Dental Restoration or Tooth Fillings
A dental filling is a type of restorative dentistry treatment used to repair minimal tooth fractures, tooth decay or
otherwise damaged surfaces of the teeth.The main cause why dental fillings are advised is due to the presence of
dental cavities. Dental cavities are a normal occurrence and can affect any one at any age. Enamel loss is a common
component of tooth decay, and may result in tooth sensitivity. In many cases, tooth sensitivity caused by enamel loss
will be significantly improved or completely eliminated once an appropriate dental filling material is placed.
To treat a cavity or teeth decay your dentist will remove the decayed portion of the tooth and then "fill" the area on the
tooth where the decayed material once lived.
Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse such as from
nail-biting or tooth grinding.
Who are all in need of Dental Fillings?
Cavities in the teeth may cause teeth pain, gives discomfort, infection, difficulty chewing, difficulty talking, and
halitosis. When these occur, your dentist might recommend dental fillings as an effective healthcare procedure to
prevent future symptoms. The probable reasons of dental cavities are insufficient brushing; poor dental hygiene, caustic
foods, and tobacco use are the most popular causes of cavities and tooth decay which can only be repaired with the help
of dental fillings.
What Steps Are Involved in Tooth Filling?
Tooth Feeling involve several steps:
Steps f, g and h are specific for tooth-colored fillings.
- A local anesthetic will be applied to numb the area around the tooth to be filled by your dentist.
- Next, a drill, air abrasion instrument, or laser will be used to remove the decayed area. The choice of instrument
depends on the individual dentist's comfort level, training, and investment in the particular piece of equipment as well
as location and extent of the decay.
- To determine whether all the decay has been removed your dentist will probe or test the area during the decay
- Next your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris once the decay
has been removed. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite
resin, or other material to protect the nerve.
- After the filling is in, your dentist will finish and polish it.
- The tooth-colored material is applied in layers on the teeth after your dentist has removed the decay and cleaned
- Next, a special light that "cures" or hardens each layer is applied.
- After that your dentist will shape the composite material to the desired result, trim off any excess material, and
polish the final restoration once the multilayering process is completed .
What are types of Tooth Fillings?
Dental Filling fall in two catagories base on the method used to place them. They are Direct Restorations
and Inderect Restorations . Direct restorations are feelings are placed immidiately in to a prepared
cavity in a single visit.They include dental amalgam,glass ionomers, resin ionomers and most composite(resin)
fillinfs.The dentist prepares the tooth,places the filling and adjust it during one appointment.
Indirect Restoration include inlays,onlays,veneers,crowns, and bridges fabricated with gold,ceramics or composites.
They are made in a dental laboratory and require two visits before being placed. Indirect fillings are considered when
not enough tooth structure remains to support a filling but the tooth is not so severely damaged that it needs a
What Types of Filling Materials Are Available?
Now a days, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam
(which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic and glass materials called
composite resin fillings. The location and extent of the decay, cost of filling material, patients' insurance coverage, and
your dentist's recommendation determines the type of filling that will best for you.
Cast Gold Fillings
Advantages of cast gold fillings:
1. Durability : Lasts at least 10 to 15 years.
2. Strength : It withstand chewing forces.
3. Aesthetics: Some patients find gold more attractive than silver, amalgam fillings.
Disadvantages of cast gold fillings:
1. Expense : It is more than other materials. Ten times higher than cost of amalgam filings.
2. Additional office visits : Atleast two office visits may be required.
3. Galvanic shock : A sharp pain due to a gold filling placed immediately next to a silver, amalgam filling can cause
a sharp pain (galvanic shock) to occur due to the interaction between the metals and saliva.However this is in some
4. Aesthetics:Some patients may not like any "colored" fillings
Silver Fillings (Amalgams)
Advantages of silver fillings:
1. Durability : Least 10 to 15 years and usually outlasts composite fillings.
2. Strength : It withstand chewing forces.
3. Expense : It is less expensive when compared to composite fillings.
Disadvantages of silver fillings:
1. Poor aesthetics : It don't match the color of your natural teeth. It can create a grayish hue to the surrounding
2. Destruction to tooth structure : Parts of the healthy tooth must often be removed to make a space to hold the
3. Cracks and fractures : In comparison with other filling materials silver fillings may experience a wider degree of
expansion and contraction and lead to a higher incidence of cracks and fractures.
4. Allergic reactions : Approximately 1%, are allergic to the mercury present in amalgam restorations.
Advantages of composites:
1. Aesthetics : The shade or color of the composite fillings can be closely matched to the color of existing teeth.
2. Bonding to tooth structure : Fillings composite are chemically bonded to tooth structure thus providing further
support to the tooth.
3. Versatility : Composite fillings can also be used to repair chipped, broken, or worn teeth in addition to use as a
filling material for decay.
4. Tooth-sparing preparation : While removing decay and preparing for the filling, less tooth structure needs to be
removed compared with amalgams.
Disadvantages of composites:
1. Lack of durability : Last at least 5 years compared with at least 10 to 15 for amalgams.
2. Additional visits : More than one office visit may be required, if composites are used for inlays or onlays.
3. Chipping : Composite materials can chip off the tooth depending on location of the teeth.
5. Expense : Composite fillings can cost up to twice the cost of amalgams.
In addition to tooth-colored, composite resin fillings, two other tooth-colored fillings exist .They are ceramics and glass
All ceramic materials include porcetain, glass like fillings and crowns. They are used in inlays,
onlays, crowns and cosmetic veneers. Porcetain fues to metal increases the durablity due to the metal substructure.
But it requires more tooth removal for the substructure and in rare case a localized allergic reaction may occur.This
material generally lasts more than 15 years and can cost as much as gold.
Glass Ionomer :
Glass Ionomers are tooth colored materials made of a mixtures of acrylic acide with fine
glass powders that are used to fill cavities, particularly those on the roots surface of teeth. They are primarily used for
small fillings in areas that need not withstand heavy chewing pressure. glass ionomers also are used to cement dental
crowns. However, this material is weaker than composite resin and is more susceptible to wear and prone to fracture.
Glass ionomer generally lasts 5 years or less with costs comparable to composite resin.
What are the types of Indirect Fillings?
There are two main types of indirect fillings - inlays and onlays.
Inlays are similar to fillings but the entire work lies within the cusps (bumps) on the chewing surface of the
Onlays are more extensive than inlays, covering one or more cusps. Onlays are sometimes called partial
Inlays and onlays are more durable than traditional fillings and can last up to 30 years. They can be
made of tooth-colored composite resin, porcelain, or gold. Inlays and onlays weaken the tooth structure, but do so to a
much lower extent than traditional fillings.
How much Dental Fillings may cost?
The cost varies depending on the number of teeth that require fillings,the type of filling material being used,the
procedure used and the area of the country you live.
Mostly dental insurance plans cover the cost of the composites up to the price of the silver filling, then the patient
must pay the difference.
How to take care for the Teeth with Fillings?
To maintain your fillings:
- You should follow good oral hygiene practices. Brushing with a fluoride toothpaste, and flossing at least once
- Visiting your dentist regularly for cleanings.
- Sometimes filling might be cracked or is "leaking" or if your tooth is extremely sensitive, if you feel a sharp edge,
or if a piece of the filling is missing, call your dentist for an appointment.
What Problems you might face with Dental Fillings?
- Tooth Pain and Sensitivity : Usually, the sensitivity resolves on its own within a few weeks.Contact your dentist if
the sensitivity does not subside within 2 to 4 weeks or if your tooth is extremely sensitive. Pain around the fillings can
also occur. If you experience pain when you bite, the filling is interfering with your bite. You will need to return to your
dentist and have the filling reshaped.
- Filling Allergies : Allergic reactions to silver fillings are rare. Mercury or one of the metals used in an amalgam
restoration might be responsible these allergiese. Symptoms of amalgam allergy include skin rashes and itching.
Patients who suffer amalgam allergies typically have a medical or family history of allergies to metals. Once an
allergy is confirmed, another restorative material can be used.
- Deteriorating Fillings : Constant pressure from chewing, grinding, or clenching can cause dental fillings to wear
away, chip, or crack. Although you may not be able to notice that your filling is wearing down, your dentist can
identify weaknesses in your restorations during a regular check-up.
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