As you know, tooth filling is one of the most common dental procedures. It is a kind of repair job to fix the damage done by tooth decay. It is a painless dental restoration and generally takes about an hour to complete.
Cavities are a common dental problem. According to the National Institutes of Health, more than 90 percent of adults aged between 20 to 60 have had a cavity. A filling is important as it helps prevent further decay and allows your tooth to function normally.
What is a Tooth Filling?
If you have a tooth cavity, to treat it, your dentist will remove the decayed portion of your tooth and then fill the area on the tooth where the decayed material was present.
Your dentist might also use a filling to repair(filling replaced) your cracked or broken teeth. Teeth worn down from misuse, such as from tooth grinding or nail-biting.
In simple terms, a filling is a way to restore your tooth damaged by decay back to its normal functioning. During the procedure, your dentist first removes the decayed tooth material, cleans the area, and then fills your cleaned-out cavity with a filling material. Your dentist tries to close off spaces where bacteria can enter, thus helping to prevent further decay.
Steps Involved in Tooth Filling
First, your dentist will numb the area around the affected tooth with a local anesthetic. Next, a drill, air abrasion instrument, or laser can remove the decayed area. The instrument used will depend on the choice of your dentist’s comfort level, training, as well as the location and extent of your decay.
Next, your dentist will test the area during the decay removal process to check if all the decayed material has been removed. After the removal of bacteria and debris from your decay, your dentist will prepare the space for the filling.
If the decay is very near your root, your dentist may first put in a liner made of composite resin, glass ionomer, or other material to protect your nerve. Generally, after filling your dentist will finish and polish the teeth.
If you opt for tooth-colored fillings – several additional steps are required. Once your dentist has removed the decayed portions and cleaned the area, the tooth-colored material is applied layer by layer. Next, he uses a special light that hardens or “cures” each of these layers.
With the completion of the multilayering process as part of your tooth-colored fillings, your dentist will shape the composite material to the desired result. If trimming off any excess material is required, it is completed and polished to give it the final shape.
Types of Tooth Filling Materials Available
Today, you can find several dental filling materials. Your teeth can be filled with gold, porcelain, silver amalgam (consisting of mercury mixed with silver, tin, zinc, and copper).
Or your dentist can also use tooth-colored, glass, and plastic materials called composite resin fillings. The location of your decay and extent of the decay, cost of filling material, and your dentist’s recommendation – all assist in deciding the type of filling that will best address your needs.
1 Cast gold
- Aesthetics – Some people find gold more pleasing to the eye than silver, amalgam fillings.
- Durability – These fillings last 10 to 15 years and even longer as they do not corrode.
- Strength – It can withstand chewing forces.
- Expense – They are more expensive than other materials. They might cause ten times higher than the cost of amalgam fillings.
- Additional visits – You might require at least two visits to the clinic.
- Galvanic shock – Note that if a gold filling immediately next to your silver, amalgam filling can cause a sharp tooth pain as a galvanic shock can occur. The reaction between the metals and saliva might cause an electric current to flow, though it is rare.
- Aesthetics – Most people do not prefer ‘colored’ fillings as they are eye-catching.
2 Silver-fillings (Amalgams)
- Durability – It can last at least 10 to 15 years and usually outlasts composite fillings.
- Strength – Can easily withstand chewing forces.
- Expense – They are less expensive than composite fillings.
- Poor aesthetics – As fillings do not match the color of your natural teeth hence are not a preferred choice.
- Discoloration – Amalgam fillings might create a grayish shade to the surrounding tooth structure.
- Destruction of healthy tooth structure – Your dentist might remove the healthy parts of your tooth to make a space large enough to hold the amalgam filling.
- Cracks and fractures – Most of your teeth expand and contract in the presence of hot and cold liquids. Ultimately causing your tooth to crack or fracture. If you have an amalgam material in comparison with other filling materials might experience a wider degree of expansion and contraction. As a result, it would lead to a higher incidence of fractures and cracks.
- Allergic reactions – A negligible percentage of people, approx 1%, are allergic to the mercury present in amalgam restorations.
Tooth-colored Composite Fillings
Aesthetics – Your dentist can closely match the color of the composites to the color of existing teeth. Therefore, this type of filling is particularly well suited for use in your front teeth or other visible parts of the teeth.
Bonding to tooth structure – Composite fillings are chemically bonded to your tooth structure, providing further support to your tooth.
Less tooth to remove – In the case of composite fillings, less tooth structure needs to be removed compared with amalgams, where a large section of your healthy tooth needs removal to hold the amalgam filling.
Versatility in uses – In addition to use as a filling material for decay, your dentist can use composite fillings to repair chipped, broken, or worn teeth.
Lack of durability – Your composite fillings might wear out sooner than amalgams. Meaning composite fillings last at least five years compared to amalgams that last for 10 to 15years. These might not last as long as amalgams under the pressure of chewing. And might wear away faster if the filling material is used for large cavities.
Increased chair time – You might require a longer time because applying the composite material is more time-consuming. These fillings can take up to 20 minutes longer than amalgams take place.
Additional visits – If your dentist uses composites for inlays or onlays, you might require more than one visit to the clinic.
Chipping – Depending on the location where the composite filling is placed, it can chip off your tooth.
Expense – Composite fillings can cost double the cost of amalgams.
Other Types of Filling
In addition to tooth-colored composite resin fillings – there are two other tooth-colored fillings. They are – ceramics and glass ionomers.
Ceramic fillings are mostly porcelain fillings, are also more abrasive, and are more resistant to staining than composite resin material. This material can last more than 15 years and can cost equivalent to what gold filling might cost.
Glass ionomer fillings, made of acrylic and a specific type of glass material. This material, preferably used below your gum line and for fillings in young children. Glass ionomers are designed to release fluoride, which can help protect your tooth from further decay.
However, note that the material is weaker than composite resin and might be more susceptible to wear and prone to fracture. Glass ionomers might last five years or less. Their costs are comparable to composite resin.
What Are Indirect Fillings?
There exists lot of similarity between indirect fillings and tooth-colored or composite fillings, except they are laboratory-made. You may require two visits to complete the filling procedure.
Your dentist might consider indirect fillings when not enough tooth structure remains to support a filling. Meaning the tooth is not so severely damaged that it needs a crown, and a filling might suffice.
During your first visit, the removal of the decay or an old filling takes place. Your dentist takes an impression to record the shape of your tooth that needs repair. The impression is generally sent to a lab that will prepare the indirect filling.
While the preparation of your restoration, your dentist will place a temporary filling to protect your tooth. During your second visit, post temporary filling removal, and your dentist will check the fitting of the indirect restoration. When your dentist is satisfied with the perfect fit, it will be permanently cemented into place.
Two Types of Indirect Fillings – Inlays and Onlays
Inlays are very similar to fillings, but the entire work lies within the cusps on your tooth’s chewing surfaces. Also known as partial crowns, onlays are more extensive than inlays, covering one or more cusps.
Both inlays and onlays made of tooth-colored composite resin or porcelain or gold are more durable. They can last much longer than traditional fillings, even up to 30 years. However, inlays and onlays weaken your tooth structure, but to a lesser extent than traditional fillings.
How Should You Care for Your Teeth Filling?
To maintain your fillings so that they can last longer, you should follow good oral hygiene practices which should include regular brushing and flossing. You should also visit your dentist regularly for cleanings. In addition, brushing with fluoride-containing toothpaste gives an added advantage. Moreover, flossing at least once daily is equally important to remove the particle stuck between two teeth.
If your dentist suspects that a filling has cracked or is leaking – he will take X-rays to assess the condition. If your tooth is extremely sensitive (tooth sensitivity), if you notice a crack in the filling, if you feel a sharp edge, or if a piece of the filling is missing – call your dentist immediately for an appointment.
Ask your dentist about the pros and cons of the filling materials used for your tooth. You will come to know the best best way to care for your filling. With diligent dental hygiene and dental care, you can expect your tooth fillings to last for many years.