Fillings are materials used to restore a tooth that has lost its structure. There are three situations where a filling is used:
- Tooth caries or decay
This is damage to tooth caused by bacteria in dental plaque turning sugars into acid. This acid combined with the acid in foods and drinks causes the enamel and dentine to degrade. Eventually, this leads to a hole or cavity in the tooth (alongside gum disease). If left untreated, the tooth can die, and a dental abscess can form. The longer a patient leaves this problem, the more difficult and costly the treatment will be.
- Tooth fracture caused by trauma:
A filling can be placed to restore the shape, integrity, and function of a broken tooth. Sometimes, if the fractured portion is too big, then an inlay, onlay, or a crown is advisable.
- Tooth wear:
Where the tooth loses its protective enamel cover. The main reasons are:
- Harsh teeth brushing: This occurs normally around the neck of the teeth and can weaken the tooth or lead to sensitivity as the underlying dentine layer which has nerve endings in them is exposed. A white filling can rebuild the enamel and protect the tooth from further wear and improve the sensitivity as well as the appearance of the tooth.
- Tooth wear through grinding teeth together: In some cases, fillings, crowns, onlays and veneers can be used. In milder cases, a bite guard (night guard) is advisable to protect against further damage from grinding. This can be worn at night or when necessary. The tooth surface affected is normally the top surface.
- Tooth wear due to acid erosion: excessive and frequent intake of food and drinks that are acidic leads to accelerated tooth wear. The outer enamel layer or dentine will erode. White fillings, veneers and crowns can be used to restore the tooth especially in front teeth.
Types of Fillings:
- Composite resin (white filling): These are especially suitable for restoring the front teeth, but modern composite resins can also be used in the back. It can be placed directly in the tooth or painted over the tooth as a veneer.Patients often prefer these as restorations as they are more aesthetically pleasing. They are slightly more expensive than amalgam metal fillings but cheaper than crowns and inlays. In certain situations, leakage can occur leading to decay around the filling, so regular check-ups are necessary.
- Amalgam filling: this is a mixture of different alloys containing mercury. However, the mercury forms a stable structure with the other alloys and is considered safe by public health bodies. Amalgam fillings are cheaper and can be more durable but may be less aesthetically pleasing to some.
- Ceramic restorations: Unlike the previous two, these are not placed directly on the tooth. They are made in the laboratory and cemented into place using a permanent dental cement. They are more expensive but are more aesthetically pleasing and stronger than composite white fillings.
- Gold restorations: Like the ceramic ones, these are placed indirectly. They are more expensive than direct fillings like amalgam or composite resins. However, they are stronger, more durable, and better suited for back teeth where aesthetics is not a deciding factor.
Your dentist will discuss the advantages and disadvantages of the treatment in order to help you make an informed decision