There comes a point where tooth brushing and diet alterations can no longer undo the damage of decay. Once this decay has spread into the dentine it is very likely the tooth will require a filling. This is often necessary because spreading decay compromises the integrity of the tooth, therefore putting it at risk of fracture. There is also a risk that the nerve may become infected if the decay spreads further which may lead to further complications (abscess, swelling, pain).
Those of you with fillings will know that there are different types, and these can generally be broken down into those you can clearly see (silver amalgam) and those you can’t (mainly tooth-coloured composite fillings). These days more and more patients are asking to have composite fillings placed, and it is becoming more important that patients understand what the benefits and risks are of having these fillings.
What is a composite filling?
A composite filling is a resin which is mixed with glass to make it resemble a tooth when placed in a cavity. The technology of these materials has advanced enough that they now have multiple uses, for example, front teeth can be altered to improve the smile, or repair fractures after accidents.
How is the filling done?
Composite materials are VERY moisture sensitive, so sometimes a dry rubber dam is placed to avoid the tooth getting wet. The cavity is prepared and then the composite is applied in layers which are set hard with a blue light. Once finished, the filling is shaped so it fits the tooth and then polished smooth.
What are the advantages of composites?
Composites are more aesthetically pleasing (i.e. they look more natural) than other materials. Placing this type of filling can be an art form, and different shades can be blended to create a colour nearly identical to that of the actual tooth. Resin fillings can provide some extra support for the remaining tooth structure which can help delay breakage and insulate the nerve of the tooth from temperature changes.
What are the disadvantages?
After having a composite filling, a patient may experience some sensitivity once the local anesthetic has worn off. Over time the colour of the composite can change slightly, especially if regular amounts of tea, coffee or other staining foods are consumed which may stain it. A coating can be placed over the filling to reduce how quickly it stains, however, regular maintenance is needed to remove staining. Composites tend to wear away a little faster than amalgam fillings when in large cavities, although they hold up as well in small cavities.
Here are some photos of composite fillings I have done recently: