No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:
- Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.
- Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.
- Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.
- Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.
Normally your dentist will notice any problematic areas on your teeth throughout your regular check ups, and as a result of this it is important that you visit a dentist on a regular basis, about once a year. If a cavity hasn’t been spotted throughout your check ups then it will become apparent as the pain increases and your tooth becomes more and more sensitive. In this case you will have to arrange an emergency appointment.
When the tooth has been identified then your dentist will want to fill it as soon as possible in order to prevent any further damage. They will clean the cavity and remove any dead or decayed elements using drills or other techniques such as air abrasion.
The tooth will be contained, and moisture from the area removed so that the filling can stick properly. An adhesive is placed to the affected area so that the filling will stick and stay in place, and then the composite filling is applied. Sometimes a light source will be used to properly bond the agents together, and you will be left with a filled cavity.
Traditionally, fillings were made from an amalgam of metals including silver, tin, zinc, mercury and copper. Amalgam fillings are very sturdy and have a long life, upwards of seven years. Unfortunately, amalgam fillings will not match the colour of your tooth and often require healthy parts of the tooth to be removed to make room for the filling. One of the most popular types of filling currently used is composite fillings, created from a mixture of plastic and tiny glass particles. This type of filling also has a relatively long life, lasting upwards of five years. Composite fillings also have the advantage of matching your tooth natural colour. The downside is that composites tend to cost more and often take longer to place than their amalgam counterparts. Tooth fillings made from gold, gold foil and glass ionomer are also available.
If your dentist decides to fill a cavity, he or she will first remove the decay and clean the affected area. The cleaned-out cavity will then be filled with any of the variety of materials described above.
How Do I Know if I Need a Filling?
Only your dentist can detect whether you have a cavity that needs to be filled. During a checkup, your dentist will use a small mirror to examine the surfaces of each tooth. Anything that looks abnormal will then be closely checked with special instruments. Your dentist may also X-ray your entire mouth or a section of it. The type of treatment your dentist chooses will depend on the extent of damage caused by decay.