WHEN YOU NEED A FILLING THERE ARE OPTIONS
There are a variety of options when a tooth requires a filling. Each has advantages and disadvantages for patients to consider in deciding which is the appropriate choice for them.
To discuss what filling materials are available some terms must first be defined. A filling refers to a situation where part of a tooth that is missing (due to decay, fracture, previous filling, etc.) is shaped to support and retain some type of material to restore the lost tooth structure. A direct filling is a filling that is placed in the defect in an unset state and sets, or hardens, in the mouth. An indirect filling is brought to the mouth fully set. This allows for use of stronger materials than can be place directly. To place an indirect filling a mold of the tooth is used to fabricate a model on which the filling is made.
The common alternatives for direct fillings are composite resin (white tooth colored fillings) and bonded amalgam (a silver mercury alloy).
White tooth colored fillings
White tooth colored composite resins have been available for filling front and back teeth for several years and have several advantages. Teeth restored with white tooth colored fillings look natural not repaired. In many cases using composite resin instead of amalgam requires removing less of the healthy tooth to prepare a shape that will hold and support the filling, causing less weakening of the remaining tooth. They may in fact strengthen the tooth by bonding it together. These fillings are fully set when you leave the office and require less post treatment care. When placed with the necessary time and care white tooth colored fillings have longevity that compares favorably with other filling options.
Many dental plans cover the equivalent non-bonded amalgam fee for white tooth colored fillings on back teeth.
Bonded amalgam fillings
Amalgam is the grey/black material once commonly used in back teeth. It is now only one of a number of acceptable materials available to restore the form and function of a tooth. The reliability and durability of amalgam are well established. It will not, unfortunately, restore the appearance of a tooth due to it’s gray, unnatural appearance. There has been some health and environmental concerns raised as to the appropriateness of using mercury in dental fillings. There is research and opinion on both sides of the The benefits of amalgam as a restorative material are at this time considered to outweigh the perceived risks.
Most dental plans cover the equivalent non-bonded amalgam fee for bonded amalgam fillings. The difference not covered is $ per filling.
Indirect fillings (called inlays or onlays depending on the part of the tooth being replaced) can be made of composite resin, porcelain, or gold. The composite resins used for indirect fillings are generally stronger than those used for direct filings. Both the composite resin and porcelain can match the tooth’s color, resulting in invisible restoration of the lost tooth structure. The gold color of gold fillings is considered an advantage by some patients, a disadvantage by others. Regardless, it is a strong, reliable way to restore a tooth.
Sedative (temporary) fillings
The purpose of placing a sedative filling prior to a final restoration is two fold:
1) To allow inflammation in the pulp (soft middle) of the tooth to clear up if it can, prior to placing the final restoration.
2) To test to make sure the inflammation can be cleared up and that a restoration will be comfortable. If the inflammation is not reversible a root canal will be required prior to restoring the tooth.
At your convenience, let’s meet and discuss which fillings are right for you.