When a “cavity” is found during your examination it will be noted in your chart and you will be shown the area(s) of concern on your digital x-ray. Additionally, we may take an intraoral photograph that can show you what we see. The next step is to determine what kind of filling is most appropriate for you. The two main kinds of fillings are direct and indirect fillings.
Direct fillings are placed into a prepared tooth immediately (after removal of the decay). The choice of filling material varies based upon location and environment in the mouth. Most commonly, a composite resin bonded filling (tooth-colored filling) material is used. This “white” filling blends to natural tooth color and is mechanical and chemically “stuck” to the tooth utilizing advanced bonding protocols. These fillings require extra steps to maintain a “dry field” meaning no spit, blood, or other fluids touch the teeth during the process. A rubber dam, cotton rolls, or other methods of isolation may be utilized to achieve the desired results. One of our favorite advances in technology is the use of our Sonicfill handpiece. The Sonicfill handpiece allows us to injection mold a standard white composite resin filling material into your tooth while in a semi-viscous state. This allows it to more readily adapt to your tooth and lessen the chances for voids in the filling. Once we deactivate the handpiece the resin material becomes sculptable and dense. There is no better way to place white fillings in the back teeth.
In high cavity risk individuals or where decay is located near the gum lines, a glass-ionomer filling may be utilized. These fillings are mechanically and chemically bonded to teeth in a similar, yet different manner. The chemical bond is weaker, but these fillings release fluoride that can be recharged with toothpaste and fluoride treatments. They have the ability to remineralize weak enamel after they are placed. Some patients have “white lines” on their teeth where cavities and acid have weakened the teeth. Those patients may be ideal candidates for a glass ionomer filling. These fillings are tooth-colored as well and blend almost as well as their resin counterparts. Dr. Reynolds utilizes these fillings when perfect isolation cannot be obtained along gumlines, in high risk patients, or as a temporary filling after a root canal. These fillings do not hold up long term to chewing forces, so they are never utilized when the cavity extends onto biting surfaces.
Amalgam fillings are an option as well. It is mostly utilized for cavities where isolation is not able to be gained. These silver/mercury based fillings were commonly placed prior to the advances of bonding and tooth-colored fillings. They remain in use today in the military, in children, and as a permanent filling after a root canal has been done through a metal crown. Their main disadvantages are color and weakening of the surrounding tooth. Commonly cracks are seen around older amalgams. As the filling leaks and decay softens the tooth, the filling becomes a strong wedge that will crack teeth. These cracks slowly grow and lead to further decay. If the crack leads decay into the center or root of a tooth, then a root canal or a crown may be needed to save that tooth.
Indirect restorations require two appointments. At the first appointment, the cavities are removed from the tooth and an impression is made of the cavity. A temporary filling will be placed in the interim while the laboratory technician makes the filling. That impression is sent to the laboratory where a technician fabricates a filling made of resin, metal, or porcelain. These indirect fillings can be inlays, onlays, or crowns based upon the way the cavities were removed and the tooth was prepared. Metal based indirect restorations can be made of numerous types of gold alloy or titanium. These metal fillings with then be luted into place. Resin and porcelain based indirect fillings are bonded into place. The advantage of these fillings is a more precise fit, leading to a more longevous restoration.
Please ask Dr. Reynolds or the Dynamic Dentistry staff if you have any questions about the type of filling that you would like to be placed. Below is a synopsis of filling types.
We rarely use amalgam (mercury filling material). However, many people still have silver/mercury fillings in their mouths from years past. These fillings are not particularly pleasing to the eye, and we know that by unavoidable design, silver/mercury fillings ultimately result in a weaker tooth structure. Porcelain inlays and onlays are tooth-colored restorations we use to create fillings that are not only beautiful (or unnoticeable) but also add strength to weakened teeth. These restorations are esthetically pleasing and very strong thanks to new bonding technologies.
Disadvantages of Silver fillings:
Silver fillings have many drawbacks. The edges of the silver filling can wear down, become weak or break. This results in the tooth not being protected and lets cavities get started once again. With age, the metal of a silver filling expands, contracts, and can split. Oftentimes, a tooth with an amalgam filling cracks overtime.
Silver fillings contain 50 percent mercury. They can corrode, leak and cause stains on your teeth and gums.
Fortunately, silver fillings can safely be replaced with Tooth-Colored Restorations.
Advantages of Tooth-Colored Restorations
There are many advantages to tooth-colored restorations. Resin and porcelain onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.
The result is a beautiful smile!
Replacing Silver Fillings with a Tooth Colored Restoration
You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.
Your First Appointment:
- The old filling is removed along with any additional decay.
- An impression is made of your teeth. A model of your teeth is made and sent to the lab.
- A temporary onlay is placed on the tooth.
At the Lab: A resin or porcelain piece is carefully placed into the model of your teeth. It is then designed to look natural.
Your Second Appointment:
- The temporary onlay is removed.
- A conditioning gel is placed on your tooth to prepare it for the new onlay.
- Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
- The tooth is then polished.
Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!