Tooth decay is one of the most common reasons for having a filling.
Filling (also known as restoration), if done at an earlier stage of tooth decay can prevent decay from affecting the nerve. This reduces sensitivity to cold, sweet or sour things and improves the aesthetics of your teeth. Fillings also potentially reduce any worsening of cracked, fractured or worn down teeth.
A variety of dental filling materials are available. Different restorative materials are chosen for the following reasons:
Most fillings can be completed in a single visit to the dentist. Any decay is removed and a filling material is applied to the tooth. Nowadays, we commonly use composite resin or GIC material, also called ‘white fillings’, for direct fillings. Direct fillings do require replacement from time to time and more frequently than indirect fillings.
When you have larger areas of decay, indirect filling is the preferred choice of filling. This is because the indirect filling material can withstand heavier chewing forces and replacement of indirect filling is less frequent.
Indirect filling/restoration can be an inlay or onlay. They are customised fillings prepared outside your mouth, in a laboratory environment. For that reason, indirect filling treatment usually needs to be done across two appointments, about two weeks apart. Onlays cover the chewing surface involving one or more tips of the tooth while inlays lie within the tips of the tooth. Porcelain, composite resin and gold are often used for indirect restorative materials.
At Dentist Mandy, we are dedicated in discussing all options with you in order to choose the most suitable filling material to match your needs and expectations.
Composite resin fillings provide excellent aesthetics as they come in a range of shades to replicate the precise colour of your teeth.
Unlike metal-based fillings, composite fillings bond directly to the remaining parts of the tooth so only decayed portions need to be removed, maximising the preservation of natural tooth structure. This stabilises and strengthens your restored teeth and mimics how the crowns of natural teeth flex under biting forces. The old “stronger and stiffer is better” restorative concepts (where tough materials were used) contributed to further fractures, fatigue, decay or cracking in the teeth as the tough materials did not yield as well as composite filling materials.
Glass ionomer fillings store and release small amounts of fluoride over time and can act as a preventive measure or treatment against tooth decay. However, unlike composite resin, ionomers do not have as wide a wide range of colours to choose from, and are weaker than composite fillings.
Glass ionomers can be used as permanent fillings, temporary fillings, or as a base layer for composite resin filling when the cavity is deep. It is also useful for children as children often have small mouths and have short attention spans making the more comprehensive preparations needed for composite fillings more difficult.
Both composite or glass ionomer fillings are firmly set by a dental curing light. You are ready to eat and chew from the moment you walk out of the clinic. However, care should always be taken with harder foods as these materials are not as strong as natural teeth.
You may experience either reversible or irreversible tooth decay if decay occurs very close to the nerve and the filling is very deep. If the tooth is irreversibly damaged, the nerve will die off even if a filling is placed, requiring root canal or extraction.
Inlays and onlays are indirect restoration methods (made outside of the mouth) and are more effective long-term solutions for large areas of decay when compared to direct fillings. An inlay is where the restoration is made inside the tooth and an onlay is made on top of the tooth replacing the cusps (or points) of the tooth.
Porcelain and ceramic inlays and onlays are the most commonly used indirect filling materials and provide very natural results in mimicking the original tooth and biting surface. They are less prone to stains and discolouration than composite materials. They increase the strength of the tooth as most of the remaining natural tooth is retained. Porcelain and ceramic are extremely durable and can resist the pressure of grinding or bruxism. As they are customised, decay is less likely, as a good seal can be achieved between the remaining tooth and the filling material.
However, indirect fillings are completed in 2 visits. In the first appointment, a customised impression of the tooth is made. The impression is then sent to a laboratory and is made by a dental technician. As we need multiple appointments, more material and labour from a laboratory, indirect fillings are considerably more expensive than direct fillings.
During the first appointment, the tooth cavity will be prepared and impressions of the teeth will be taken. A temporary indirect filling will be made to keep the cavity clean and prevent sensitivity whilst waiting for the next appointment.
During the second appointment, the temporary filling will be removed and the teeth will be cleaned and dried. The inlay (or onlay) will then be applied. The fit and bite will be examined and can be adjusted accordingly.
After the first visit, when the temporary filling is inserted, a diet consisting of softer foods is advised as the temporary filling is weaker. After the final inlay or onlay is placed, you are then able to eat and chew as per normal.
Always remember that as with all dental treatments, how long your indirect filling will last also depends on good daily oral hygiene (by brushing and flossing regularly) together with frequent dental visits to prevent tooth decay from occurring again.
At Dentist Mandy, we are committed to identifying your oral problems at the outset so we can ensure a sustainable dental plan for a lifetime. Contact us today to discover which filling is the most beneficial for your optimal oral health.