Types of dental fillings
11 Apr 2019

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Types of Dental Fillings

Your Edmonton area dentist may recommend fillings to replace tooth structure lost to decay, excessive wear, or trauma in order to restore the original shape, size, function, and aesthetic, and make the tooth last longer. The performance, durability, and longevity of dental fillings varies depending on the material used. And while they last for many years, all of them eventually need replacing due to the constant assault from chewing and the stress from clenching and grinding.

The Procedure for Dental Fillings

The procedure for a dental filling is the same for all dental materials. First, the dentist rubs a gel onto the gum tissue to make the injection for the local anaesthetic more comfortable. This is necessary to numb the tooth and surrounding area and prevent any pain. You will still be awake during the procedure, but if you’re nervous, then you should discuss the available sedation options. Very small fillings don’t require the tooth to be numbed.

If there is tooth decay, the dentist will remove it and then clean, wash, and dry the remaining hole, before disinfecting it and adding the filling material. The filling material is pushed to fill the space completely, restoring the tooth to its original shape and size. Your dentist will ask you to bite your teeth together to check whether the restored tooth feels natural or oversized, and whether you can chew normally. The necessary adjustments will be made on the spot to ensure a comfortable fit.

Choosing a Dental Filling Material

There are two common types of dental filling materials, namely, amalgam or silver fillings, and tooth-coloured or white fillings. There are several types of tooth-coloured filling materials, all of which will be discussed below:

  1. Dental amalgam (silver) filling

Although amalgam fillings were the only option for dental fillings before the 21st century, they are rarely used for tooth repair in modern dentistry. They’ve been widely used for over 150 years, until recently when concerns were raised about the dangers of mercury to human health. Besides mercury, amalgam fillings also contain other metals like silver, copper, tin, and zinc. This mixture of metals gives the fillings their silver colour, which is why they’re also referred to as “silver fillings.”

Considering that dental amalgam has been used for more than one-and-a-half centuries, it has been thoroughly researched and tested. And even though it contains some mercury, the Food and Drug Administration (FDA), the U.S. Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO) have not objected its use as a dental filling material on the basis that the mercury contained is too little to cause any harm to humans.

Silver fillings are durable and long lasting, which makes them a popular option for filling the back teeth (molars) that bear the full force of crushing food and, therefore, get a lot more wear and tear.

Other benefits of amalgam fillings include:

  • Strength, stability, and durability.
  • Easy to place in a single visit.
  • High resistance to wear and further decay.
  • Least expensive filling material.
  • Self-sealing with minimal-to-no shrinkage and resistance to leakage (food and bacteria penetration behind or beneath the vacuum), which reduces the risk of new decay.
  • Amalgam is the only dental filling material that can be placed in a wet environment, and might be used when treating special needs patients.

Besides the mercury toxicity concern, many patients avoid amalgam fillings because of their unattractive metal appearance that can ruin their smile, especially when used to repair front teeth. Moreover, the fillings darken over time due to corrosion, which makes them even more unattractive. But this does not affect the function of the filling.

  1. Composite fillings

Composite fillings are a mixture of tooth-coloured materials. The mixture ensures a strong and durable restoration that is resistant to fracture in small-to-mid-sized restorations that are not exposed to heavy chewing pressure.

Composite material is self-hardening, though it may also be hardened by exposure to blue light. It’s typically used for fillings, veneers, and inlays, and can be recommended to replace a portion of chipped or broken teeth.

Other benefits of composite fillings include:

  • Ability to match the colour and shade of filling to the existing tooth.
  • Relatively strong with good durability for small-to-mid-sized restorations that have to bear moderate chewing pressure.
  • Can be used to restore either front or back teeth.
  • Allows preservation of more of the natural tooth compared to amalgam.
  • Low risk of leakage when bonded to enamel.
  • Resistance to corrosion.
  • Moderate resistance to breakage and further decay.

That said, composite fillings are not as resistant to breakage or wear as metal fillings, especially when used to repair molars. They are more expensive than amalgam, yet they wear faster than natural tooth enamel. Moreover, the fillings can be difficult and time-consuming to place, and may require more than one visit in the case of veneers, crowns, or inlays.

  1. Glass ionomers

These are made from a mixture of fine fluoride with glass powder and organic acid to provide a tooth-coloured restoration that releases fluoride. They’re primarily used to fill cavities on the root surface of teeth, and other small fillings in areas that don’t experience heavy chewing pressure. They can also be used to cement dental crowns.

Here are some reasons to choose glass ionomer fillings:

  • They’re tooth-coloured and give you a more natural look.
  • They contain fluoride that helps to reduce the risk of further decay.
  • Their placement requires minimal removal of tooth structure.
  • The procedure can be completed in a single visit.
  • They have a low incidence of localized allergic reaction.

However, glass ionomer fillings cost about the same as composite fillings, yet they have a lower resistance to fracture, can be dislodged, and often become rough over time, allowing plaque to build up and increase the risk of gum disease. As such, they can only be used to repair small areas of decay on non-biting areas of the tooth.

  1. Porcelain or ceramic

All-porcelain dental materials include ceramic, porcelain, or glass-like crowns or fillings. They are typically used in onlays, inlays, crowns, and cosmetic veneers. Porcelain can be fused to metal to increase durability.

Benefits of porcelain include:

  • Tooth-coloured with great translucency, like natural tooth enamel.
  • Resistance to further decay and surface wear.
  • Resistant to leakage.

However, porcelain tends to crack when exposed to heavy chewing pressure, which makes it unsuitable for the molars. It also costs as high as gold fillings.

  1. Gold alloys

Cast gold and gold alloy fillings (containing gold, copper, and other metals) provide a strong and effective filling, crown, or bridge. They are the most expensive filling material, but offer exceptional durability with over 20 years of service. They have great resistance to decay, do not crack under stress, and are resistant to tarnishing and corrosion.

Other benefits include:

  • Do not cause excessive wear to opposing teeth.
  • Have good resistance to leakage.
  • Require minimal removal of tooth structure during placement.

However, the high cost of gold makes them prohibitive to most people; that is, if you don’t mind a gold-coloured tooth. They also require two or more appointments to complete the restoration.

Final Note

While there are many different options in Edmonton for getting fillings to help repair and preserve decayed and chipped teeth, the best course of action is to protect and preserve your teeth by practising good oral hygiene, which includes flossing every day, brushing your teeth twice a day, and visiting your dentist for professional cleanings and checkups.

Sources
https://www.webmd.com/oral-health/guide/dental-health-fillings#1
https://www.stpetedentist.com/different-types-dental-fillings/
http://www.winningsmilespd.com/adult/blog/2017/10/05/the-different-types-of-fillings

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