Fillings are needed to fix holes in teeth caused by tooth decay or breakages. There are multiple different filling material available which have various properties. The traditional silver amalgam materials have been used for almost 150 years but new materials such as composite filling material which is tooth coloured and can bond to a tooth have become much more popular in recent years.
Fillings are most commonly needed due to tooth decay. Dentist can see decay in the mouth during an exam or on an X-ray. If it is not removed it can get bigger and eventually cause pain or breakage of the tooth. The sooner decay is removed the better as it can increase in size very quickly. Fillings are also needed when a tooth fractures or when old fillings need replaced.
Amalgam (Silver fillings)- This materials has been used for over 150 years and has shown to work very well over a long period of time. It is quick to place and generally cheaper than other tooth coloured filling materials. The main disadvantages of amalgam are that it is metallic in appearance and cannot be bonded to natural tooth. This means that it is more visible in the mouth and not as kind to the remaining tooth as other filling materials.
Composite ( White fillings)- Composite is a tooth coloured filling material that comes in a wide variety of shades allowing the material to blend seamlessly into the natural tooth. White material can be bonded to your natural tooth which makes it kinder to the remaining tooth and allows it to be placed in many different scenarios.
Ceramic– Ceramic fillings are excellent for larger cavities where white fillings materials are not ideal. They are constructed in a laboratory so are more expensive than white filling material. They look incredibly natural, very strong and are bonded in place similar to white filling material. The most commonly used ceramic material is Emax which is a particularly brand of ceramic which has excellent aesthetics.
Gold– Gold can be used in similar scenarios as ceramic fillings. It is an excellent dental material but has gone out of fashion as patients generally request tooth coloured materials. It is very durable and can last a long time if it is looked after.
Glass Ionomer– Is tooth coloured like composite but is not as natural in appearance. Is used every commonly as a temporary filling material but can be used permanently in certain scenarios.
Silver fillings ( amalgam) are made from a combination of metals such as silver, tin, copper and mercury. White fillings ( composite) are made from resins and very small glass particles. Silver fillings do not stick to teeth so special features have to be cut into the tooth to allow the material to lock in. White filling material can be glued directly to a tooth so these features are not required.
The main benefits are as follows:
- White filling material can be used to create a filling which blends into your natural tooth. It comes in a wide variety of shades which can be matched to your natural tooth and then sculpted to recreate the original shape of the tooth. Amalgam only comes in one colour.
- White filling material can be bonded to your natural tooth, amalgam cannot. Amalgam therefore requires special features to be added to the cavity which involves removing more natural tooth tissue which is never ideal. These features are not required for white filling material therefore it is kinder to the remaining natural tooth.
- White fillings can be resurfaced, repaired or polished in the future if any issues occur.
There are many factors that can determine just how long it will take to get a composite filling, including the size of a cavity, its location, and how many fillings you need. A special cover called rubber dam is often needed which goes over the tooth temporality during the appointment to create a seal which stops moisture in the mouth from contaminating the surface of the natural tooth. This is important as the bond will not work if any moisture touches the tooth while the filling is placed. Once the filling is set the cover is removed. The appointment time for one filling is generally between 45-60 mins but will be longer if more fillings are carried out at the same time.
White fillings on back teeth are not covered by the NHS and can only be provided on a private basis. We can place white filling material on the front six teeth on the NHS however this does not include layered cosmetic white fillings which are used for composite bonding.
On occasion you may experience pain or sensitivity after a white filling is placed. This is more common with deeper fillings but can happen even with a very small filling. The reason for this is that the nerve in the tooth can be upset after the removal of a broken filling or decay. Symptoms tend to resolve after a few weeks but can last for a few months. If symptoms do not resolve removal of the filling may be needed or occasionally a root canal treatment is needed.
Yes, this is an acceptable treatment option however patients must be aware that they can have issues with sensitivity after any filling is replaced
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