Dental White Fillings

For much of the past 150 years, silver (or black) coloured amalgam has been the standard material used for filling dental cavities. Although amalgam fillings are strong, durable and cost-effective, they simply don’t look good and can make you feel reluctant to smile or laugh. Silver fillings can also expand over time, which can further weaken – or even crack – the filled tooth.

However, what is of even more concern to some people is that amalgam is made by mixing liquid mercury with powdered silver, tin, copper and zinc. The mercury content of amalgam is usually close to 50% and while there are varying opinions about the potential health impacts of amalgam, Holistic Dental in Melbourne is a mercury free practice. (For more on this, read our section on Mercury Free Dentistry.)

While non-metallic fillings have been available for many years, they were mainly used for cosmetic treatments. However now, advances in dental adhesives, resins, ceramics and porcelain, combined with new technologies and processes, mean that composites of these materials can provide the strength and resilience that’s required for restoring or rebuilding damaged teeth. In addition, because the material used in white fillings bond so well to teeth, the procedure is less invasive than that used for amalgam (which often requires the removal of healthy tooth structure in order to ensure that the filling is securely held).

The term ‘white fillings’ is used for a variety of tooth-coloured fillings including the following:

Composite resin fillings consist of an acrylic “resin” that is combined with “fillers” made of small glass particles. The resin helps provide flexibility while the fillers provide resistance to wear while also mimicking the translucency of natural teeth. Composite resin can be closely matched to the colour of your teeth and bonds well with tooth enamel. It is used for filling decayed teeth as well as for restoring chipped, broken or worn teeth.

Glass ionomer fillings are made from an acrylic resin and often include a component of glass called fluoroaluminoscilate that slowly releases a small amount of fluoride to help strengthen the remaining portion of the tooth. As glass ionomer fillings aren’t as strong as composite resin, they are most often used for small restorations and fillings below the gum line. They are also often used for filling children’s primary teeth.

Ceramic fillings are made using computer aided design equipment, and manufactured to create a natural and life-like look that makes it hard to distinguish the filling from the natural tooth. The porcelain material used in ceramic fillings is typically stronger than other filling alternatives (including amalgam), and is also more resistant to staining than composite resin. However ceramic fillings can be quite expensive.

At Holistic Dental our first concern is to preserve as much of natural tooth structure as possible, and to return to your mouth the function and form that’s been destroyed or lost by the damaged tooth or teeth. In other words, we want to make sure your teeth are doing the job they were intended to do. Our next concern is to make sure you get the most natural-looking result.

Our Brunswick Dentist will discuss with you the best options for each tooth based on where its placed in your mouth (and the amount of work that tooth needs to do), as well as the condition of the tooth and the level of restoration required.

While we understand that almost everyone needs to consider their finances, we believe it’s important that you understand the true long term cost of each alternative. This includes factors such as how long it will last and the impact the treatment will have on your general (as well as dental) health.

1.  Composite Resin Fillings

Advantages

• Match the colour of your teeth.
  Procedure can often be completed in one visit.
• Less drilling involved than with amalgam fillings because the bonding process holds the filling securely in the tooth.
• Composite resin fillings are heat cured, which further increases their strength.

Issues to consider

• More expensive than amalgam.
• Although advances in composite resin have made these fillings much tougher, it’s not yet certain how many years they will last under the pressure of chewing.
• If not correctly applied in thin layers, composite resin may shrink over time. This can lead to new cavities emerging where the filling is not making good contact with your tooth.
• Some teeth may be more sensitive to pressure, air, sweet foods and cold for a period of time after the procedure.
• Prolonged consumption of certain foods and drinks may cause staining of composite fillings.

2. Glass Ionomer Fillings

Advantages

• Contains slow release fluoride to help protect the tooth from further decay.
• Good adhesion and bonding qualities help prevent leakage around the filling and the risk of further decay.

Issues to consider

• Traditional glass ionomer fillings are considerably weaker than those made from composite resin. For this reason they are better suited for smaller restorations or for repairing children’s teeth.
• While glass ionomer can be matched to the colour of your teeth it can’t always be achieved with the same accuracy of composite resin. (Resin-modified glass ionomer provides a better match than straight glass ionomer.)

3. Ceramic Fillings

Advantages

• Ceramics provide a highly aesthetic result that matches and blends with your natural teeth.
• Long lasting and durable.
• More resistant to staining and abrasion than composite resin.

Issues to consider

• Ceramics are usually a more costly procedure.
• Fitting a ceramic restoration usually takes at least two visits to your Holistic Dental practitioner.
• The nature of ceramic material means that the filling needs to be large enough to prevent it from breaking. As a result, a tooth may have to be reduced in size (that is, healthy parts of the tooth removed), to make room for the filling.

Composite Resin and Glass Ionomer Filling

• The tooth is first cleaned and prepared.
• This may involve giving you a local anaesthetic to numb the area.
• The decayed portion of the tooth is gently, but thoroughly removed using a drill, air-abrasion instrument or laser.
• If the filling is deep and close to the nerve, a special lining material may be inserted to help protect the nerve.
• With the area cleaned and prepared, the composite resin is then bonded to the tooth. The filling is slowly built up, one thin layer at a time, with each layer being hardened and cured by a special bright light before the next layer is applied.
• Once the filling has been completed, the composite material is shaped to fit the tooth, and then polished to reduce discolouration or staining.

Ceramic Fillings in Melbourne

• The process with ceramic fillings is quite different. Once the tooth has been prepared, a special tool is used to scan and create an image of the cavity.
• The image is sent to a computer-aided design and manufacturing machine, which mills a ceramic block that exactly matches the cavity in your tooth.
• The ceramic filling is polished and fitted precisely inside the cavity, where it is bonded using a cement that is hardened with light.
• The filling is polished and glazed, providing a life-like look that blends with you natural teeth.