Dental FillingsSo, you suspect you need a filling but aren’t a fan of visiting the family dentist. You needn’t be leery of dental care! Sure, no one loves the sensation of the drill, but armed with the facts, filling types, the pros and cons of each, and the ins and outs procedure, you’ll be motivated to get your teeth back to their healthy state pronto.

Why Fillings?

Fillings are a type of tooth restoration used to replace decayed portions of teeth, repair broken or cracked teeth and remedy wear caused by grinding, nail-biting and other misuse.

Dental Fillings Procedure

The procedure for dental fillings is much simpler (and more painless) than you might think. First, your dentist will numb the area adjacent to the tooth that needs to be filled with a local anesthetic. Next, if you have a cavity, your dentist will clear away the decay with an air abrasion instrument or other tools appropriate for the extent of the decay and where it is located. After probing to verify that all decay is removed, they prepare the empty space by cleaning the area thoroughly to remove any debris or bacteria.

For decay next to a root, we can apply a composite resin or glass ionomer liner to protect the nerve. Otherwise, we’ll get to work applying the filling material.

Note: If you opt for a tooth-colored filling, there are a few more steps. We will apply the composite material in layers, utilizing a light to harden or cure each layer. After the final layer, we’ll shape the material, trimming off the excess. Once the filling is complete, it can be finished and polished.

Dental Filling Material Options

There are a number of dental filling material options to choose from. We can use tooth-colored plastic or composite resin, porcelain, gold, silver amalgam, or glass ionomer. Depending on the extent and location of the decay, costs, dental insurance coverage and other factors, we’ll help you arrive at the best choice for your specific needs.

To help you decide which material is suitable for you, here are some pros and cons for each of the materials:

Tooth-Colored Plastic + Composite Resins

Tooth-colored plastic and composite resins offer the most natural-looking fillings. If appearance is your number one concern, especially when needing a filling for front teeth or other visible areas, this will be the best material. As a restoration dentist with expertise in cosmetic dentistry, Dr. Kirakosian will select the shade and color that most closely matches the rest of your tooth and teeth.

They bond to the existing tooth structure and can provide added support, plus may be utilized to fix chips, breaks and worn areas, as well as to remedy decay. Patients wanting to preserve their natural tooth structure as much as possible will appreciate the tooth-sparing preparation this material provides over amalgam fillings.

The trade-off with tooth-colored materials lies in durability since composite fillings last about five years. They aren’t as strong as gold or silver amalgam fillings in terms of ability to hold up to chewing pressure and may chip off when placed in certain locations.

While there are about 20 extra minutes of chair time to place the tooth-colored materials, and they are about two times the cost of amalgams, we think the natural look is well worth it, especially since you will be wearing your new smile for years. However, if you are using composites for inlays or onlays with larger cavities, know that you will have to make an extra dental appointment or two to get that beautiful, natural appearance.

Tooth-Colored Ceramics

Mostly made of porcelain, this filling material resists staining even better than composite resin. While this material has a similar cost to gold, it can last over 15 years.

Tooth-Colored Glass Ionomer

Tooth-colored glass ionomers combine acrylic and a unique glass material. Ideal for young children and when fillings are needed below the gum line, they release fluoride to help safeguard teeth from further decay. This dental filling cost is equivalent to composite resin. However, it lasts approximately five years as it is susceptible to wear and fractures. However, newer versions show promise with better longevity, equal to composites.

Cast Gold

Exceptionally durable and strong, gold fillings do not corrode and can last anywhere from 10 to 15 years or more. However, gold is the most expensive material, costing approximately ten times more than if you choose silver amalgam. On top of that, you will have to visit the dentist office two or more times to complete your filling placement. They cannot be placed adjacent to silver amalgam fillings as the two metals and saliva trigger an electric current, potentially causing a painful Galvanic shock. While some patients favor their appearance over fillings made of silver amalgam, others find metal “colored” fillings unattractive.

Silver Amalgam Fillings

Silver amalgams, a combination of copper, mercury, silver, tin, and zinc, are highly durable, withstanding the force of chewing and lasting the equivalent amount of time as gold. They beat out tooth-colored fillings in terms of durability and expense but are not without disadvantages. Silver fillings are not aesthetically pleasing and can cast a grayish appearance on the surrounding tooth. They also require removing more healthy tooth structure than other options to make adequate space to hold them. They are also found to expand and contract more in response to heat and cold than other materials, causing more risk of fractures and cracks.

In addition, silver amalgam fillings have come under controversy and disfavor.

Fillings made with amalgam may release a small amount of vaporized mercury that is inhaled and absorbed. While some believe exposure to mercury vapor harms the brain and kidneys, plus triggers Alzheimer’s disease, autism, multiple sclerosis and other diseases, the FDA, public health agencies, and the ADA (American Dental Association) indicate that these health risks are not universal. The FDA allows that mercury vapors could potentially harm those with health conditions, children younger than six, women who are pregnant, nursing or trying to become pregnant, and patients with kidney dysfunction or neurological impairment. Despite the lack of evidence validating the side effects of mercury, many people who have silver amalgam fillings take measures to have them replaced.

While it is true that roughly 1% of people are allergic to mercury or other filling materials exhibited by itching or rashes, this is extremely rare. However, we are happy to discuss your concerns and the multiple materials we can use to keep your teeth and body healthy.

Indirect Fillings

Should there not be enough tooth structure to support a filling, but the situation doesn’t require a crown, your dentist will likely determine that an indirect filling inlay or onlay will better protect the weakened tooth. (Inlays are applied on the chewing surfaces, while onlays, also referred to as partial crowns, cover one or more cusps, with both being exceptionally durable, lasting up to 30 years.) During your dental appointment, your dentist will remove the old filling or decay, then take an impression to document the tooth shape to be repaired and the surrounding area. Then we will send it to a dental lab to make a temporary filling, also known as an indirect filling, designed to help protect the tooth while the restoration is completed. Upon your return appointment, we will remove the temporary filling and check to ensure that the indirect restoration fits properly and then permanently cement it into place.

Should there be adequate sound tooth structure, direct inlays and onlays can be executed in a single visit as they are made directly in the mouth.

Temporary Fillings

With indirect composite and gold fillings, after a root canal, or with emergency dental treatment, and when more than one appointment is required, temporary fillings are an excellent stopgap. However, they are not intended to last longer than a month when they must be swapped out for a permanent filling to prevent infection and other complications.

Caring For Your Fillings

The good news is that you don’t need to do much beyond daily oral hygiene and twice-yearly trips to the dental clinic for cleanings to maintain fillings. Brush, floss and use fluoride toothpaste and antibacterial mouthwashes according to your dentist’s recommendations. At your dental appointment, we will check for any signs of leaks, cracks, ill-fitting fillings, sharp edges or sensitivity that can occur due to clenching, grinding or regular chewing over time and proceed according to our findings.

Sensitivity or pain lasting beyond two to four weeks post-filling placement requires prompt attention. While a desensitizing toothpaste or agent can help, we may need to reshape a filling, while in others, a root canal or crown may be necessary to remedy your discomfort. Call us right away, as we aim to provide comfortable dental services that enable our patients to enjoy life to the fullest.

Now that you know what to expect, we encourage you not to put off your oral health care needs any longer. With most insurance plans covering the price of silver fillings (which can be applied towards composite dental fillings costs), the healthy smile you deserve is within reach.