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Dental Fillings

Reviewed by Paul Amato, DDS
 

The procedure a dentist uses to fill a cavity or hole in your tooth is known as a dental filling. The filling is used to repair cracked, broken, decayed and/or worn down teeth. There are several types of materials used today to restore teeth, including silver amalgam, composite (resin), or gold. Fillings generally enhance the overall functionality and/or appearance of the tooth and mouth while taking away pain and sensitivity to hot, cold, sweets, etc.

Most dental insurance plans cover a percentage of the costs of dental fillings, whether amalgam or composite. Often, composite fillings will cost more than amalgam fillings, and the insurance only covers the cost of the composites up to the price of the amalgam filling, leaving the patient to pay the difference.

There is also much debate surrounding the topic of whether or not dental fillings are safe for consumers. The American Dental Association, the FDA, and other public health agencies believe and have scientific studies that demonstrate that dental fillings are safe for the public. People that are sensitive to metals should discuss this with their dentist and physician prior to having any dental work. There are known allergy screens to test many dental materials.

Types of Dental Filling Materials

As mentioned above, there are several different types of materials used today to make up fillings, including:

Silver Amalgam – These fillings last for 10-15 years and can withstand great chewing forces. Unfortunately, these fillings are silver in color (they are unaesthetic), they can cause stress fractures in the tooth, and expand and contract with hot and cold causing more stresses on the tooth. They are the least expensive fillings.

Gold - Many people elect to use gold fillings instead of silver due to aesthetics and longevity. There are documented cases of gold fillings (inlays) that are 40+ years old. However, gold fillings can be much more expensive than amalgam fillings, sometimes costing up to 3-4 times more per filling. Unlike composite and amalgam fillings, patients who are receiving gold inlays must see the dentist for 2 appointments, 2-3 weeks apart.

Porcelain - Porcelain inlay fillings cost about the same as gold inlays. They will last approximately 10-15 years, and are becoming more and more popular. Similar to gold inlays, porcelain inlays take 2 appointments with your dentist.

Composite Resin - Composite fillings are the “white” fillings that most dentists do. They are the material of choice for small, conservative, direct fillings. Composite fillings can last anywhere from 5-15 years. There are many different types of composite resin materials that can make up a filling. Tooth-colored composites chemically bond to the tooth structure and provide extra support. However, composite can wear faster than amalgam and/or porcelain fillings.

Indirect Fillings

Indirect fillings (inlays) are created in a dental laboratory. Inlays will cover the internal part of the tooth similar to a direct filling (amalgam or composite filling). Generally, patients must visit the dentist for 2 appointments when receiving an inlay.

Indirect fillings are considered when there isn’t enough tooth structure remaining to support a filling, yet the tooth is not so damaged that it needs a crown.

During your initial visit to the dentist for an inlay, he or she will isolate the teeth with a rubber dam or isolite device. After removing the old filling and decay, an impression is taken of the prepared tooth and surrounding teeth. The impression is sent to a dental laboratory, where an expert dental technician will create the inlay. A temporary is used until the indirect filling can be cemented or bonded into place, 2-3 weeks after the initial preparation appointment. During the second visit, the temporary filling is removed and the inlay is tried in and adjusted. If the inlay fits properly, it is bonded or cemented in place.

Temporary Fillings

Temporary fillings are used for a number of reasons, including:

  • When emergency dental treatment is needed
  • If the pulp or nerve becomes irritated, temporary fillings are used to soothe the nerve
  • After a root canal

Temporary fillings are not meant to last, hence the name. Generally, permanent dental work should be done within a month of receiving a temporary filling. They are not very strong, and tend to fall out, fracture, and wear out quickly. If temporary fillings are left in place, the tooth could become infected and other complications may arise.

Page updated March 2011

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