What is a Dental Filling

If you have a cavity your, dentist will probably need to put a dental filling in your tooth. The dentist will remove the cavity(decayed)area of the tooth and replace the decayed area on the tooth with a filling. Fillings can also be used to repair cracked or broken teeth.

There are several steps involved in the filling of a tooth. The dentist will want you to be as comfortable and pain free as possible.  The area around the tooth to be worked on will be numbed, with a local anesthetic. The dentist has some choices in the next step. The decayed area will be removed with the use of either a drill, air abrasion instrument or laser. The choice of instrument will be up to your dentist.

Once the cavity has been removed the dentist will  test the area to make sure all the decay has been removed. If all the decay has been successfully removed, your tooth will be prepared for a filling. This is done by cleaning the cavity area of your tooth and making sure it is free of any bacteria or debris. If the decay is near the root, your dentist may need to do some additional work to protect the nerve. Your tooth will be finished and polished, after the filling is in and complete.

There are several choices for dental fillings. You can choose from silver amalgam, porcelain, gold or composite resin materials. The silver amalgam is a combination of mercury, silver,tin,zinc and copper. The composite is tooth colored and contains plastic and glass. The ceramics are usually made of porcelain and glass ionomer is made of  acrylic and specific type of glass material.
 
There are several factors that effect the choice of materials. You will want to consider cost and insurance coverage. Your dentist will make recommendations based on the location of the cavity and extent of the decay.
 
Gold is durable, lasting 10-15 years or longer and it doesn’t corode. It can also endure the forces of chewing. One of the disadvantages of gold, is that it is much more expensive than the other materials. It can be up to 10 times more than amalgam fillings. It will also require at lease 2 office visits to complete.

Amalgam fillings will also last 10-15 years and can withstand the forces of chewing. They are much less expensive than gold or composite fillings. The amalgam doesn’t match the tooth color and can create a grayish color in the surrounding tooth structure. More healthy parts of the tooth need to be removed to make room for the amalgam filling. Your teeth will always expand and contract as a reaction to hot and cold. These changes lead to a higher incidence of cracks and fractures in alalgam fillings, as compared to other filling materials. Approximately 1% of people find that they are are alergic to the mercury present in the amalgam fillings

Composite fillings can be closly matched to the color of your natural teeth and are a good choice for front teeth or visibil parts of teeth. The composite filling is actually chemically bonded to tooth structure and provides additional support to the tooth. In addition to use as a filling material for decay composits can also be used  to repair chipped, broken or worn teeth. In some cases, less tooth structure needs to be removed, compared with amalgams when removing decay and preparing for the filling

Composite fillings will only last about 5 years and may not perform as well as amalgams under the pressure of chewing or if used as the filling material for large cavities.  If composites are used for inlays or onlays, more than one office visit may be required. Composits also require more chair time than amalgams to place. Composit fillings, in general, can cost up to twice as much as amalgams.

Ceramics are also tooth colored fillings , are most often made of porceline and are more resistant to staining than composite. Ceramics usually last over 15 years and can cost as much as gold.

For fillings below the gum line, an acrylic material called glass isonomer is most often used. This material is not as strong as composite resin and is more susceptible to wear and prone to fracture. Glass ionomer usually lasts 5 years or less and the costs are comparable to composite.

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