WHAT ARE FILLINGS (RESTORATIONS?)

COMPOSITE RESTORATIONS are tooth colored fillings that use a plastic-like material in the resin family to fill teeth. The traditional composite resins are made up of a large amount of inorganic filler particles bound by an organic polymer matrix or mesh. The newer generation composites have superior properties which include higher strength, hardness, elasticity, abrasion resistance and high polish ability to make the restoration appear life like. Tooth colored fillings are used to fill teeth that have decayed, or to cover parts of teeth for esthetic reasons. They are held to the teeth with bonding agents. The shades match closely to natural tooth structure.

Although it is not possible to predict success for individuals, the average lifespan for a tooth colored filling is 4 to 7 years, but failure may occur sooner. A strong bite, large fillings or decay can shorten the longevity. Smoking and tea or coffee drinking will stain the fillings. Decay will occur around the filling if good plaque control is absent. Composite restorations have post-operative discomfort which can last from one week to as long as three months.

AMALGAM RESTORATIONS are silver in color and are a combination of silver, tin, copper, and mercury. They have been used for over a hundred years to fill teeth. Their use has declined considerably due to the improvement of bonding and composite materials. They are metallic and so can withstand the strong biting forces in the back of the mouth. The color is initially soft gray but will turn darker with age.

The average lifespan of a silver amalgam filling is 5 to 9 years, and although it is possible to predict for individuals, certain situations can contribute to failure. They can fail sooner if there is a strong bite, if the filling is very large, or if the tooth around the filling decays. Decay will occur if plaque control is inadequate.

Alternatives to amalgam restorations:

1. Gold onlays or inlays
2. Crowns
3. Composite restorations
4. Extractions
5. Indirect (lab processed) porcelain inlays or onlays

Pin Retention: Sometimes pins are needed to hold an exceptionally large filling in place. A risk in using pins is perforation into the nerve or outside the root. If the nerve is invaded, a root canal may be necessary. If the pin is placed so it perforates the side of the root, a surgical procedure to repair the area may be required.

Alternatives to pin retention restorations:

1. Gold onlay
2. Crown
3. Endodontics
4. Extraction

RISKS: Certain risks are associated with all filling procedures. Rarely do they occur, but they include:

1. Allergies - possible allergy to latex in rubber dam and/or gloves or chemicals in impression materials and/or chemicals in filling materials.
2. Damage to pulp or weakening of tooth structure leading to endodontic treatment.
3. Damage and weakening of hard tooth structure leading to crown placement.
4. Electrolytic action between dissimilar metals, gold and silver amalgams, causing sensitivity.
5. Deterioration and loss of cementing materials leading to secondary caries and/or loss or restoration.

For more information http://www.ada.org/public/topics/alpha.asp