Fillings

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Fillings

A filling is the restoring of lost tooth structure and generally involves using materials such as metal, alloy, cement, porcelain or synthetics to fill in any missing part(s).

There are a wide range of different fillings that are used by dentists when performing a filling procedure. These include:

• Amalgam (silver coloured)

• Composite fillings (tooth coloured)

• Glass ionomer (tooth coloured)

• Gold inlays and onlays (gold coloured)

• Porcelain inlays (tooth coloured)

Amalgam fillings:

Amalgam fillings consist of mercury and a silver alloy, along with other metals, which gives them there silver colour. Amalgam is long lasting - amalgam fillings usually last for 15-20 years - and hard wearing and has been used in fillings for at least 150 years. Amalgam fillings are normally fitted onto the back ‘chewing’ teeth.

Prior to the filling being placed, the surrounding area must be prepared by removing all the decay and shaping the cavity to hold the filling in place. If the tooth is badly broken, your dentist may need to place a small stainless steel pin to help secure the filling.

Dangers involved?

Although mercury is harmful by itself, once combined with the other materials in the amalgam filling, its chemical nature changes so that it becomes harmless. Research into the safety of dental amalgam has been carried out for over 100 years and up till now no reputable controlled studies have found a connection between amalgam fillings and any medical problem.

Composite fillings:

Composite fillings are tooth coloured and are made from powdered glass quartz, silica or other ceramic particles added to a resin base. They are strong and hard-wearing, although not to the same level as amalgam fillings. Once the tooth is prepared, the filling is bonded onto the area and a light is then shone onto it to help it set. Your dentist will choose a shade to match your existing teeth, although over time staining can occur.

Glass Ionomer fillings:

Glass ionomer fillings are used to form a chemical link with the tooth and may also release fluoride, helping to prevent further tooth decay. This type of filling is fairly weak and as a result is usually limited to use on baby teeth and non-biting surfaces such as around the necks of the teeth. The filling bonds directly to the tooth, which means only a small amount of preparation is needed.

Gold Inlays & Onlays?

An inlay is small and usually inserted within the biting surface of the tooth, whereas an onlay can cover a larger area of the tooth. Gold is one of the most long lasting and hard wearing filling materials. One of the differences between gold and other filling materials is that the gold filling is made in a laboratory, although this is reflected in the costs with gold inlays and onlays more costly than other filling options.

In terms of preparation, your dentist will usually take an impression of the prepared cavity and send it to the laboratory so that a technician can produce the inlay or onlay. During this period a temporary filling will be placed into the cavity until your inlay or onlay is ready – which is then fitted in using dental cement.

What are Porcelain Inlays?

Digital technology, known as CADCAM, can now be used by your dentist to design and prepare perfectly fitted porcelain inlays in only 1-2 visits. Porcelain can be hard wearing and long lasting and also has the advantage of being able to be coloured to match your natural tooth. However, similar to gold inlays and onlays, this type of filling can be quite expensive.

How to choose?

Your dentist will be able to advise you on which type of filling material is best suited to your situation. Make an appointment to see your dentist if you feel that you would like a particular type of filling material such as tooth-coloured fillings or gold inlays. Finally, always remember to request a treatment plan and a written estimate on the costs involved before going ahead with any filling treatment.

White Fillings:

White fillings are usually chosen by patients who are more conscious about the way they look. Unlike silver ones, they won’t show when you laugh or smile, making them not only functional, but natural looking as well.

Costs

Having white fillings fitted is usually quite expensive, as they are generally classed as a cosmetic treatment, meaning they are only fitted privately. Costs do depend on your dentist and the size and type of white filling used, the time taken to complete the treatment and how much your dentist will charge for performing the fitting. Costs can also depend on which region of the UK you are based in.

White or Amalgam

Although white fillings have always been considered less long lasting than silver amalgam fillings, there are now new materials available with properties similar to silver amalgam, which are proving to be very successful. The life expectancy of a white filling can vary, although those provided on the NHS are automatically guaranteed for one year.

You should only look at changing your filling when your dentist decides that an old filling needs replacing, at which point you can ask to have it replaced with a tooth-coloured material. Note that some dentists may prefer not to put white fillings in back teeth as they are not always successful, so one alternative option would be to use crowns or inlays. However, this can mean removing more of the tooth and will cost you more in the process.

Where can I get them fitted?

Most dental practices in the UK offer white fillings as a normal part of the treatment they provide, although they will come at an extra cost due to their ‘cosmetic’ treatment classification.

The National Health Service (NHS) will not usually allow white fillings on the biting surfaces of back teeth, but having them fitted to the sides of back teeth or to any front teeth is permitted.