dental fillings

problem: I hate my black, mercury fillings

In our practice we prefer to use white, tooth-coloured materials to fill teeth.

Fillings and restorations may be required in decayed or fractured teeth, or to replace old or worn fillings. The basic types of fillings are the silver-mercury amalgam fillings which are easy to place and are reasonably long- lasting, and composite resin fillings which are more demanding to place and are tooth-coloured.

Other types of restoration, for very large cavities, are the inlay or overlay that can be made of composite resin, cast/carved/built-up porcelain, or metal. The inlay is cemented into the tooth to replace a large amount of lost tooth, while an overlay covers the tips of some or all of the cusps of the tooth to protect weak or compromised cusps. Inlays and overlays are also used to correct or accommodate patients with deep or heavy bites. Resin and porcelain inlays and overlays are cemented into the teeth or they are bonded with the tooth structure forming a “monoblock” that provides strength by forming a solid bonded unit between tooth and porcelain filling. Metal inlays are stronger, but are not as beautiful.

Advantages: Silver fillings are easy to place, have a proven track record, are reasonably priced and are easy to maintain. All dentists are well versed in the use of amalgam.

Composite fillings are natural looking, their preparation is more conservative as the filling bonds with the tooth, resulting in less tooth material needing to be removed to hold the filling. The filling is cured with a light and is instantly hard so there is no setting time required before it can be used.

Inlays allow more natural tooth material to be retained than crowns, are easier to prepare and are extremely hard-wearing.

Disadvantages: Silver fillings do not bond with the tooth, are grey when placed but oxidise in the mouth to appear black. They expand minutely, continually, over the life of the filling and may result in breaks, fractures or splits of the teeth with large old amalgam fillings.  Due to the way the material needs to be placed, amalgam fillings often have internal stress cracks and fractures that are not detectable until they break.

Composite fillings are not as easy for the dentist to place as the tooth has to be absolutely dry all the time that the filling is being put into the tooth. These fillings need to be properly cured and highly polished or they discolour or degenerate with time, making them less long-lasting. There is sometimes hot and cold sensitivity and postoperative pain resulting from the curing properties of the filling material that may take a while to settle down.
Inlays require two appointments to allow time for the restoration to be made at the dental laboratory. Metal inlays are cemented into the tooth and are not bonded to the tooth.  Inlays are fairly expensive.