There are a variety of different materials and techniques available to restore a tooth that needs a filling. Fillings are indicated when a tooth has a small to medium cavity or crack and also when existing fillings become defective. In general, fillings instead of crowns are indicated when the filling will occupy less than half the width of the tooth. Simple fillings do not make teeth stronger.
A direct filling is one that is made in the patient’s mouth. Dental offices bill for fillings by number of surfaces filled. There are five surfaces to all teeth. Most direct fillings are one, two or three surfaces.
Direct Filling Materials
Composite Resin:Composite resins (white fillings) were originally intended for use in the front teeth. As the material became stronger and more versatile they were brought into use for back teeth. Most patients prefer the white color of these fillings. Unfortunately, composite resin fillings leak. When done under isolated and exacting conditions they can be successful. Composite resin should not be used in patients who are cavity prone. Composite resin does not prevent cavity recurrence.
Amalgam Silver fillings:Amalgam continues to be one of the very best, longest-lasting materials in dentistry. Amalgam helps prevent future decay. The American Dental Association sanctions amalgam based on more than a decade of continuing research.
An indirect filling is one that is made in the laboratory. An impression is made of the preparation and a temporary restoration is placed in the tooth. The final filling is then delivered and placed at a later date.
Indirect Filling Configurations
- Inlays:An inlay is a filling that sits between the cusps of the teeth.
- Onlay:An onlay covers one or more cusps of a tooth. This type of restoration strengthens the tooth.
Indirect Filling Materials
Porcelain:Is the most popular restorative dental material. However, porcelain is very abrasive. Porcelain can abrade the natural teeth. While porcelain is a highly popular material with patients, it has poor biocompatibility with teeth.
Composite ResinWhile rarely used, composite resin is more biocompatible and has similar esthetic qualities to porcelain. The dental materials industry has not attempted to develop technology for the widespread use of these fillings. It is likely due to a conflict with the bottom line. Technology for porcelain restorations appears to be more profitable for the manufacturers than that for composite resin restorations.
Metal Alloy:Gold is the most common metal alloy. Though not highly esthetic, gold alloy has excellent strength and longevity. Metal alloys are still an outstanding restorative material.