bondings

What Steps Are Involved in Filling a Tooth? 

• First, Dr. Prouty will use a local anesthetic to numb the area around the tooth to be filled.  Next, he  removes the decayed area. Then he probes or tests the area to determine if all the decay has been removed. Once the decay has been removed, he prepares the space for the filling by cleaning the cavity of bacteria and debris.  If the decay is near the root, he may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Then he will finish and polish it.
• Several additional steps are required for tooth-colored fillings. After he removes the decay and cleans the area, the tooth-colored material is applied in layers. Next, a special light that "cures" or hardens each layer is applied. When the multi-layering process is completed, he shapes the composite material to the desired result, trims off any excess material, and polishes.

Deteriorating Fillings

• Constant pressure from chewing, grinding, or clenching can cause dental fillings to wear away, chip, or crack. Although you may not be able to tell that a filling is wearing down, we can identify weaknesses in them during a regular check-up.
• If the seal between the tooth enamel and the filling breaks down, food particles and decay-causing bacteria can work their way under the filling. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscess leading to new problems and more costly procedures. 

“Preventive care and regular check-ups are key to assuring the longevity of your restorations and overall health of your teeth and gums.”

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.
  

What Types of Filling Materials Do You Use?

• Dr. Prouty uses only the best tooth colored (highest quality) composite resin material available.  Advances in this material now make it a sound choice, providing long lasting results.  Though Amalgam (see description below) is easier to use and requires less skill from the practitioner to place, Dr. Prouty only uses tooth colored (metal free) composite.  See the benefits of composite over metal below.  

LISTED HERE ARE THE TWO MOST COMMONLY USED FILLING MATERIALS

WHITE Fillings

Advantages of TOOTH COLORED RESIN COMPOSITE fillings:

• Aesthetics -- the shade/color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth, but the latest materials (highest quality composite resin) can also be used for back teeth.
• Bonding to tooth structure -- composite fillings actually chemically bond to tooth structure, providing further support (as opposed to cementing).
• Versatility -- in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.  See bonding above.
• Tooth-sparing preparation – often times less tooth structure needs to be removed compared with amalgam restorations
• Durability – New advances in composite materials now provide long lasting results that compare to metal restorations.
• X-rays can see through them.  Since there is no metal in this material, x-rays will show any decay starting underneath the restoration.

Disadvantages:

• Slight increased chair time -- because of the process to apply the composite material, these fillings can take 10-15 minutes longer to place.
• Not all composite resin material is alike and choosing the best and highest quality resin is key to the longevity and strength of the restoration.
• Requires an experienced and highly skilled dentist.  Not all practitioners are skilled in placing composites on back teeth.  Years of experience and use of the best materials available assure a positive outcome.

METAL Fillings

Advantages of SILVER (AMALGAM) fillings: 

• Durability -- silver fillings last at least 10 to 15 years.
• Strength -- can withstand chewing forces.

 Disadvantages: 

• Poor aesthetics -- silver fillings don't match the color of natural teeth.
• Destruction of more tooth structure -- healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling.
• Discoloration -- amalgam fillings can create a grayish hue to the surrounding tooth structure.
• Cracks and fractures -- although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, amalgam material -- in comparison with other filling materials -- may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fractures.
• Allergic reactions -- a small percentage of people are allergic to the mercury or metal present in amalgam restorations.
• Metal fillings may increase hot/cold sensitivity.
• X-rays cannot see through metal fillings and as such, making it more difficult to determine if decay is present.  (However, an x-ray is still useful as it will also show the root of the tooth.)

Should I have my old silver fillings removed?

Many patients have to opted to have their old silver (amalgam) fillings replaced for various reasons, whether it be health related or aesthetics.  We’re happy to discuss your options. 

WEBMD.com:  “Over the past several years, concerns have been raised about silver-colored fillings, called amalgams fillings.  Because these fillings contain mercury, some people believe they are responsible for causing a number of diseases…

Although amalgams do contain mercury, when they are mixed with other metals, such as silver, copper, tin, and zinc, they form a stable alloy that dentists have used for more than 100 years to fill and preserve hundreds of millions of decayed teeth.

In June 2008, the FDA said, "Dental amalgams contain mercury, which may have neurotoxic effects on the nervous systems of developing children and fetuses."  And there's more…   women and persons who may have a health condition that makes them more sensitive to mercury exposure, including individuals with existing high levels of mercury bioburden, should not avoid seeking  dental care , but should discuss options with their health practitioner," according to the FDA.”