is virtually undetectable.
What Types of Filling Materials Are Available?
Several dental filling materials are available today. Your insurance coverage, the area and extent of the decay, filling material cost, and your dentist's recommendation are factors that will determine the best filling material for you. Teeth can be filled with mercury blended amalgam, cast gold, natural-colored, plastic, porcelain or composite resin fillings.
Advantage of Cast Gold Fillings
Cast gold fillings are a great filling option for dental patients to consider because they can last up to 15 years or longer and won’t corrode. Moreover, gold fillings can bear greater chewing forces and are considered to be more aesthetically pleasing than silver amalgam fillings. Many dental patients can’t afford the extra expense of getting gold fillings and will have to go to at least two office visits to have this material applied. Another concern of getting a gold filling is the potential of creating galvanic shock, which happens when two metals (gold filling and silver amalgam filling) are placed next to each other.
Silver Fillings (Amalgams)
Silver fillings also have several advantages for dental patients to consider. First, silver fillings can last up to 15 years which is typically a longer wear life than composite fillings. They can bear greater chewing forces and are less expensive than gold or composite fillings. Unfortunately, silver fillings don’t look as pleasing as tooth-colored fillings, require more of the be removed to allow space for the placement, can discolor, crack or fracture the tooth, and potentially trigger allergic reactions in about 1 percent of the population.
Tooth-colored fillings are a popular dental material since they closely match the shade of natural teeth. They also provide better support for the tooth since they can be bonded to its structure. Composite fillings are a versatile restoration material for worn, chipped, and broken teeth. Usually less tooth structure must be removed in preparation for the filling compared to amalgam applications.
However, tooth-colored fillings can cost as much as twice the amount of silver fillings, and are not as durable as their metal counterparts. Unfortunately they only wear well until approximately 5 years. Also, they can’t withstand the same chewing force (especially with larger cavities) as metal fillings and require additional chair time with their application. Composites can even chip off the tooth depending on their location.
Other Filling Types
- Ceramic fillings are most often made of porcelain, are more stain resistant than composite resin material but has a rougher texture. This material's longevity is typically over 15 years and can be priced similar to a gold filling.
- Glass ionomer is a material that consists of acrylic and a specific glass type most widely used for pediatric filling and those beneath the border of the gum. Although the fluoride in this material can help prevent further tooth decay, it is more fragile than composite resin, and more vulnerable to degrade and fracture. Glass ionomers are comparable in cost to composite resin and generally last five years or less.
Inlays and Onlays
Inlays and onlays are structurally resilient and last up to 3 decades. They can be fabricated of porcelain, natural tooth-shade composite resin or cast gold. Inlays and onlays compromise the tooth's structure, but to a smaller degree than traditional fillings. Inlays and onlays are both classified as indirect fillings and are an option when inadequate tooth structure is left to hold a filling but is not so severely worn away to require a crown. Inlay and onlay procedures require additional dental visits.
Inlay applications rest completely within the cusps or "peaks" on the tooth's surface, whereas onlays or partial crowns cover one or more peaks.
Temporary fillings are used when fillings require several appointments, such as for composite indirect fillings or when applying a gold filling, after a root canal procedure, and when a tooth’s nerve needs time to calm down if the pulp became irritated. Be sure to contact your dentist this type of filling substituted for a permanent filling.