Filling

What is a Filling?

A filling is exactly what it sounds like. When a tooth has a hole, chip, small crack, or void, we fill it up. Fillings are usually reserved for small issues found in teeth when caught early by visiting the dentist regularly. In our office, if your tooth needs a filling, we first remove the decayed, chipped, or broken tooth material, clean the affected area, and then fill the cleaned out cavity or void with a filling material.

The purpose of the filling is to close off spaces where bacteria, food particles, and saliva can enter the inner surfaces of the tooth.

The most common fillings can be made of the following materials:

• composite resin (tooth-colored fillings)
• amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).
• Porcelain fillings (also possible if the extent of the void or cavity indicate its use)

Which Type of Filling is Best?

That question is difficult to answer for everyone and every tooth. No one type of filling is best for everyone. What’s right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost.

Considerations for different materials include:

• Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The filling material is bonded directly into the cavity, where it is hardened with a blue light. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings. Generally they last from three to ten years.
• Porcelain fillings are called inlays or onlays and are produced in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is higher than other filling materials.
• Amalgam (silver) fillings are resistant to wear and are relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth. Amalgam fillings are used less than before, but most people have had one or two amalgam fillings placed in their mouth.

Which one should I get?

In today’s dental offices, composite fillings are the most common filling type placed. Amalgam fillings are not as commonly placed due to poor esthetics. Many dental offices no longer use amalgam as a filling material so most patients choose between composite and porcelain fillings.

What is dental amalgam?

Amalgam(silver filling) is a filling material that is known for its resistant to chewing forces and its longevity. It is a metal alloy comprised of mercury, silver, copper, tin and sometimes zinc . However, due to its dark color, it is more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth. Amalgam fillings are used less than before, but most people have had one or two amalgam fillings placed in their mouth. Many people are concerned with the mercury content in amalgam, but there has been extensive research done proving that amalgam continues to be a safe dental filling material.

What are resin composite fillings?

Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of filling material (generally from three to 10 years).

What are porcelain inlay and onlay fillings & what is the difference between the two?

Sometimes a tooth has decay or a fracture so extensive that an amalgam or composite filling would compromise the structural integrity of the restored tooth and not be able to withstand chewing forces. In such situations, porcelain inlay and onlay restoration may be indicated. While an inlay or onlay restoration might be ten times the price of amalgam or composite fillings, the superiority of an inlay or onlay in terms of resistance to occlusal forces, protection against recurrent decay, precision of fabrication, marginal integrity, proper contouring for gingival (tissue) health, and ease of cleansing offers an excellent alternative to the other filling choices.

An inlay is used to restore a smaller portion of the tooth that does not involve a cusp (or point) of the tooth. An onlay is used when the cusp (or point) of a tooth is compromised and requires removal and restoration. Typically, an inlay is smaller than an onlay.

What Happens When I get a Filling?

Once we determine your tooth will be able to support a filling, we will numb your tooth and then remove the decay or affected tooth surface and clean the area. The cleaned-out area will then be filled with any of the materials described above. Once the filling has been placed, the dentist will go to great lengths to mimic how the tooth functioned prior to the development of the issues requiring replacement with a filling. This includes adjusting, polishing, and occasionally staining the filling material.

How Do I Know if I Need a Filling?

You usually don’t know, unless you can visibly see an issue. If you are feeling pain on a tooth, you are usually past the point of needing a filling and will need something more. Only an exam with the dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth and also use x-rays to help evaluate for cavities. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.

Why are fillings necessary?

Fillings are necessary to correct or stop a small issue from developing into a big one. Fillings are usually the first step of prevention so you can continue to use your natural teeth without having to use caps, bridges, or other more aggressive treatments. Fillings allow you to keep more of your natural tooth structure in your mouth.

What is the process for a filling?

Once we determine your tooth will be able to support a filling, we will numb your tooth and then remove the decay or affected tooth surface and clean the area. The cleaned-out area will then be filled with any of the variety of materials described above. Once the filling has been placed, the dentist will go to great lengths to mimic how the tooth functioned prior to the development of the need for a cavity. This includes, adjusting, polishing, and occasionally staining the filling material to restore the tooth back to its natural function.

What to expect after a filling has been placed in your mouth?

After a filling has been placed, you should be careful while the mouth is numb. Use caution not to bite on your cheek or tongue. Occasionally, a tooth will have some slight sensitivity to temperatures after placement of a filling due to the change of material in the tooth. A filling will send a different message to the brain when electricity, heat , and cold touch the tooth. This sensitivity will decrease with time. Another common concern after the placement of a filling occurs when the filling is not adjusted to the proper height of the other teeth. Though it is checked prior to leaving the appointment, the anesthetic can cause the teeth to not close properly and you have difficulty identifying this prior to exiting the office. If you feel a high spot in your tooth, immediately call us so we can adjust the filling to the proper height.