Pacific Dental Care – Dental Fillings.
Offices in Seattle (Ballard) and Issaquah
Old Silver Filling
Tooth Colored Filling
From the Academy of General Dentistry:
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FOR THE DENTAL PATIENT…
When a filling needs to be replaced
A dental filling (also called a “dental restoration”) is intended to replace tooth structure lost to decay. Dental fillings may last many years; however, eventually all fillings need to be replaced. Constant assault from eating and drinking, or stress from clenching or grinding, eventually may cause a dental filling to fail.
Bacteria cause tooth decay. Fillings that have worn away, chipped, cracked or fallen out may leave gaps between the tooth and the filling that can provide an entry point for bacteria. Bacteria are abundant in the mouth and are commonly found in saliva and in dental plaque (a thin film that forms on teeth and gums). If the seal between the tooth and the filling breaks down, food particles and decay-causing bacteria can work their way between the worm filling and the tooth. These bacteria cannot be removed easily with a toothbrush or other means, and decay may develop along the edge of the filling or underneath it. Decay that is undiagnosed and untreated can progress to infect the dental pulp (which contains the tooth’s nerve and blood supply), which often results in the need for root canal (endodontic) treatment or, possibly, loss of the tooth.
Regular dental examinations are important because problems with existing fillings generally can be detected in the early stage. Although you may not be able to tell that your filling is worn, your dentist can identify any weaknesses in it during a regular checkup. During the examination, the dentist determines if the existing fillings are intact or if any have cracked or worn away. He or she uses an instrument will help your dentist determine if the dental filling is sealed to the tooth, or if it is sufficiently worn and needs replacement. Dental radiographs (“X-rays”) may be taken to help detect decay under existing dental fillings or between teeth, neither of which can be seen simply by looking at the tooth. If the dentist finds evidence that a filling has failed or detects decay on the radiograph, the dental filling should be replaced promptly. Don’t wait until the tooth hurts or a crack appears in the filling of the tooth. Early detection and treatment can minimize the need for extensive and costly procedures.
CHOICES FOR NEW FILLINGS
Advances in dental materials and techniques offer new ways to create more pleasing, natural looking smiles. Researchers are continuing their often decades-long work in developing materials, such as ceramic and plastic compounds, that mimic the appearance of natural teeth. There are several types of tooth-colored materials that can be used to repair damaged or decayed teeth.
Several factors influence the performance, durability, longevity and expense of dental fillings. These factors include the components in the fillings material; where and how the filling is placed; the chewing load that the tooth must bear; and the length and number of visits needed to prepare and adjust the restored tooth.
Amalgam. Amalgam is composed of a mixture of silver, copper, tin and mercury, all of which combine to form a strong and stable filling material. It is durable, easy to use, highly resistant to wear and relatively inexpensive compared with other materials.
Composite. Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide durability and resistance to fracture in small-to-mid-sized restorations that need to withstand moderate chewing pressure.
Glass ionomers. Glass ionomers are tooth colored materials made of a mixture of fine fluoride containing glass powder and organic acid that forms a solid restoration able to release fluoride.
TALK TO YOUR DENTIST
The ultimate decision about what to use is best determined by the patient in consultation with the dentist. Before your treatment begins, discuss the options.
Prepared by the ADA Division of Communications, in cooperation with The Journal of the American Dental Association. Unlike other portions of JADA, this page may be clipped and copied as a handout for patients, without first obtaining reprint permission from the ADA Publishing Division. Any other use, copying or distribution, whether in printed or electronic form, is strictly prohibited without prior written consent of the ADA Publishing Division.
“For the Dental patient” provides general information on dental treatments (and dental careers) to dental patients. It is designed to prompt discussion between dentist and patient about treatment options and does not substitute for the dentist’s professional assessment based on the individual patient’s needs and desires.
- What is a Composite resin (white filling)?
- How is a composite placed?
- How long does It take to place a composite?
- What is the cost?
- What are the advantages of composite?
- How long will a composite last?
What is a Composite resin (white filling)?
A composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide). Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed in the back teeth as well. Composites -are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.
How is a composite placed?
Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer. When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear.
How long does It take to place a composite?
Because a composite is more difficult to place than silver fillings, it takes the dentist about 10-20 minutes longer to place. Placement time depends on the size and location of the cavity.
What is the cost?
Prices vary, but composites average about one-and-a-half to two times the price of a silver filling. Most dental insurance plans comer the cost of the composite up to the price of a silver filling, with the patient paying the difference. As composites continue to improve, insurance companies are more the cost of composites
What are the advantages of composite?
Esthetics are the main advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.
Along with the higher cost and the extra placement time, the patient can experience post-operative sensitivity. Also, the shade of the composite can change slightly if the patient drinks tea, coffee or other staining foods. The dentist can put a clear plastic coating over the composite to prevent the color from changing if a patient is particularly concerned about tooth color. Another drawback: composites tend to wear out sooner than silver fillings in larger cavities, al-though they hold up as well in small cavities.
How long will a composite last?
Studies have shown that composites last 7-10 years, which is comparable to silver fillings except in very large restorations, where silver fillings last much longer than composites.
AGD Vice President E. “Mac” Edington, DDS “Aesthetic Guidelines for Posterior composite Restorations,” by Paul R Chalifoux, DDS The Aesthetic Chronicle 1996; “Posterior Restorations Change, Challenge and controversy,” Shane N White, BdentSc, MS, MA, California Dental Journal, September, 1996.