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Fillings

It is important to remember that any man-made material is never going to be as good as the enamel and dentine that your tooth started with.

Technology has improved over time to offer various options to restore your teeth, but none of these are perfect, and none will last a lifetime. Most filling materials will only last 5-15 years.
Fillings can last much longer if the area they are filling is not load-bearing, but it is important to realise that restoring a tooth with decay is about trying to recover from a severely weakened tooth that has had its integrity completely compromised.

The answer is prevention from early in life to avoid the decay that then requires dental intervention.

Below are the available restoration options that dentists routinely use.
Your dentist will discuss the restoration options with you and advise you of the best (and sometimes only) option that suits your tooth. This may be different for each different tooth in your mouth, if several teeth need restoring.

AMALGAM FILLINGS:

A metal alloy filling material made from silver, tin, zinc, copper and mercury.

Advantages
• Amalgam fillings are strong and can withstand the forces of chewing.
• They are relatively inexpensive, compared with alternatives.
• An amalgam filling can be completed in one dental visit.

Disadvantages
• Amalgam doesn't match the colour of your teeth.
• Amalgam fillings can corrode or tarnish over time, causing discoloration where the filling meets the tooth.
• A traditional (non-bonded) amalgam filling does not bond (stick) to your tooth. The preparation developed by your dentist requires undercuts or ledges to provide retention of the filling. Your dentist may have to remove additional tooth structure to establish good retention for the filling.
• Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury exposure from fillings is similar to what people get from other sources in the environment.

COMPOSITE FILLINGS:

A white filling material with a mixture of plastic-like resin and fine glass particles (silica/quartz).

Advantages
• Your fillings or inlay will match the colour of your teeth.
• The glassy effect of the silica mimics nature successfully to be polished and shaped to be virtually undetectable.
• A filling can be completed in one dental visit.
• Composite fillings can bond directly to the tooth, potentially making the tooth stronger than it would be with an amalgam filling.
• Less drilling may be involved because the dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth and can be used to deliberately strengthen a weak part of the tooth alongside the filling that is at risk of fracturing in the future.
• Composite resin can be used in combination with other materials, such as glass ionomer (see below), to provide the benefits of both materials.

Disadvantages
• Although composite resins have become stronger and more resistant to wear, it's not clear whether they are strong enough to last as long as amalgam fillings under the pressure of chewing.
• These fillings take more time to place because they are usually placed in layers. The increased time and labour involved also contribute to the higher costs.
• These fillings are more technique sensitive to place – if the tooth becomes wet during placement, the material may not bond properly, therefore not successfully seal the tooth from bacteria. The composite may also shrink when placed in contact with your tooth, leaving microscopic voids that bacteria can penetrate. The shrinkage is reduced to an acceptable level when your dentist places this type of filling in thin layers.

GLASS IONOMER FILLINGS:

A white filling material made from acrylic and a component of glass called fluoroaluminosilicate.

Most commonly used as cementation for inlay fillings, but glass ionomer also is used for fillings in front teeth or to fill areas around the necks of your teeth or on roots. As filling material, glass ionomer is typically used in people with a lot of decay in the part of the tooth that extends below the gum (root surface). It is also used for filling baby teeth and as a liner for other types of fillings

Advantages
• Glass ionomer matches the colour of the teeth, although it does not always match as well as composite resin.
• In some cases, no drilling is needed to place a glass ionomer filling. This makes this type of filling useful for small children.
• Glass ionomers release fluoride over time which can help protect the tooth from further decay.
• Glass ionomer restorations bond (stick) to the tooth, which helps to prevent leakage around the filling and further decay.

Disadvantages
• Normal glass ionomer is significantly weaker than composite resin. It is much more likely to wear or fracture. It is commonly used in areas in teeth that are not heavily loaded with chewing forces. A resin-modified version is stronger but is missing other beneficial properties.
• Normal glass ionomer does not match your tooth colour as precisely as composite resin.

Thorndon Dental • 246 Tinakori Rd Thorndon Wellington • 04 472 8353
Dentists and staff include: Parm Gill Andrew McKenna Sophie McKenna Colleen Loo Hannah Kelly Michelle Rochelle hygienists Vanessa and Michelle and administration Anne