Fillings are used to treat cavities after the decayed (rotten) part of the tooth is removed. The fillings may be made of porcelain, amalgam, or composite materials. Fillings are placed after the tooth has been ‘prepped’, and is a permanent fix for a tooth.
At Elison Dental Center, we provide the type of filling that best suits our patients’ mouths. Dr. Elison feels that composite, or white, fillings are currently the best over-all filling for the mouth.
According to WebMD, the following types of filling are available and with varying advantages and disadvantages.
Silver (amalgam) Fillings
Disadvantages of silver fillings:
1. Poor aesthetics -- silver fillings don't match the color of natural teeth.
2. 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.
3. Discoloration -- amalgam fillings can create a grayish hue to the surrounding tooth structure.
4. Cracks and fractures -- although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, 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 fractures.
5. Allergic reactions -- a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations.
Tooth-colored, or Composite fillings:
Advantages of composites:
1. 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.
2. Bonding to tooth structure -- composite fillings actually chemically bond to tooth structure, providing further support.
3. Versatility -- in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
4. Tooth-sparing preparation -- sometimes less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
Glass Ionomer filling:
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 ionomers 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 lasts five years or less with costs comparable to composite resin.
What are Indirect fillings?
Indirect fillings are similar to composite or tooth-colored fillings except they are made in a dental laboratory and require two visits before being placed. Indirect fillings are considered when not enough tooth structure remains to support a filling but the tooth is not so severely damaged that it needs a crown.
During the first visit, decay or an old filling is removed. An impression is taken to record the shape of the tooth being repaired and the teeth around it. The impression is sent to a dental lab that will make the indirect filling. A temporary filling (described below) is placed to protect the tooth while the restoration is being made. During the second visit, the temporary filling is removed, and the dentist will check the fit of the indirect restoration. Provided the fit is acceptable, it will be permanently cemented into place.
Inlays and Onlays
There are two types of indirect fillings -- inlays and onlays.
- Inlays are similar to fillings but the entire work lies within the cusps (bumps) on the chewing surface of the tooth.
- Onlays are more extensive than inlays, covering one or more cusps. Onlays are sometimes called partial crowns.
Inlays and onlays are more durable and last much longer than traditional fillings -- up to 30 years. They can be made of tooth-colored composite resin, porcelain, or gold. Inlays and onlays weaken the tooth structure, but do so to a much lower extent than traditional fillings.