Tooth Fillings

Tooth fillings, restore the previous function and appearance of a decayed or damaged tooth. For this procedure, the dentist usually first numbs the area with local anesthesia. Next, the dentist removes the decayed tooth tissue from the tooth. After cleaning the caries-affected area in the tooth, it fills the cavity with filling material. Tooth fillings also aim to prevent bacteria from entering the tooth cavities and to prevent future decay of the tooth.

When is a tooth filling needed?

The dentist decides whether a tooth needs a filling or not. At this time, the dentist resorts to various diagnostic methods. For example, the color change in the tooth can be an important criterion for the need for filling. Apart from that, the dentist can also use special paint to detect cavities. For this, the dentist rinse the teeth with this paint. If the tooth has cavities, the paint will adhere to them.

In case of abnormality of the tooth, the dentist examines it in detail with the help of a mirror or a special device. If necessary, the dentist may order a dental X-ray test. This imaging test allows dentists to see caries surfaces more clearly. Sometimes, however, dental X-ray tests may also be insufficient to detect small caries.

Tooth decay is not the only reason for tooth fillings. Cracked or broken teeth may also require filling depending on the situation. In addition, in case of tooth discoloration, the dentist can do an esthetic tooth filling to eliminate the bad appearance.

Which tooth fillings are better?

Today, patients can make various choices such as long-lasting or more aesthetic fillings. However, the person who will know best which tooth filling is better is still the dentist. Because a certain filling option may not be suitable for every person.

Tooth Fillings

Amalgam Fillings

An amalgam filling is prepared from a material consisting of a mixture of mercury, silver, copper, and zinc. Dentists generally use this filling in back teeth because it is dark in color and incompatible with natural tooth color. Amalgam fillings are relatively cheaper than other filling materials. But these fillings are very durable. Depending on usage, their lifespan is usually at least 7-8 years.

The dentist can do an amalgam filling in a single session. However, to make this filling, the dentist should take some amount of the healthy parts of the tooth. Because amalgam fillings do not easily adhere and integrate with the tooth.

The mercury contained in amalgam is considered toxic if inhaled, especially during the construction or removal of the filling. However, hardened amalgam fillings are considered harmless, as they don’t release mercury when eating or drinking.

Composite Filling

Composite is a filling material consisting of a mixture of small glass particles and plastic. Today, it is the filling material that dentists routinely use. Because the dentist can easily shape it while making the filling. In the next stage of the filling process, the dentist performs polishing. Composite hardens with the effect of ultraviolet light (UV). For this reason, its name is ‘beam filling’ in the population.

A composite filling is mostly preferred for anterior teeth. Because the color of the composite filling is compatible with the natural tooth color and is good in terms of aesthetic appearance. A composite filling, unlike amalgam filling, is a type of filling that integrates more easily with the tooth. It is also good in terms of durability, but in very large fillings, the amalgam is more durable.

Over time, minimal shrinkages may occur in the composite filling. In this case, there may be leaks from the filling edges, which can cause tooth decay in the future. Excessive alcohol consumption may also cause deterioration in the structure of the composite filling. Moreover, color change may occur in composite fillings over time.

The life of the composite filling may vary depending on the size of the filling, dental hygiene, and nutritional habits of the person. The average life of these fillings is 7-10 years, which is less than the life of amalgam fillings.

Porcelain Fillings

The porcelain filling is preferred in cases where the lack of tooth tissue is too much. This filling is made of ceramics. These filings are very durable. Since they are durable and do not shrink, they do not leak. The life of the porcelain filling varies according to the person’s oral care and the quality of the material used. In general, the average duration is less than the life of the amalgam filling but longer than the life of the composite filling.

For porcelain filling, the dentist prepares a suitable space in the tooth. Then the dentist brings the tooth to a position where the porcelain filling to be applied can sit. After that, the size of the space is taken and porcelain fillings are prepared according to these dimensions. In the other session, the dentist places the prepared porcelain filling on the tooth.

The dentist applies porcelain filling with inlay and onlay filling methods. After removing the decayed tooth tissue, the dentist does the filling of the formed space with the inlay method. In cases where the protrusions of the tooth, called tubercles, are destroyed, the dentist applies onlay method to reconstruct the lost tooth structure. The onlay filling is also sometimes called the partial crown.

Indirect Fillings: Inlay and Onlay

Inlay and onlay fillings are specially prepared for the patient and measurements are taken from the tooth for this. For these fillings, materials such as porcelain, composite, and gold are most preferred today. Inlay and onlay fillings are a good solution for teeth that are unrepairable with conventional filling methods and where crowns are not preferred.

Especially in deep fillings, inlay, and onlay fillings have reduced the incidence of classical fillings failing to adhere to the tooth and falling. Inlay and onlay fillings are adapted to the tooth with a special adhesive and thus integrate well with the tooth. In this respect, inlay and onlay fillings are more effective restorations than conventional fillings. In addition, these fillings are much more durable than conventional fillings.

Situations, where inlay and onlay fillings can be advantageous, are as follows;

– Decayed teeth with root canal treatment or severe tissue loss,
– Large volume fillings that may look bad aesthetically,
– Teeth in which contact with neighboring teeth cannot be achieved,
– Areas where chewing pressure is too strong.

Gold Filling

Dentists prepare gold filling by adding gold to other filling materials. In this respect, it is more expensive than other tooth fillings. But gold filling can last for more than 10 years and by comparison, it has a much longer lifespan than the others. It is stainless and resistant to chewing power. Dentists usually do this filling in two sessions and the high gold prices increase the cost.

Glass Ionomer

A glass ionomer is a filling material consisting of a combination of acrylic and glass-based materials. This material is mostly preferred for anterior teeth and its durability is close to 5 years. The main advantage of glass ionomer is that it prevents tooth decay thanks to the fluoride it secretes. In this respect, it is a frequently preferred filling, especially for children.

Glass ionomer is more suitable when caries extend under the gum or root of the tooth. The main reason for this is that this filling cannot match the tooth color as much as the composite filling. Glass ionomer is not as durable as it is compared to a composite filling.

Glass Carbomer

A glass carbomer is a type of tooth filling containing nanoparticles. This filling allows the tooth to have a self-healing feature. However, glass carbomer is not more advantageous than other fillings in terms of color and durability.

Temporary tooth filling

Dentists do temporary filling during dental treatment to give the tooth time (21 days) to repair itself. In this process, the temporary filling aims to minimize the thermal conductivity. In particular, during root canal treatment, dentists often do temporary filling to easily reach the root canal of the tooth in the next stage of the treatment. Some types of temporary fillings have pain-reducing effects.

Estimated Relative Comparison of Filling Materials (max 5)

	Aesthetic	Durability	Price
Amalgam	1	4	1
Composite	4	2	3
Porcelain	5	3	4
Gold	2	5	5
Glass ionomer	3	1	2

After Tooth Filling

If the dentist did a filling under local anesthesia, the patient should not eat anything until the numbness in the mouth completely disappears. Because due to numbness, the patient may injure himself by biting the tongue and cheek without realizing it. In this respect, it is necessary to wait for the numbness in the area to pass before eating.

Fillings other than amalgam fillings harden during their preparation and if the dentist doesn’t apply anesthesia, the patient can eat immediately. The amalgam filling is sensitive to temperature changes within the first 2 hours after it is made. For this reason, you can brush your teeth right after the filling other than an amalgam filling.

If the patient feels any height of the tooth after the filling process, it needs correction. Because in this case, the filling may break as a result of excessive pressure.

Normally, there is no pain after the filling. However, in cases where the decay is deep, it may take up to 21 days for the tooth to repair itself. During this time, the patient may experience thermal sensitivity in the tooth.

When is it necessary to renew the tooth filling?

Tooth filling can remain in the mouth for years. However, in the long term, the filling may need to be renewed due to abrasions and new caries that occur in the tooth. Movements such as chewing, clenching, or grinding cause the tooth filling to wear and weaken over time.

If there are signs of wear on the tooth filling, it will be necessary to replace it. Continuing to chew with a worn filling can cause the tooth to crack. In this case, the damaged tooth may require additional repairs, which are more expensive and more complex than a simple tooth filling.

If the filling is cracked or broken, it will already be necessary to replace the filling. Because there will be microleakage between the cracks. This can cause the tooth to decay from the inside. In this respect, broken, cracked, or fallen fillings leave gaps that can provide an entry point for decay-causing bacteria. They also cause oral malodor (halitosis). In such cases, especially zinc-containing oral care products (eg,  TheraBreath Plus Fresh Breath Toothpaste or Tom’s of Maine Natural Wicked Fresh Mouthwash, etc.) can provide good protection to maintain oral hygiene.

Finally, there must also be contact between the teeth so that food residues do not enter and remain between the teeth. If there is no contact in one of the filled teeth, one of these fillings should be removed and renewed in such a way as to ensure contact.