Dental Treatments - Filings

Amalgam

You might think of amalgam fillings for teeth as a classic option. According to the Food and Drug Administration (FDA), dentists have been using this type of filling for more than 150 years. As the name suggests, amalgam fillings are made up of a mixture of metals. They typically contain about 50 percent mercury, along with tin, copper, silver or zinc. Compared to other types, amalgam fillings have a few things going for them: They are the least pricey option, and they’re also very strong and long-lasting.
Amalgam fillings aren’t without drawbacks, though. They’re silver in color to start and tend to become darker with time, meaning they are a fairly conspicuous item when you open your mouth. And although the FDA has determined that the level of mercury in the filling is safe for people over the age of six, you might prefer not to have a filling made from this material.
• Made of: A mixture of silver, tin, zinc, copper and mercury. Mercury is nearly 50% of the mixture.
• Types: Traditional (non-bonded)
• Used for: Fillings in back teeth
• Lasts: At least 10 years, usually longer
• Costs: The least expensive type of restorative material, available on the NHS ( band 2 charge)
Advantages
• Amalgam fillings are strong. They can withstand the forces of chewing.
• They are less costly than the alternatives.
• Amalgam fillings can be completed in one dental visit.
• They are less sensitive to moisture during the filling process than composite resin.
Disadvantages
• Amalgam doesn’t match the color of your teeth.
• Amalgam fillings can corrode or tarnish over time. This can cause discoloration where the filling meets the tooth.
• A traditional (non-bonded) amalgam filling does not bond (hold together) with your tooth.
• The cavity preparation (the “pocket” in your tooth) developed by your dentist requires undercuts or ledges to keep the filling in place. Your dentist may have to remove more of the tooth to create a secure pocket.
Some people may be allergic to mercury or be concerned about its effects. Research shows that the amount of mercury exposure from fillings is similar to what people get from other sources in the environment

Composite

A composite tooth filling, typically made of powdered glass and acrylic resin, offers a few advantages over an amalgam filling. For one, the filling can be shaded to match the color of a person’s existing teeth, making it much less visible. As more people want natural-looking smiles, composite fillings have become increasingly popular.
Nonetheless, this type of filling isn’t always the right pick. The material it’s made from is less durable than a mix of metals, such as in amalgam, according to Thomas P. Connelly, DDS. Therefore, the useful life of a composite filing isn’t always as long as other options. It’s perfect as a small filling, and best suited for teeth that experience a moderate amount of pressure when chewing, compared to teeth that handle the bulk of your chewing action.
• Made of: A mixture of plastic and fine glass particles.
• Types: Direct and indirect. Direct fillings are placed by your dentist using a bright blue light that hardens the soft material. For indirect fillings, your dentist prepares the tooth and takes an impression of it. A laboratory or the dentist then will make the filling from the mold. During a second visit, your dentist cements this filling into place.
• Used for: Small and large fillings, especially in front teeth or the visible parts of teeth; also for inlays
• Lasts: At least five years
• Costs: More than amalgam, available on the NHS in front teeth ( band 2 charge). For back teeth available on private basis ( ask your dentist for a quote as it will depend on the size of the restoration)

Advantages
• Your fillings or inlay will match the color of your teeth.
• A filling can be completed in one dental visit. An inlay may require two visits.
• Composite fillings can bond directly to the tooth. This makes the tooth stronger than it would be with an amalgam filling.
• Less drilling is involved than with amalgam fillings. That’s because your dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth.
• Indirect composite fillings and inlays are heat-cured. This step increases their strength.
• Composite resin can be used in combination with other materials, such as glass ionomer, to provide the benefits of both materials.
Disadvantages
• Composite resins cost more than amalgam fillings.
• Although composite resins have become stronger and more resistant to wear, it’s not clear whether they last as long as amalgam fillings under the pressure of chewing.
• The composite may shrink when placed, producing gaps between the tooth and the filling. This can lead to more cavities in areas where the filling is not making good contact with your tooth. The shrinkage is reduced when your dentist places this type of filling in thin layers.
• These fillings take more time to place. That’s because they are usually placed in layers. The increased time and labor involved also contribute to the higher cost.
• Indirect fillings and inlays take at least two visits to complete if your dentist is not prepared to make the inlay while you wait. Your dentist takes impressions at the first visit and places the filling or inlay at the second visit.

Glass Ionomer

Kids get cavities, too, and need to have those cavities filled just like their parents – even if they’re on the baby teeth. Resin or glass ionomer fillings are often used on the primary teeth or to fill in small areas of decay, as they tend to be very delicate and take considerable wear and tear. When used on a permanent tooth, this type of filling is usually placed in a spot that isn’t subject to extreme pressure or chewing action.
Although you have multiple options when arranging a filling, no filling is objectively better than another. Maintain a good personal routine by brushing with Colgate® Cavity Protection toothpaste at least twice a day, flossing daily and seeing your dentist twice a year.
• Made of: Acrylic and a component of glass called fluoroaluminosilicate
• Types: In a traditional filling, the material sets without a bright light. Resin-modified or hybrid composite glass ionomer fillings are stronger than traditional ones. A bright blue light is used to set the material.
• Used for : Glass ionomer is used most commonly as cement for inlay fillings. It also is used for fillings in front teeth, or around the necks of your teeth, or in roots. As filling material, glass ionomer is typically used in people with a lot of decay in the part of the tooth that extends below the gum (root caries). It is also used for filling baby teeth and as a liner for other types of fillings.
• Lasts: Five years or more
• Costs: Comparable to composite resin , available on NHS for deciduous teeth and in some exceptional situations for permanent teeth (band 2 charge)
Advantages
• Glass ionomer matches the color of the teeth, but not always as well as composite resin. Resin-modified glass ionomer is usually a better match than traditional glass ionomer.
• Glass ionomers release fluoride, which can help protect the tooth from further decay.
• Glass ionomer restorations bond (stick) to the tooth. This helps to prevent leakage around the filling and further decay.
Disadvantages
• Traditional glass ionomer is significantly weaker than composite resin. It is much more likely to wear or fracture.
• Traditional glass ionomer does not match your tooth color as precisely as composite resin.
• A resin-modified glass ionomer filling needs to be applied in thin layers. Each layer must be cured, or hardened, with a special bright blue light. Then the next layer can be added. This makes the tooth stronger, but can lengthen the time of the dental appointment.

Please feel free to take the opportunity to ask any questions regarding the nature and purpose of crowns and/or bridge treatment.