Your guide to Fillings
While, hopefully the number of fillings placed is declining there is still a need for them.
There are a wide range of materials available, each having specific merits and applications.
Fillings (or restorations) are used to fill spaces caused by:
They may also be used to:
Change the size or shape of teeth (e.g. to close a small gap between teeth)
Build up a tooth prior to placement of a crown:
Fillings are usually prepared and completed in one visit.
There are two categories of filling materials:
Metal fillings – these are only usually used for back (premolar/molar) teeth.
Tooth Coloured fillings – these are used on both front and back teeth.
Metal Fillings
There are two types of metal filling material:
1) Amalgam fillings
These are made from a mixture of metals (alloy) and are silver coloured but may
darken with age. These are the most widely used fillings for back teeth in the U.K.
Amalgam fillings are reasonably strong, fairly durable and often easier to place than tooth coloured fillings.
Unfortunately, they require extensive tooth preparation, thereby weakening the remaining tooth and they can be unsightly.
There have been some concerns about the incorporation of mercury in amalgam fillings over the years. However, the following statement has been issued by the The British Dental Association:
“No government or reputable scientific, medical or dental body anywhere in the world accepts, on present published evidence, that amalgam is a health hazard”.
Your dentist will be happy to discuss these issues and alternatives with you.
We use encapsulated amalgam fillings for our patients. These are the safest, strongest and most durable available and the material itself costs some ten times that of normal amalgam alloy fillings.
2) Gold fillings
These are also called inlays (see: Your guide to Inlays, Onlays and Crowns). These may be used in teeth with large cavities or where a stronger, more durable material is required.
Tooth coloured fillings
There are two types of tooth coloured filling
material and both bond (glue themselves) to
the teeth:
1) Composites
These are the most commonly used tooth coloured material.
Composites can be closely matched to the existing tooth for a natural appearance and due to minimal tooth preparation can preserve more healthy tooth. They may also strengthen the remaining tooth.
These fillings require very careful placement and tend to wear down with time and may also take up stain. However, composites can be added to or repaired thereby avoiding the need to replace the entire restoration.
They can be used in anterior (front) or posterior (back) teeth but slightly different types of composite are used for each.
Anterior composites have excellent shade matching and a highly polished finish. Posterior composites are harder and stronger than anterior composites and they are particularly suited to small and medium size cavities. For patients requiring large tooth coloured fillings, a posterior inlay, onlay or crown may be a better alternative (see: Your guide to Inlays,Onlays and Crowns).
2) Glass Ionomers
These are used on non-biting surfaces of teeth, usually around the edges near the gums, where there is abrasion, decay or sensitivity. They are also used to fill children’s baby teeth where the biting forces are less and the teeth are to be lost eventually anyway (when the adult teeth replace them).
These fillings adhere (stick) well to all areas of the tooth and like composites require minimal tooth preparation. They also release protective fluoride ions which helps to prevent further decay.
Unfortunately they do not look as good as composites and tend to wear away and discolour quite quickly.
Commonly asked questions
Q: How do I decide which filling to have?
A: Your dentist will discuss all the suitable options and help you make an informed choice.
Q: How long does a filling last?
A: This is extremely variable but factors such as the size of the filling, the strength of the bite, and the eating habits of the patient all affect longevity. Amalgam fillings statistically last longer than white fillings in back teeth.
Q: How can I ensure my filling lasts as long as possible?
A: Follow the advice given by your dentist when the filling is placed (some fillings take 24 hours to set fully).
Cleaning twice a day (using floss in addition to brushing) will help to prevent decay at the margins between the tooth and the filling. A daily fluoride mouth rinse may also be helpful (check with your dentist first though).
Watch your diet! Sugary foods are likely to result in decay; hard foods (e.g. nuts) are more likely to fracture your filling(s).
Attend for your regular recall visits so that your dentist can check your teeth, fillings and general oral health.
