Definition & Overview

A tooth filling is a procedure wherein the damaged and decayed part of a tooth is removed and the area is filled with a replacement material to protect against further damage and to restore the tooth’s appearance and function. The replacement material, which is called the filling, can be made out of gold, silver amalgam, composite resin, glass ionomer, or porcelain. Each type of material has its own set of advantages and disadvantages, which have to be weighed along with the patient’s specific considerations, to determine the most appropriate material to be used.

Who Should Undergo & Expected Results

Tooth fillings are used to fill the space in a tooth once the decayed or damaged part has been removed. This treatment is most commonly used to treat cavities, but it is sometimes used to repair cracked and broken teeth. Patients have various options when it comes to materials to be used, which include the following:

  • Cast gold fillings are known for their durability and strength. These can last up to 15 years or even longer due to their natural resistance to corrosion. On the other hand, they are very expensive, needs a minimum of two dental visits to be completely placed, and sometimes causes galvanic shock during the treatment procedure.

  • Silver amalgams are preferred for their durability and affordability, however, due to their colour, they do not blend well with the natural teeth.

  • Composites are the better options for those who want more realistic-looking fillings. However, they only last up to 5 years and takes a long time and several office visits to be placed.

  • Porcelain fillings are the material of choice for many patients. Although just as expensive as gold fillings, these combine the benefits of durability and aesthetics, offering patients very natural-looking fillings that can last up to 15 years or more.

  • Glass ionomer fillings are made of acrylic, which is a glass type material most commonly used for paediatric patients and for fillings that need to be placed below the gum line. These fillings are designed to release fluoride as a way to protect the tooth from getting damaged and decayed again. However, it is not as durable as other materials used for fillings and is prone to wear and tear. Generally, glass ionomer fillings last for only five years or even less.

Aside from traditional fillings, there are also indirect and temporary fillings.

  • Indirect fillings are composite fillings that are fabricated in a dental laboratory and thus need at least two dental visits to be placed. Indirect fillings are used in cases where the remaining tooth structure is insufficient to support a filling but the damage is not significant enough to require a crown. Indirect fillings come in two types, namely inlays and onlays, both of which are far longer lasting than traditional fillings with a lifespan of up to 30 years.

  • Temporary fillings are used in cases that require several visits, such as a root canal or when the tooth’s pulp becomes irritated. Temporary fillings are placed to give the tooth and gums enough time to heal or the nerves to settle down before the permanent filling is placed. If a temporary filling is not used, there is a risk that the exposed tooth will become infected during the waiting period.

How Does the Procedure Work?

If you are going to get a tooth filling, it helps to know what you should expect during the procedure. The treatment begins with the administration of a local anesthetic, which effectively numbs the area around the affected tooth. The dentist will then use a drill, laser, or air abrasion instrument, depending on equipment availability and location of the decay, to gradually and carefully remove the decayed part of the tooth. After ensuring that all decayed parts have been removed, the dentist will start preparing the space so the filling can be placed. This entails removing all debris and bacteria from the area.

In some cases, the decayed part may reach near the root of the tooth, which can cause some sensitivity due to the close proximity to the nerves. If this is the case, the dentist may put a glass ionomer or composite resin liner, which purpose is to keep the nerve protected throughout the procedure. Once this is done, the filling can finally be placed and the tooth will then be polished.

However, some specific materials used for fillings may require additional work. For example, fillings that are tooth-coloured, such as porcelain ones, have to be applied in layers, with every layer ‘cured’ or hardened by a special light beam. Once the material is in place, the dentist will proceed to shaping it to achieve the desired result.

Possible Complications and Risks

There is a very small risk of complications in the placement of tooth fillings, except for silver amalgam fillings. Silver amalgam fillings have long been the subject of concern due to the risk of allergic reactions to the mercury content of the amalgam material. Mercury has been linked to a number of diseases such as Alzheimer’s and multiple sclerosis. However, dental professionals state that once the amalgam is mixed with silver, copper, tin, or zinc, the result is a stable alloy that have been in use to make fillings for over a hundred years. Although the risks are not scientifically proven, the FDA has warned against the potential dangers of mercury particularly to pregnant women, persons with existing health conditions, and individuals with naturally higher levels of mercury in their systems. These risks, however, can easily be avoided by discussing other options with dental care providers and by opting to use other tooth filling materials.

There are also some warning signs to watch out for after getting a tooth filling placed. Although it is normal to feel some pain and sensitivity after the procedure, if these symptoms persist longer than two to four weeks, it would be best to consult your dentist.

References:

  • "FDA: Possible Risk From Dental Fillings."
  • American Dental Association: "Dental Filling Options."
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