To treat a cavity your dentist will remove the decayed portion of your tooth and then “fill” the area on the tooth where tooth structure was lost. Fillings are also used to repair cracked or broken teeth and teeth that have been worn down. The most common fillings are amalgams (silver fillings), composites (white fillings/bonding), ceramics (porcelain), and glass-ionomers(used mostly in pediatrics and geriatrics).
Advantages of silver fillings:
Durability — silver fillings often last at least 10 to 15 years and historically outlasts composite (tooth-colored) fillings.
Strength — can withstand some chewing forces, but will wear over time.
Expense — is less expensive than composite fillings
Disadvantages of silver fillings:
Poor aesthetics — silver fillings don’t match the color of natural teeth.
Destruction of more tooth structure — healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling.
Discoloration — amalgam fillings can create a grayish hue to the surrounding tooth structure.
Cracks and fractures — although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, amalgam material — in comparison with other filling materials — may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fractures.
Allergic reactions — a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations.
TOOTH COLORED COMPOSITES
Advantages of composites:
Aesthetics — the shade/color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth.
Bonding to tooth structure — composite fillings actually chemically bond to tooth structure, providing further support.
Versatility — in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
conservative preparation — less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
Disadvantages of composites:
Less durability — composite fillings may wear out sooner than amalgam fillings, particularly if used for large cavities, where the function under the pressure of chewing.
Increased chair time — because of the process to apply the composite material, these fillings can take up to 15 minutes longer than amalgam fillings to place.
Chipping — depending on location, composite materials can chip off the tooth.
Expense — composite fillings can cost up to twice the cost of amalgam fillings.
NOTE: composites have advanced significantly in past years and new studies are showing they may last almost as long as amalgams, particularly if the restoration is small. We practice “minimally invasive dentistry”, meaning we prep the smallest amount of tooth structure as possible.
CERAMICS AND INDIRECT COMPOSITES
Indirect procedures consist of making the restorations outside of the mouth. Typically these are called inlays or onlays. These restoration are the best option for large filling when tooth structure has been compromised. We can now offer these restorations same day.
Inlays and onlays are more durable and last much longer than traditional fillings — up to 30 years. They can be made of tooth-colored composite resin, porcelain, or gold. Inlays and onlays weaken the tooth structure, but do so to a much lower extent than traditional fillings.