What are Dental Fillings?

For some people smiling or even meeting new people can be difficult because they feel self conscious about their teeth. Dark fillings and cracked or broken teeth can be very embarrassing, yet there are many options available to improve the smile and repair imperfections of the teeth. Tooth colored or composite fillings can do just that!

Composite fillings help to strengthen the tooth and have a very natural look. For aesthetic reasons composite fillings are normally chosen over traditional amalgam fillings. Amalgam (silver) fillings are very noticeable and can be removed and replaced with tooth colored fillings. This will improve and brighten the appearance of the smile.

Over time dental fillings will need to be replaced due to decay or fracture of the tooth. Both composite and amalgam fillings will provide adequate function necessary to support the tooth.

There are many reasons for replacing dental fillings:

  • Remove old amalgam fillings
  • Treat cavities and eliminate decay
  • Repair broken or chipped teeth
  • Close gaps between teeth
  • Improve smile by reshaping teeth

Keep in mind there are many differences between the composite and the amalgam filling. A composite (tooth colored filling) will blend into the natural tooth structure making it very difficult to see. An amalgam (silver) filling can give the tooth a gray tone or dark appearance. Composite fillings generally cost more due to the material used, and a composite filling is placed in layers, requiring more time for this procedure.

Composite fillings are more resistant to temperature changes than amalgam fillings. Composite fillings insulate the inside of the tooth and add structural support. Amalgam fillings contract and expand with temperature changes, and overtime can cause the tooth to crack. In this situation, a filling will no longer be considered. A crown, inlay or onlay would be the desired treatment in the case of a cracked tooth.

Many patients if given the choice, will choose a composite tooth colored filling over the old traditional amalgam filling. This is due to aesthetics. There is a wide range of tooth colored materials allowing the completed restoration to blend into the natural tooth color. Not only do composite fillings look natural, they actually restore strength to the tooth while sealing and protecting the tooth.

Composite filling material consists of acrylic resin and glass particles that are self curing, or light cured to set. Amalgam fillings are a mixture of mercury and silver alloy powder. This material will harden over time.

Advantage of a composite filling over an amalgam filling:

  • Composite fillings can be placed on front (anterior) teeth and back teeth (molars)
  • Give a natural appearance to the tooth, as amalgam fillings have a dark color and can be noticed more easily
  • Add strength, amalgam fillings can weaken the tooth
  • Do not require as much “healthy” tooth structure to be removed when placing the filling as an amalgam filling requires
  • Are more resistant to temperature changes than amalgam fillings
  • Do not contain any mercury

Disadvantage of composite filling over an amalgam filling:

  • Generally more expensive than amalgam fillings
  • Composite fillings take longer to complete
  • When placing a composite filling, the tooth must be very dry. Amalgam fillings can be placed in a situation where it is very difficult to keep the area dry

Depending on the size of the filling necessary, a porcelain crown, inlay or onlay may be required or recommended. This would be necessary if there is not enough tooth structure to hold the filling in place. If indeed a crown, inlay or onlay is completed, the treatment could cost the patient more money because of the extra time and laboratory fees involved.

It is highly recommended that a patient check with their dental office prior to completing treatment regarding treatment options and dental reimbursement. Often, patients will have a higher out-of-pocket expense associated with composite fillings, especially if placed on a posterior tooth (molar). There is a wide range of dental plans and coverages. Some will cover all composite fillings regardless of where they are placed, while others have strict requirements and are very specific as to what teeth will be covered. If a plan will not pay composite fillings on posterior teeth, they will often reduce the fee to pay an amalgam rate, giving the patient a reduced benefit.

When a filling is recommended, it is best to complete the treatment in a reasonable time. Decay left untreated can progress to the nerve of the tooth, causing additional treatment and expenses at a later date.

A dentist will help to determine the best treatment for each individual. They will take into consideration treatment options for the patient as well as time and financial considerations.