A filling is a way to restore a tooth damaged by decay back to its normal function and shape. If you have a tooth that requires a filling, the dentist will first remove the decayed tooth material, clean the affected area, and then fill the cleaned out cavity with a filling material. A filling also helps prevent further decay by closing off any cracks or spaces where bacteria can enter.
There are a variety of filling materials available including gold, silver, plastic and porcelain. The dentist will work with you to determine which material is best for you, depending on the extent of repair, where in your mouth the filling is needed, and cost. Each of the filling materials is briefly explained below:
- Composite (plastic) resins are custom made to the exact color of your natural teeth, creating a more natural appearance. Composite fillings are kinder to the teeth and have a lower chance of causing major problems over time than silver fillings. Composite fillings are bonded to the tooth for strength which also seals out bacteria. However, there are limitations to how large the composite filling can be and retain its strength.
- Porcelain fillings are called inlays or onlays and are custom created in house with our digital Cerec system and bonded to the tooth. They can be matched to the color of the tooth, resist staining, and because they use the same system as our crowns, they are about the same cost as a crown. A porcelain restoration generally covers most of the tooth and are used when the tooth needs a restoration that is too large for a composite filling but doesn’t require a crown yet.
- Amalgam (silver) fillings have been around since the middle ages. Although they are the cheapest option to place, they open the patient up to experiencing major complications with the tooth later. Silver fillings are not glued or bonded to the tooth which allows saliva and bacteria to leak between the filling and the tooth immediately after placement which results in a new cavity forming in that space at a later time. Silver fillings are also much harder than natural tooth structure and expands and contracts with temperature changes at a different rate than the tooth. This combination cracks all teeth over time. The amount of time it takes the tooth to crack is different for every tooth, but it will happen. At that point, the tooth may need a crown to fix which is much more expensive than if a composite filling had been placed initially. For these reasons, Dr. Knable is against the use of amalgam fillings and removes them every day and replaces them with a more compatible material. There are many studies regarding the mercury that is used to make the silver filling. Although there may be evidence to support a link between that mercury and systemic mercury discovered in certain individuals, Dr. Knable is more focused on the damage to each tooth from the problems listed above.