To treat a cavity (caries) your dentist will remove the damaged part of the tooth and then fill the tooth cavity with the appropriate dental material. The same materials are also used to repair cracked or broken teeth and teeth that have been damaged by bad habits (such as nail biting).
What is the dental filling process?
First, the dentist will use a local anesthetic to numb the area around the tooth that will receive the dental filling. Next, he will use the dental wheel to remove the caries.
Your dentist will then check or examine the area to see if all of the caries has been removed. Once the caries is removed, the dentist will prepare the area for the dental filling by cleaning the cavity of bacteria.
If the caries is close to the root, your dentist may first apply a layer of ionomer or other material to protect the nerve. Generally, once the filling is complete, your dentist will finish and polish it.
What materials are used for the dental fillings?
Today there are many dental materials for fillings. These are gold, porcelain, amalgam (which consists of mercury mixed with silver, tin, zinc and copper) and materials called resins. There is also a material known as an ionomer. This material is used in ways similar to the use of composite resins.
The advantages of gold tooth filling are:
- Durability - lasts at least 10 to 15 years or more. They do not corrode
- Endurance - can withstand chewing forces
- Aesthetics - some patients find gold more pleasing to the eye than silver amalgams.
The disadvantages of gold tooth filling are:
- Costs - Casts cost more than other materials, up to 10 times the cost of silver fillings.
- Additional visits to the doctor's office - at least two visits to the doctor's office are required
- Galvanic shock - a gold tooth filling placed next to an amalgam filling can cause a sharp pain (galvanic shock). The interaction between the metals and the saliva causes an electric current. But it is a rare phenomenon.
- Aesthetics - most patients dislike metallic colored fillings and prefer fillings that match the rest of the tooth.
Black filling (Amalgam fillings)
The advantages of using black amalgam fillings are:
- Durability - seals with amalgam (black) last at least 10 to 15 years
- Endurance - can withstand chewing forces
- Cost - can be less expensive than resin
The disadvantages of using amalgam black fillings are:
- Reduced aesthetics - black amalgam fillings do not match the color of natural teeth.
- Removing a more healthy tooth - Healthy parts of the tooth often need to be removed to create a space large enough to hold the black filling.
- Discoloration - Black fillings can create a grayish tinge on the surrounding tooth surfaces.
- Cracks and fractures - although all fillings expand and contract in the presence of hot and cold liquids, which can eventually cause cracks or fractures of the tooth, amalgam - compared to other materials - can show a greater degree of expansion and shrinkage and lead to a higher incidence of cracks and fractures.
- Allergic reactions - a small percentage of people, about 1%, are allergic to the mercury present in amalgam restorations. The mercury contained in amalgam releases low levels of mercury in the form of vapor that can be inhaled and absorbed by the lungs.
Are black seals with amalgam safe?
In recent years, concerns have been raised about seals. Because these seals contain the toxic substance mercury, some people believe that they are responsible for causing several diseases, including autism, Alzheimer's disease, and multiple sclerosis. The American Dental Association (ADA), the FDA, and many public health organizations say there is no evidence that amalgam fillings are harmful to consumers.
The causes of autism, Alzheimer's disease and multiple sclerosis remain unknown. In addition, there is no reliable scientific evidence to suggest that if a person removes amalgam seals, he or she will be cured of these or other diseases.
Although amalgams contain mercury, when mixed with other metals such as silver, copper, tin and zinc, they form a stable alloy that dentists have used for more than 150 years to seal and retain hundreds of millions of teeth. In June 2008, the FDA stated that amalgam seals contain mercury, which can have neurotoxic effects on the nervous system of children and fetuses.
Pregnant women and people who may have a health condition that makes them more susceptible to mercury exposure, including those with high levels of bioactive mercury, should not shy away from seeking dental care, but should discuss options with their doctor.
White filling (composite)
The advantages of composite tooth filling are:
- Aesthetics - the color of the white fillings, can match the color of existing teeth. Composite resins are particularly suitable for use on the front teeth or visible parts of the teeth.
- Bonding to the tooth structure - white fillings with composite resins are micro-mechanically bonded to the tooth structure, providing further support.
- Flexibility - in addition to being used as a filling material, resin fillings can also be used to repair broken or worn teeth.
- Preparing to Protect Teeth - Sometimes less toothpaste needs to be removed compared to amalgam fillings when removing caries and preparing for filling.
The disadvantages of composite tooth filling are:
- Lack of durability - white resin fillings wear out sooner than amalgam seals (lasting at least five years compared to at least 10 to 15 for amalgam). In addition, they can not last as long as amalgam fillings under the pressure of chewing and especially if used for large cavities.
- Increased processing time - due to the process of applying the resin material, these fillings may take up to 20 minutes longer to complete than amalgam sealants.
- Additional visits
- Costs - White fillings can cost up to twice the cost of amalgam.
These fillings are most often made of porcelain and are more resistant to dyes than the composite resin material. This material generally lasts more than 15 years and can cost as much as gold.
The ionomer is made of acrylic and a special type of glass material. This material is most commonly used for sealing below the gum line and for filling in young children. Ionomers release fluoride, which can help protect the tooth from further decay.
However, this material is weaker than composite resin and is more prone to wear and fracture. The ionomer generally lasts five years or less at a cost comparable to the composite resin.
How should I take care of my teeth after filling?
Good oral hygiene is essential to maintain fillings - visit your dentist regularly for cleaning, brushing with fluoride toothpaste, flossing and using an antibacterial mouthwash at least once a day.
If your dentist suspects that a filling may have cracks or leaks (when the sides of the filling are not in good contact with the tooth), he or she should do an x-ray to assess the condition.
If your tooth is extremely sensitive, if you feel a sharp edge, if you notice a crack in the filling or if a piece of the filling is missing, contact your dentist for an appointment.
How much does it cost?
The cost and price for a filling depends on several factors. The three most important factors that affect the price of a tooth filling are the material that will be used, the size of the problem that exists and finally the dentist.
Are there side effects and problems?
Pain and Sensitivity
The sensitivity of the teeth after the placement of a filling is quite common. A tooth can be sensitive to pressure, air, sweet foods or temperature. Usually, the sensitivity resolves on its own within a few weeks. During this period, avoid those things that cause sensitivity.
Contact your dentist if the sensitivity does not go away within two to four weeks or if your tooth is extremely sensitive. Your dentist may recommend a desensitizing toothpaste.
Pain around the Fillings
If you feel pain when you bite, the seal may interfere with your bite. You will need to go back to your dentist and modify the filling. If you feel pain when you touch your teeth, the pain is most likely caused by touching two different metal surfaces (for example, the amalgam on a new tooth and a gold crown on another tooth it touches). This pain must resolve on its own within a short period of time.
If the caries was too deep or close to the tooth pulp, pain may occur. This toothache response may indicate that this pulp is no longer healthy. If this happens, endodontic treatment may be needed.
Sensitivity to other teeth
Sometimes people experience what is known as reported pain or tenderness in teeth other than the one that received the filling. With this particular pain, there is nothing wrong with your teeth. The sealed tooth simply transmits the pain signals it receives to other teeth. This pain should go away on its own within 1 to 2 weeks.
Constant pressure from chewing, grinding or tightening can cause tooth fillings to break, fracture or crack. Although you may not be able to see if the filling is worn, your dentist may find problems during a regular checkup.
If the seal breaks, food particles and caries-causing bacteria can cause a problem under the seal. Next, you run the risk of developing additional caries on this tooth. Caries that remains untreated can progress to infect the dental pulp.