Everything You Always Wanted To Know About Fillings
The dental filling, or what we refer to as a restoration, in it’s simplest form is material that replaces some amount of missing tooth structure. If you think you need a filling, call The Smile Anchorage at (502)243-9200
Fillings, or dental restorations, are materials that are placed on teeth that have been damaged by decay or trauma, in order to restore them to their original function and sometimes their natural appearance. The most common reason for a filling is the presence of dental decay. We remove the decay, and “fill” the area with a material to bring the tooth back to normal function. Fillings help prevent the decay from damaging the affected tooth more.
There are a number of different materials that fillings can be made from. Historically, the most common type of filling is the amalgam filling which is a mix of silver, tin, copper, mercury and possibly other metals. Other material include gold, porcelain and composite resin which is the tooth colored material that blends with your natural tooth color.
Types Of Fillings
There are a few basic types of fillings available. Each has advantages and disadvantages. Toggle the plus sign for more information about each type of filling and the advantages or disadvantages that each has to offer.
Amalgam (Silver) Fillings
Silver fillings are made of a mixture of metals. They are called amalgam fillings because they are an amalgamation (mixture) of several metals. They are a mixture of mercury, tin, silver, copper and usually zinc. The mixture is primarily made of mercury. They are the least expensive of the restorative materials used for fillings.
Advantages of amalgam fillings include:
- They are strong. They can withstand forces that are created on the back teeth when chewing.
- They cost less than other options for fillings.
- They are less sensitive to the fluids in the mouth when placing them, making them less technique sensitive during placement.
Disadvantages of amalgam fillings include:
- The appearance. They are silver in color (at first) and do not blend with the natural teeth.
- They corrode over time. The corrosion is black, and can stain the tooth around the filling material. (see picture)
- Requires a larger hole to be drilled compared to composite fillings. Amalgam does not bond to teeth, so they are held in by physical forces, which means they must have engineered designs in them to hold them in place. This requires a little more cutting.
There is also the concern of some that the mercury in the fillings may be detrimental to their health. Currently there is no strong scientific evidence that the mercury in amalgam fillings poses a danger to those with amalgam fillings. However, avoidance of mercury fillings for this reason is understandable.
Composite Resin (Tooth Colored) Fillings
Composite resin fillings are made from a mixture of materials, much like a plastic with particles of glass embedded within. Today, composite resin materials are becoming as strong as ever, and are able to withstand the forces of chewing in the mouth. These are almost always used in front teeth, because the material blends with your natural tooth color and can’t be seen like amalgam fillings. Advantages of composite resin fillings are:
- They match your natural tooth color.
- They bond to the tooth structure.
- They require less drilling and a smaller hole size than amalgam fillings.
Some of the disadvantages include:
- They cost a bit more than amalgam, and many insurance companies do not cover composite materials for back teeth.
- They are not as strong as amalgam, and may not last as long.
- They are more sensitive to technique of placement than amalgam. This means that you need to have a skilled professional that understands how to place the composite resin correctly.
Cast Gold Fillings
Gold can be used to create a filling. Gold has long been used as a dental material due to it’s properties, and is a wonderful material. However, many of the positive features are outweighed in the minds of patients due to some of the disadvantages of using gold. Advantages are:
- They last a very long time, perhaps the longest lasting material available.
- It does not corrode like amalgam.
- Strong, able to withstand the forces of chewing very well.
The disadvantages include:
- Cost. Gold is expensive, and the cost can be many times more than an amalgam or composite filling.
- Time to place. Because the gold fillings must be cast, they require multiple visits to place them. You will need at least two visits and will be required to have a temporary filling while you are waiting on the lab work to be completed.
- Appearance. The gold does not blend well with the natural tooth color.
Ceramic or porcelain fillings are somewhat strong, but like gold can be expensive for use as filling material. The primary advantage is that they are tooth colored and blend with natural teeth.
Glass Ionomer Fillings
Glass ionomer materials are used when the placement of a filling is difficult due to saliva contamination, or when you wan the protection afforded by the fluoride that is released from glass ionomer materials. These are most often used on cavities that are along the gumline or down below the gums on the roots of the teeth. Advantages are:
- Release of fluoride to protect teeth.
- Bonds to the teeth like composite resin materials
- The color only matches somewhat, and does not give the same natural look as composite resin.
- Not nearly as strong as composite, and not at all as strong as amalgam or gold. Glass ionomer fillings can wear easily over time, so they are not often used on chewing surfaces.
There may be an occasion when a temporary filling is needed. Temporary fillings are meant to help protect the tooth for a short time, until it is appropriate to place a permanent final restoration.
A couple of examples for the need to place a temporary might include:
A temporary might be placed in the access opening of a tooth treated with a root canal until a crown or final filling can be placed
A temporary filling might be placed while the tooth is being evaluated for treatment
A temporary might be placed if you need to have the tooth repaired but do not have time to fix it today
Whatever the reason might be for having a temporary filling placed, the most important thing to remember is that they are TEMPORARY. We often see patients that have temporary fillings that have been in place for weeks, months and even years. The problem with not limiting the use of the temporary is that additional damage from decay and trauma can increase, sometimes to the point that the tooth is no longer in a condition to be repaired.
If you have a temporary filling, you will want to get it replaced as soon as possible. While you have the temporary filling, you will want to take some care to make sure it stays intact during the time it is in your mouth. Because they are temporary, they can be removed from the mouth more easily than a typical filling. Care must be taken when eating and chewing, flossing your teeth and performing any dental hygiene on your teeth. While brushing can remain the same as your normal routine (assuming you use a soft or extra-soft toothbrush) but flossing should be done carefully. Rather than pulling the floss up from between the teeth, try flossing down and then pulling the floss out of the side of the teeth.
Frequently Asked Questions
These are some of the most frequently asked questions that we get at The Smile Anchorage regarding dental fillings
The cost of any particular procedure is going to vary depending on a number of factors. For example, you may have an insurance plan that has a specific contracted payment amount, or you may have an insurance co-pay or deductible. For an accurate cost on any particular treatment, please contact our front office staff and we will gladly help you determine your out-of-pocket costs.
A filling is when artificial materials are used to “fill” an area of a tooth that has been damaged by decay or trauma. They are called fillings because they are typically filling a hole, but modern fillings can also replace broken edges of teeth, or cover defect on the front surface of teeth.
We can only be certain that you need a filling by doing an examination in our office. If you are having sensitivity to hot or cold foods, or pain when you eat, especially sugary foods, then you might need a filling. We use a number of pieces of evidence to determine if you have a cavity or cracked or broken tooth that needs a filling. Some of those are:
- A visual inspection of the teeth. Cavities appear as defects in the surface of the teeth, and can be white, brown or black and sometimes even yellow or other colors.
- X-Rays. Taking a picture of the teeth allows us to look at the space between the teeth, or on the roots of the teeth.
- Cavity Detection Aids. There are devices that use laser light to determine if teeth are decayed.
We take these pieces of information, plus your history and the signs and symptoms that you are experiencing and determine if a filling is something you may need.
Under most circumstances, you are able to eat immediately after a filling is placed. The biggest risk to eating immediately following a dental filling is the possibility of biting your lips or cheeks due to the dental anesthesia.
There are concerns about silver (amalgam) fillings due to their containing mercury. While there is no conclusive scientific evidence that amalgam fillings are detrimental to the people that have them, it is understandable that some people might want to have them replaced.
You will want to consider this carefully, because each time you remove a filling, you will make the preparation of the tooth larger, potentially causing a compromise of the tooth structure. If your fillings are defective, leaking or broken then you would certainly want to replace them. But, if they are intact and not damaged, then you may not want to remove them.
The American Dental Association supports using amalgam restorations, and believes they are safe and reliable.
If you are thinking about removing your amalgam fillings only for cosmetic reasons, come by and discuss the positive and negative aspects of that kind of treatment.
The answer is, it depends.
There are many factors that can determine how long a filling might last.
- Size. The larger the filling, the shorter it will likely last.
- Location. Is it in the front where it receives little wear? Or is it on a back tooth chewing surface where it gets punished daily?
- Care. Your home care and regular dental visits can influence the length of the fillings lifetime.
While it is true that you may have to replace a filling in the future, you can prolong it’s lifespan by taking good care of your teeth and the dental work that exists in your mouth.
Fillings do not last forever. You can help them last as long as possible by having excellent home care and regular dental check-ups and hygiene visits. But sometimes fillings will fail. The most common reason for them to fail is recurrent decay, or new cavities developing in the tooth around the edges of the filling. There can be other reasons to replace a filling. You may want to replace a discolored filling for one that blends more with your natural teeth. Or, you may want to replace a silver metal filling with one that is tooth colored.
Dental Insurance Plans
Our dental office is a participating provider for a number of dental insurance plans. The Smile Anchorage accepts the insurance plans of most of the major employers in the area. Notably this includes United Parcel Service UPS, Humana, Ford Motor Company, Yum! Brands, Papa John’s and many others.
Please keep in mind that your insurance coverage may be different that that of your co-workers. Even though you have the same provider, you may be enrolled in a different plan. Hence, plans can vary greatly. For example, your co-worker might have coverage for braces. In contrast, you may have no coverage for those procedures. By the same token your co-worker may pay $25 for a filling. Instead, you might pay nothing for a similar filling. The Smile Anchorage does not have any say in what your plan covers. Call or come by our office. Speak to one of our insurance specialists. They can tell you about your exact coverages.
You Have No Insurance
We know that many of our patients have no insurance. So, The Smile Anchorage has an in-house dental plan for those without insurance called The Smile Program. Firstly, The Smile Program covers twice per year cleanings. Secondly, exams are included two times per year. Likewise, all necessary x-rays are included. Thirdly, there are discounts on certain treatments. Additionally there are no claim forms. Equally important other benefits are explained on our New Patients page. Click here to learn more about The Smile Program.
The list of dental insurance plans that are accepted at The Smile Anchorage is not a static list. Correspondingly, changes sometimes occur. With this in mind, we advise that you call to confirm that your insurance is accepted in our office before you make an appointment.
A current list of insurance providers that are accepted in our office is shown below. Providers change. The list is updated as of July 2017.
LHI Logistics Health Incorporated
Lincoln Financial Group
United Concordia & ADDP United Concordia