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Dental Fillings

If you have a cavity in your tooth, you need a filling. How do cavities form? Cavities result from tooth decay. Tooth decay starts when sugars and starches from your food and drink activate bacteria in your mouth. The activated bacteria put out an acid that eats away at your tooth enamel causing a cavity.

If you have tooth decay, it is best to find it when it is smaller so that a filling may be done. You may not even realize you have any decay that needs treatment! By the time a cavity hurts, it’s often too late for a filling! If it’s left untreated, tooth decay continues to grow larger. Once it grows too large, it reaches the dental pulp at the center of your tooth and a simple filling is no longer an option. More involved (and expensive) treatments become necessary. This is one reason why seeing your dentist on a regular basis is so important. You don’t want to wait until the decay forces you into other choices.

There are two types of fillings that are commonly done in the dental office. Amalgam fillings are silver or metal in color and composite resin fillings are tooth colored. These two materials are the most common because they are able to be completed in one visit to the dental office and do not contain expensive materials. The dental laboratory can also make fillings from gold or porcelain and there are some CAD/CAM machines that create lab-type fillings in dental offices.

So which of these filling types is the best for you? Let’s take a closer look at them to find out.

Amalgam fillings, also called silver fillings or metal fillings, have been in use for many years. Because of this, dentists know they hold up well in your mouth with normal chewing function. Like any fillings, amalgams occasionally need to be replaced. The average time before replacement is 5 to 10 years for this type of filling. In recent years, amalgam has fallen out of favor with patients because it is not cosmetic and because it contains mercury. The issue of mercury seems to surface every few years. The American Dental Association (ADA) has reviewed data on amalgams at various times and concluded that it is safe, but they are recommending decreasing its use. Some dental offices have stopped offering this type of filling for a variety of reasons.

Composite resin fillings are also called white fillings, bonded fillings, and tooth colored fillings. They are routinely used on front teeth. Patient demand for an inexpensive cosmetic option fueled their use in back teeth. Composite fillings require following the manufacturer’s instructions to bond them to your tooth. Typically, this consists of an etching gel that is placed, then rinsed off; a bonding agent that is placed then dried and light cured, and then placing the resin filling material in layers—all while keeping the tooth dry and uncontaminated. Composite fillings do not hold up quite as well as the amalgam fillings and need to be replaced every 3 to 7 years on average. This is partly due to heavier chewing on your back teeth causing the filling material to wear down more quickly and partly because your tooth surface must be kept very dry during the filling process so that the material bonds to your tooth—something that’s harder to do as we get farther back in your mouth.

Some dental offices have special machines that use computers to design and create tooth colored filling in the dental office while you wait. These fillings are similar to ones the dental lab makes but it is not yet clear if the material used will last as long as the gold or porcelain used by the dental lab. This type of filling blends the advantages of one-visit cosmetic fillings and precise construction with the disadvantages of having a longer appointment including a waiting period while the machine carves the filling and being more expensive than the other one-visit filling types.

The dental lab can make fillings from gold or tooth colored porcelain. Both of these materials are quite strong and can last for many years after being cemented into your tooth. But with gold prices being high, they are much more expensive than the other types of fillings available to you. They also require at least two visits to the dental office—one to prepare your tooth and take an impression to send to the lab and a second to cement the filling in your mouth.

Nobody wants to hear that they need a filling, but now you can make educated decisions on what type of filling may be best for you…and how to help avoid them entirely. Talk to your dentist or call me at 440-960-1940 if you would like more information. You can also reach me through the contact form on my website at www.drjrobb.com.

*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.