Being told that you need a filling is something most people will hear at least once during their lifetime. Tooth decay is still very common and even patients who brush regularly and visit the dentist regularly can occasionally develop a cavity. The good news is that repairing a small area of decay is usually straightforward. Once the decayed portion of the tooth has been removed, the space is simply restored with a filling material so the tooth can function normally again.
What many patients do not realise is that there is more than one type of filling available. Dentistry has changed quite a lot over the years. In the past the standard option was usually a metal amalgam filling, but today dentists can choose from several other different materials. Each one has its own advantages, and each is better suited to certain situations.
When discussing treatment with patients at the Smile Dental Practice, the aim is to explain these options clearly so that our patients can understand why one type of filling may be recommended rather than another.
Composite fillings are now used quite frequently, particularly when the tooth is visible when smiling or speaking. This material is tooth coloured, which means it can be matched closely to the natural shade of the surrounding tooth enamel.
The cosmetic advantage is the main reason many patients prefer composite. Once the filling has been shaped and polished it tends to blend in well with the rest of the tooth, so it is usually difficult to see where the restoration begins and ends.
Composite fillings are placed directly into the prepared cavity. Our dentists build the filling up gradually in thin layers, using a curing light to harden each stage. This method allows the material to bond to the tooth surface, which helps keep the restoration secure.
Composite is strong enough for most everyday situations, although it may not always be the best choice for very large cavities in the back teeth where biting pressure is greatest. Even so, for small and medium-sized restorations it is often an excellent option.
Amalgam fillings are the traditional silver coloured fillings that many people will remember from years ago. They have been used in dentistry for well over a century and have built up a reputation for reliability and strength.
One reason dentists used amalgam so widely in the past is that it copes well with the forces created when chewing food. Back teeth, particularly molars, experience significant pressure during normal eating. Amalgam has historically performed very well in those areas. Another advantage is that the material is relatively quick to place. This made it a practical choice in many clinical situations.
The most obvious drawback is appearance. Amalgam is metallic in colour and does not blend with natural teeth. For that reason many patients today prefer tooth coloured fillings when they are available.
Environmental regulations within the UK and Europe are also gradually reducing the routine use of amalgam in dentistry. As a result, dentists are increasingly using other materials instead.
A brief mention only for GI fillings. These are very unlikely to be used where a cavity has formed as it is a weak material and wouldn’t take any force being applied to it. It can be used on non biting surfaces though such as at the neck of the tooth where the roots have become exposed to protect the tooth from sensitivity etc.
For larger areas of damage, your Catford dentists may occasionally recommend a porcelain restoration, known as an inlay or onlay, rather than a standard filling. Porcelain is strong, stain resistant and can be matched to the shade of the patient’s own teeth.
Gold is rarely used these days, largely due to the cost. Patients that do choose gold fillings have the benefit of this durable material that provides strength and longevity. As you would expect, gold fillings are very visible which is one of the reasons why some people who chose to have them do so, as a ‘fashion statement’.
Like porcelain restorations, gold fillings are normally made in a laboratory before being cemented into place at a later visit. When fitted well they can last for many years.
There are a number of things to consider when selecting the appropriate filling material to use. Position, extent of damage, type of teeth etc all have to be taken into account which is where the experience of our Catford dentists comes into its own.
Appearance is another point many patients think about, particularly if the tooth is near the front of the mouth. Tooth coloured fillings are usually preferred in these areas. The fact is that you are not limited to the dark coloured amalgam fillings anymore and we have a wide range of materials that can be used at the Smile Dental Practice. To discuss this with us or to book an appointment with a dentist, please call our practice on 020 8314 5066.
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