In order to fill the hole on the tooth where the decaying material was removed, your dentist will first eliminate the damaged segment of the tooth.
Furthermore, tooth fillings are made to restore teeth that have been worn down, including cracked or fractured teeth (such as from nail-biting or tooth grinding).
Tooth Fillings Procedure
The tooth’s surrounding tissue will first be temporarily numb by the dentist using a local anesthetic. Next, the decayed portion will be removed using a drill, air abrasion tool, or laser. The dentist’s comfort level, training, and investment in the specific piece of equipment, as well as the site and extent of the decay, all have an impact on the tool choice.
To confirm if all of the decay has been removed, your dentist will then probe or test the spot. As soon as the decay is completely eliminated, the dentist will prepare the gap for the filling by clearing the cavity of bacteria and debris.
If the decay has already extended near the root, your dentist has to put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. After placing the tooth fillings, your dentist will often polish and complete it.
For tooth fillings that fit your teeth, the following extra steps are required. Your dentist will remove the decay and clean the area before gradually applying the tooth-colored material. Then a certain light is used to “cure” or harden each layer. After completing the multilayering process, the dentist will shape the composite material to get the desired result, trim off any excess material, and polish the final repair.
Types of Tooth Fillings Materials
There are several dental filling materials available today. Gold, porcelain, silver amalgam (mercury combined with silver, tin, zinc, and copper), tooth-colored plastic, and substances known as composite resin fillings are all options for filling teeth. Another substance, called as glass ionomer, also includes glass particles. Similar to how composite resin fillings are used, this substance is utilized.
Depending on the location and extent of the decay, the cost of the material, your insurance coverage, and their recommendations, the type of filling that is best for you will vary.
Cast Gold Fillings
Advantages of cast gold fillings:
- Durability: lasts at least ten to fifteen years, and frequently much longer; doesn’t corrode a strong jaw that can sustain chewing pressure
- Aesthetics: Compared to silver amalgam fillings, some patients feel gold to be more aesthetically beautiful.
Cast-gold fillings’ drawbacks:
- Cost: Gold cast fillings are up to 10 times more expensive than silver amalgam fillings and more expensive than other materials.
- Additional office appointments: at least two office visits are necessary to put
Filled with silver (Amalgams)
Benefits of having silver fillings:
- Durability: Silver fillings often outlive composite (tooth-colored) fillings by at least 10 to 15 years.
a strong jaw that can sustain chewing pressure
- Cost: may be less costly than composite fillings
Disadvantages of silver fillings:
- Poor aesthetics: Silver tooth fillings are unattractive because they don’t match the color of natural teeth. More tooth structure is lost since it’s frequently necessary to remove good tooth tissue to create a cavity big enough to fit the amalgam tooth filling.
- Discoloration: Amalgam tooth fillings can give the tooth structure around them a gray appearance.
- Cracks and fractures: All teeth expand and contract in the presence of hot and cold liquids, which can ultimately result in the tooth cracking or breaking. However, amalgam material, when compared to other filling materials, may experience a wider degree of expansion and contraction, which may result in a higher incidence of cracks and fractures.
- Allergic reactions: Around 1% of the population has a sensitivity to the mercury used in amalgam tooth fillings.
Low quantities of mercury are released from the amalgam in the form of a vapor that may be breathed and absorbed by the lungs. Exposure to mercury vapor at high levels is linked to negative effects on the kidneys and the brain. The FDA deems amalgam tooth fillings safe for adults and kids aged 6 and older since studies have not connected them to health issues.
Advantages of composites:
- Aesthetics: Composite tooth fillings can be accurately matched in tone and color to surrounding teeth. Front teeth or other visible areas of teeth are particularly well suited for usage with composites.
- Bonding to tooth structure: Composite fillings micro mechanically attach to tooth structure to provide further support.
- Versatility: Composite fillings can be used to repair chipped, cracked, or damaged teeth in addition to serving as a decay-filling substance.
- Tooth-sparing preparation: When eliminating cavities and preparing for the filling, less tooth structure may need to be removed than when using amalgam fillings.
Disadvantages of composites:
- Lack of durability: These tooth fillings are often composed of porcelain and are more stain-resistant than materials made of composite resin. This substance may cost as much as gold and often lasts for more than 15 years.
- Increased chair time: Due to the method used to apply the composite material, these tooth fillings might take up to 20 minutes longer to place than amalgam fillings.
- Additional visits: More than one office visit may be necessary if composites are utilized for inlays or onlays. Depending on the placement, composite materials have the potential to chip away at the tooth.
- Cost: Composite fillings can be up to twice as expensive as amalgam ones.
There are two more tooth-colored fillings besides tooth-colored composite resin fillings: ceramics and glass ionomer.
Other Filling Types
Ceramics. These tooth fillings are often composed of porcelain and are more stain-resistant than materials made of composite resin. This substance may cost as much as gold and often lasts for more than 15 years.
Acrylic and a certain kind of glass are used to create glass ionomers. This substance is most frequently utilized for fillings in young children and below the gum line (drilling is still required). Fluoride is released by glass ionomers, which can aid in preventing additional tooth decay. Though less durable than composite resin, this substance is more brittle and prone to wear. Glass ionomer typically has a lifespan of five years or fewer and costs about the same as composite resin.
Dental Insurance Cover the Cost of Composites
The majority of dental insurance policies only pay for composite tooth fillings up to the cost of a silver filling; any additional costs may need to be covered by the patient.
Indirect Tooth Fillings
Indirect fillings are similar to composite or tooth-colored fillings, with the distinction that they must be implanted over the course of two visits and are made at a dental laboratory. Indirect fillings may be a possibility when there is insufficient dental structure to support a filling but the tooth is not too severely damaged to need a crown.
Silver fillings are understandable because their color does not match that of natural teeth. During the initial appointment, any debris or old tooth fillings are removed. To capture the contour of the tooth being treated and the adjacent teeth, an imprint is obtained. A dental practice that will create the indirect filling receives the imprint.
While the restoration is being made, the tooth is covered with a temporary filling (described below). During the second appointment, the dentist will evaluate the indirect restoration’s fit after removing the temporary filling. If the fit is good, it will be securely fastened in place.
The two different types of indirect fillings are inlays and onlays.
Inlays cover the whole chewing surface of the tooth within the cusps, much like tooth fillings do (bump).
Onlays are bigger than inlays and cover one or more cusps. Onlays are also referred to as partial crowns.
Compared to traditional fillings, inlays and onlays are stronger and can last up to 30 years.
They can be made of tooth-colored composite resin, porcelain, or gold. An onlay can be used to safeguard a tooth that is already weak because it may cover the top chewing surface and disperse forces throughout the tooth like a crown.
Direct inlays and onlays are a different kind of inlay or onlay that have similar steps to indirect inlays and onlays but are manufactured in the mouth and may be applied in a single appointment. The amount of sound tooth structure that is still present and any aesthetic considerations determine the type of inlay or onlay that is employed.
Temporary Tooth Fillings and Why Would I Need One?
In the following situations, temporary fillings are used:
For fillings that need more than one session, such as those that employ composite materials or require gold fillings to be placed beforehand or specific filling methods (known as indirect fillings),
After a root canal
To help the nerve “slow down” when a tooth’s pulp becomes inflamed
The only time temporary tooth fillings should be utilized is when acute dental treatment is necessary (such as to relieve a toothache). They frequently break, wear out, or fall out within a month.
To replace a temporary filling with a permanent one, make sure to make an appointment with your dentist. If you don’t, you might get an infection or encounter other issues.
Amalgam-Type Tooth Fillings
Concerns concerning silver-colored fillings, often known as amalgam tooth fillings, have been voiced over the past few years. Some people believe that these fillings, which contain the hazardous chemical mercury, are to blame for a variety of illnesses, such as autism, Alzheimer’s disease, and multiple sclerosis.
There is no evidence to support tooth fillings harming consumers, according to the American Dental Association (ADA), the FDA, and several public health organizations. There is still no recognized etiology for autism, Alzheimer’s disease, or multiple sclerosis. Furthermore, there is no credible scientific evidence to support the assertion that having amalgam fillings removed can cure a person of these or any other ailments.
Even while amalgam fillings include mercury, they also contain other metals like silver, copper, tin, and zinc to form a strong alloy that dentists have employed for more than a century to preserve and restore hundreds of millions of decayed teeth.
Mercury is a component of dental amalgams, which the FDA warned “may have neurotoxic effects on the neurological systems of developing newborns and fetuses” in June 2008.
There’s still more. The FDA states that people who might be pregnant or who might have a health issue that makes them more susceptible to mercury exposure, including people who already have high levels of mercury bioburden, “should not avoid seeking dental care, but rather should discuss options with their health practitioner.”
The modifications are in response to a case filed by consumer advocacy organizations and people worried about mercury exposure. The FDA consented to update its website as part of the settlement.
You should practice proper dental hygiene, including going to the dentist periodically for cleanings, using fluoride toothpaste to brush and floss, and using an antimicrobial mouthwash at least once a day.
Your dentist will take X-rays to evaluate the situation if they have reason to believe that a filling may be cracked or is “leaking” (when the sides of the tooth fillings don’t fit tightly against the tooth fillings, this allows debris and saliva to seep down between the tooth fillings and the tooth, which can lead to decay).
Make an appointment with your dentist if your tooth is incredibly sensitive, you feel a sharp edge, you see a crack in the filling, or if a portion of the filling is missing.
Problems With Tooth Fillings
Tooth Pain and Sensitivity
Tooth sensitivity after a filling has been placed is quite common. A tooth may be sensitive to air, pressure, sweet foods, temperature, and other factors. The sensitivity normally disappears on its own within a few weeks. During this period, stay away from anything that makes you sensitive. Painkillers are typically not required.
Call your dentist if the discomfort continues after two to four weeks or if your tooth is especially sensitive. They could advise getting a root canal, using a desensitizing toothpaste, or applying a desensitizing agent directly to the tooth.
Also possible is pain near the tooth fillings. The filling may be obstructing your bite if you suffer discomfort when you bite. You must visit your dentist again to get the filling reshaped.
If you suffer discomfort when your teeth come into contact, two separate metal surfaces are probably to blame (for example, the silver amalgam in a newly filled tooth and a gold crown on another tooth with which it touches). Within a short length of time, this discomfort should go away on its own.
You can feel discomfort that is similar to a toothache if the decay was severe or located near the tooth pulp. This tissue may no longer be healthy, as seen by the “toothache” reaction. If so, root canal treatment could be necessary.
Referred pain, often known as discomfort or sensitivity in teeth other than the one that has the filling, can occur sometimes in persons. There may not be a dental issue causing this particular discomfort. The filled tooth is only sending other teeth the “pain signals” it is experiencing. Over the course of one to two weeks, this pain should go away on its own.
The “toothache” response may indicate that this tissue is no longer healthy. If so, root canal therapy can be required.
People can experience referred pain, also known as discomfort or sensitivity in teeth other than the one that has the tooth fillings. This soreness could not be coming from a tooth problem. Only other teeth are receiving the “pain signals” that the filled tooth is emitting. This soreness should go away on its own within one to two weeks.
The “toothache” response may indicate that this tissue is no longer healthy. If so, root canal therapy can be required.
People can experience referred pain, also known as discomfort or sensitivity in teeth other than the one that has the filling. This soreness could not be coming from a tooth problem. Only other teeth are receiving the “pain signals” that the filled tooth is emitting. This soreness should go away on its own within one to two weeks.
There might not be enough tooth structure left to support a new filling if the existing filling is massive or the recurring decay is severe. In some situations, your dentist might have to use a crown in place of the filling.
Inadequate cavity preparation, contamination before the filling is put in, or a fractured filling from a bite or chewing trauma can all cause new fillings to fall out. More often than not, decay or fracture of the surviving tooth will cause older restorations to be lost.