Dental Fillings

You need a filling when, due to tooth decay, a cavity that can be probed with a dental explorer has been formed in the enamel. In the early stages of tooth decay, when it is still in the phase of ‘white spot’ and has not reached the dentine or formed a cavity, the dentist may not recommend a dental filling because there is still chance that the tooth can repair itself. In these cases the dentist will recommend improved oral hygiene, fluoride treatment and regular examinations to check the progress of decay. If these fail to reverse tooth decay and a cavity is formed, treatment with dental filling is required.

Tooth decay is not the only condition when a filling is needed. Dental fillings are also used to repair cracked or fractured teeth and teeth that have been worn down from erosion or tooth grinding. Tooth sensitivity caused by enamel loss (due to teeth grinding, normal wear, etc) can be treated with the placement of a dental filling. Dental fillings may also be used to make small adjustments in the occlusion of teeth to improve biting and chewing.

When a cavity is formed on the enamel, the tooth can not repair itself and a dental filling is needed as soon as possible. If the tooth is not cleared of decay and filled, the decay will continue to spread deeper in the tooth, penetrating through the enamel and the underlying dentine, making treatment more difficult and costly.

If the decay is allowed to reach the pulp, it will start destroying the nerves and blood vessels causing severe pain. An even more painful tooth abscess may develop if the infection spreads through the root canals. Root canal treatment and possibly a crown will be needed.

If the tooth has sustained severe damage and has to be extracted, you will have to replace it paying for an implant or bridge up to 10 times more than it could cost you to treat dental caries with a simple dental filling in the first stages of tooth decay.

In some cases, depending on the extent and nature of tooth decay, treatment may require additional or alternative procedures, including:

• Root Canal therapy: If the pulp of the tooth is infected or/and a tooth abscess is formed, a root canal in combination with antibiotic treatment may be necessary to eliminate the tooth infection before the tooth can be restored with a dental filling.
• Dental Crowns: If there is severe loss of the tooth’s hard tissues and there is concern about the structural integrity of the tooth, the dentist will restore the tooth using a dental crown instead of a filling. Dental crowns are more suitable than large fillings in anterior molar teeth that have to withstand larger biting forces.
• Tooth Extraction, Dental Bridges and Implants: In some cases the tooth damage is so extensive that it has to be extracted. The lost tooth can then be replaced using a dental bridge or a dental implant.

Dental fillings are direct restorations which means that they are fully made in the patient's mouth in the dental office without the intervention of a dental lab such as with crowns or inlays/onlays. The procedure of applying a dental filling is generally completed in just one or two dental visits. First the dentist removes the decayed tissues to clean the tooth and then applies the restorative material which is hardened directly on the tooth. The dentist may make minor adjustments to the shape of the filling to prevent any problems of bad bite. Finally they are smoothed and polished to complete the dental filling procedure.

There are two main types of dental fillings used to restore a decayed or damaged tooth:

Amalgam Fillings - These are the traditional silver fillings that were most often used up to some years ago. An amalgam filling contains a mixture of metals such as tin, copper, silver and mercury which are resistant to wear and relatively inexpensive. However, due to their dark color, amalgam fillings are more noticeable and they are not usually used in very visible areas, such as front teeth. Some scientists debate their safety, concerning the negative effects of mercury.

Composite Resin Fillings - Also known as ‘white fillings’, these tooth colored fillings are the most popular, providing the best aesthetic results. Composite resin fillings are made by a combination of glass/porcelain particles and acrylic resins that can match the natural color of teeth. They are not suitable for large fillings and they do not last as long as amalgam fillings.

Other alternatives:

Gold / Porcelain fillings - Contrary to standard dental fillings these are indirect restorations that have to be prepared in the lab and then placed on the tooth. Gold /porcelain fillings are referred as dental inlays and onlays.