Dental Health and Tooth Fillings
To treat a cavity your dentist will remove the decayed portion of the tooth and then "fill" the area on the tooth where the decayed material was removed.
Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).
What Steps Are Involved in Filling a Tooth?
First, the dentist will use a local anesthetic to numb the area around the tooth to be filled. Next, a drill, air abrasion instrument, or laser will be used to remove the decayed area. The choice of instrument depends on the individual dentist's comfort level, training, and investment in the particular piece of equipment as well as location and extent of the decay.
Next, your dentist will probe or test the area to determine if all the decay has been removed. Once the decay has been removed, the dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.
Several additional steps are required for tooth-colored fillings and are as follows. After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that "cures" or hardens each layer is applied. When the multilayering process is completed, the dentist will shape the composite material to the desired result, trim off any excess material, and polish the final restoration.
What Types of Filling Materials Are Available?
Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic, and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material, patients' insurance coverage, and your dentist's recommendation assist in determining the type of filling best for you.
Cast Gold Fillings
Advantages of cast gold fillings:
- Durability -- lasts at least 10 to 15 years and usually longer; doesn't corrode
- Strength -- can withstand chewing forces
- Aesthetics -- some patients find gold more pleasing to the eye than silver, amalgam fillings.
Disadvantages of cast gold fillings:
- Expense -- gold cast fillings cost more than other materials; up to 10 times higher than cost of silver amalgam filings.
- Additional office visits -- requires at least two office visits to place
- Galvanic shock -- a gold filling placed immediately next to a silver, amalgam filling may cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur. It's a rare occurrence, however.
- Aesthetics -- most patients dislike metal "colored" fillings and prefer fillings that match the rest of the tooth.