Dental Tooth Fillings

To treat a cavity your dentist will remove the decayed portion of the tooth and then “fill” the area on the tooth where the decayed material was removed.

Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).

What Steps Are Involved in Filling a Tooth?

First, the dentist will use a local anesthetic to numb the area around the tooth to be filled. Next, a drill, air abrasion instrument, or laser will be used to remove the decayed area. The choice of instrument depends on the individual dentist’s comfort level, training, and investment in the particular piece of equipment as well as location and extent of the decay.

Next, your dentist will probe or test the area to determine if all the decay has been removed. Once the decay has been removed, the dentist will prepare the space for the 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, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Several additional steps are required for tooth-colored fillings and are as follows. After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that “cures” or hardens each layer is applied. When the multilayering process is completed, the dentist will shape the composite material to the desired result, trim off any excess material, and polish the final restoration.

What Types of Filling Materials Are Available?

Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic, and materials 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 type of filling best for you.

Cast Gold Fillings

Advantages of cast gold fillings:

  1. Durability — lasts at least 10 to 15 years and usually longer; doesn’t corrode
  2. Strength — can withstand chewing forces
  3. Aesthetics — some patients find gold more pleasing to the eye than silver amalgam fillings.

Silver Fillings (Amalgams)

Advantages of silver fillings:

  1. Durability — silver fillings last at least 10 to 15 years and usually outlasts composite (tooth-colored) fillings.
  2. Strength — can withstand chewing forces
  3. Expense — may be less expensive than composite fillings

Tooth-colored Composites

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

Other Filling Types

  1. Ceramics. These fillings are made most often of porcelain, are more resistant to staining than composite resin material but are also more abrasive. This material generally lasts more than 15 years and can cost as much as gold.
  2. 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. The newest ones have an even better lifespan and, when placed in appropriate areas. are equal to composites.

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