Composite Fillings

What Are Dental Inlays?

Dental inlays are also sometimes referred to as onlays.

When caries or decay happens on the flat surface of the tooth, a metal (amalgam) or composite filling can be used. However if the decay is not too invasive, an inlay or an onlay is sometimes a better option.

These restorations are used when there is a slight crack or splintering on the tooth. A dental inlay will be used when there is not enough damage to be removed and is preferable to having a crown as it is less invasive to the tooth structure.

These restorations are quite often made from composite filling material or gold, but the most popular choice is porcelain. Porcelain is used as an option when a patient is not content with the look of the metal, fillings in their mouths, and they wish for it to look a little nicer.

Dental inlays can be used in the following circumstances:

1. When there is small amounts of decay in the fissures (creases) of the tooth

2. Replacing cracked or broken or leaking Metal Fillings.

Inlays normally take two visits with your cosmetic dentist.

First dental inlays appointment

At the first appointment the decay or old metal filling is removed. An impression of your tooth will be made and sent off to the laboratory for them to make the inlay in porcelain.

A shade is then chosen to ensure the best match to your original tooth structure.

Finally, a temporary filling is placed and the patient should wait around a week for another appointment.

Second dental inlays appointment

At your second inlay dental appointment, the cosmetic dentist will remove the temporary filling, and the inlay that the laboratory made will be cemented in place.

There should be no colour difference, and the tooth should look like no procedure was performed on it.

Dental inlay procedure after-effects

There is normally no after effects of this treatment, and the patient can eat and drink normally after the procedure.

However some patients do complain of slight tenderness for a day or so after the treatment, however this soon passes.

Porcelain inlay advantages

The advantages of having porcelain dental inlays are:

– They are very hard wearing and are much stronger than your own tooth enamel.

– They look much nicer than metal fillings or composite resin fillings.

– These porcelain inlays are made specifically for your tooth and it is customized to fit exactly.

– As it is custom designed for your tooth, it seals perfectly ensuring that no bacteria can enter the cavity so no decay can take place under the porcelain inlay.

Metal Fillings Versus White Fillings

Different dentists work differently. Each uses equipment and materials that they believe will achieve the best results for their patients.

However, there are naturally advantages and disadvantages to the types of fillings available and on offer for your teeth. Here we are going to discuss the differences between metal fillings and white fillings.

Metal Fillings (Amalgam)

Metal fillings have been used in dentistry for around 150 years. These filings are made of an inexpensive mixture of Zinc, Tin, Copper, and Mercury.

However, metal filling restorations are very rarely used in today’s modern dental surgery. This is because they look rather unpleasant, and can leak metals into the surrounding tooth structure. This can cause what is called an ‘Amalgam Tattoo’, where the entire tooth can become blackened or gray.

Most people’s concerns are that the mercury in the filling can leak and be absorbed into the system. Indeed this is quite possible, and can cause the patients a wide range of health issues.

In addition, metal fillings do not seal to the tooth structure. They just lie beside the tooth, and thus there is a high risk of bacteria forming under the metal fillings causing tooth decay underneath.

This decay is hard to pick up as it will be under the filling, and not even an x-ray would not show it since it is metal based and would block the image.

Amalgam fillings vontact and expand with heat sometimes causing slight hairline cracks to appear in the tooth.

Therefore it is not recommended for an amalgam filling to be used in any tooth structure.

White Fillings (also known as composite fillings)

White fillings have been used in dentistry for around 25 years.

A white resin material called composite can be used as a restoration. This material is organic polymer mixed with inorganic parts consisting of glass and quartz.

These composite fillings have many advantages. One of the first advantages is that the dentist can remove only the decay in the tooth for this restoration. Other restorations will need larger cavities for strength.

In addition, the look of the tooth is more aesthetically pleasing. This is since there are a wide varied range of materials on the market, allowing the dentist to choose the best one to match the tooth structure.

Composite filling restorations are the first choice for front teeth.  Composites take longer for the dentist compared to amalgam fillings, but the patient is generally very pleased with the results.

There are a lot of cosmetic dentists who spend their days replacing metal fillings for composite fillings.

So contact a cosmetic dentist and replace and repair all the old black cracked metal fillings, in order get a fresh healthy mouth.

How to Place a Composite Filling

Tooth filling procedures have come a long way and have evolved into greatly improved techniques. Gone are the days when mercury or metals were used. No one needs fear heartily laughing and showing their teeth, lest others see blackened molars and “metal-mouth”.

First, a professional dentist will evaluate the dentition. Probing will find dental decay, which will be removed from the tooth using a drill (hand piece), powered air or lasers.

Once the decay is taken out, the tooth is prepared by shaping the area for the filling, to ensure that it will stay securely in place.

The next step is preparing and inserting the filling. For its durability and aesthetic appearance, composite fillings are often chosen.

Composite Make Up

There are usually three main ingredients in a composite:

• Inorganic Filler (e.g. silica)

• Synthetic filler (glass and ceramic compounds) which provide both resistance and its translucent quality

• Resin (bisphenol-A-glycidyl methacrylate or urethane dimethacrylate)

After the specific composite is chosen, painstaking care must be used by a professional and experienced dentist in the placement of the composite fillings into the prepared tooth space.

Although composites are inserted during the time that they are soft and doughy, a special light with a blue wavelength specific to the initiator and catalyst (a substance that hastens the chemical reaction) involved in the particular package which hardens (cures) the resin into a solid filling state.

The light cured composites are more dense and stronger than self-cured resins which might have porosity from air bubbles.

Because the light does not infiltrate a thickness of more than 2-3 millimeters into the resin, the composite must be placed in layers and intervals, hardening each 2-3 mm thickness, before placing the next layer until finished. This prevents the composite from remaining soft in the middle. Curing times are longer for darker shades of resin. The unpolymerized, soft resin would ultimately destroy or irritate the tooth’s nerve if inserted in bulk, all at one time.

In addition to filling cavity surfaces and gaps between teeth, composites can be applied to reshape a tooth or as a partial crown on a tooth. Even bridges between 2-3 teeth have been successfully implemented with composites.

Adhering to proper guidelines, a well-placed composite is not only pleasing to the eye; it is also markedly functional-strong, hardwearing and comfortable. In addition, the composites will last at least ten years or longer.

 

 

Advantages of Composite Fillings

Dental amalgam was the material of choice (and only one available) from the time it was first formulated in the early 19th century in France. The composition was a mixture of mercury with an additional metal.  The benefits were the strength, durability, and ease of application in addition to the fact that it limited bacterial growth (bacteriostatic).

As time and techniques evolved however, the dental profession looked for alternative materials for dental fillings to satisfy public concerns:

1.  Environmental pollution

-Emission of mercury into the atmosphere during:

o     Amalgam preparation

o     Leaching of waste from cremated remains

2.  Appearance

-Metallic look, which is accentuated from the normal tooth color

3.  Electrical Shock

-Saliva bathing the mouth can act as an electrolyte (making substances around it electrically conductive) so that jolts of shocks are felt from electrical currents to the nerves of the tooth when aluminium foil comes in direct contact with some amalgam fillings.

4.  Harmful health effects

-Mercury poisoning or toxicity

Though it took almost a century, dental restorative techniques have evolved into the use of versatile resins with many advantages.

The main advantage of dental composites over amalgams is one of pleasant appearance. Dentists have the ability with the resins to create the material in a wide assortment of tooth colors so that the restoration is visibly indistinct from the remainder of the healthy tooth.

A second advantage is that of creating tooth strength.  Acid etching creates irregularities of 5-30 micrometers in depth, which permits effective adhesion of the tooth restoration, increasing the potency of the tooth structure.  This is as opposed to the process with silver whereby the dentist had to make retentive features destroying healthy tooth sections.

Markedly strong bonds are created to both the enamel and dentin of the tooth structure with composites now. Since the resins are heat cured with laser or focused light sources the tooth is strengthened.

Composite fillings can also be used to fill gaps between teeth, which acts as a shell-like veneer as well as reshaping the individual tooth.

A composite filling can be placed during only one dental visit as opposed to an inlay in which two visits may be needed.  Less drilling is necessary with the resin than with amalgam fillings.  This is because unlike composites which are held in place by a bonding technique, the amalgam material necessitates greater tooth shaping so that the space will hold the filling more securely.

So feel free to choose a composite insertion by your dentist, you’re in good company!

What Are Composite Fillings?

Composite fillings are made of composite resin, used to fill your teeth and to build up portions of teeth to make them look natural. Composite resin is an organic, strong filling material for teeth and is tooth colored. It is used as a restorative material for decayed teeth or even re-shaping your teeth to improve their appearance.

It can be used to fix minor flaws in the teeth such as fixing a chipped tooth and can also be used to build up an entire tooth, such as a molar, to restore it to a fully functional form.

There are many uses for this resilient, tooth colored composite as is it highly durable and gives excellent long term results.Composite fillings demands much skill at the hands of the cosmetic dentist as it requires dispensing, handling, manipulating and sculpting the material which is highly adherent and difficult to work with.

Once the material is placed on the tooth surface to be treated, it is sculpted to give the tooth a whole new shape and appearance. Only a highly skilled cosmetic dentist with an excellent esthetic sense can achieve beautiful results with composite fillings.

Composite Fillings Procedure

The composite fillings procedure is relatively simple. The tooth surface to be treated is ‘etched’ (topically treated with a dilute acid) to create a slightly roughened surface for mechanical adaptation of the composite to the tooth. The roughened surface of enamel allows better bonding of the composite resin material. The material is applied in layers and each layer is hardened or cured for better adaptation to the tooth.

Once the material is applied, sculpted and the restoration is complete, a bright blue laser light (LED curing light) is used to harden the composite material and ensure perfect bondage to the tooth surface. When the material has hardened, it can then be further refined with finishing disks and polished, so that the surface becomes completely smooth and stain resistant. Any roughened, finished surface will allow pigment accumulation from coloured foods and drinks, so finishing is a must.

Composite resin materials also come in different shades and you may select the shade you desire to have used. It is always best to let the dentist aid you in your decision so as to avoid a restoration and tooth color variation. The procedure is simple but may be slightly time consuming, depending on your particular case, as much skill and hard work goes into perfecting each composite restorative bond.

This material may be used to build up an entire molar tooth due to a large portion of tooth lost by decay, such as in the case of an MOD filling.

Composite fillings can be compared to amalgam/ silver fillings in this aspect as it re-establishes almost the same amount of strength to the restored tooth, with the added advantages that it bonds mechanically to the tooth, without any extra removal of sound tooth substance. Furthermore, the results are so natural it is almost next to impossible to detect whether the tooth has been restored at all. The esthetic results of composite bonding are highly favorable for self-conscious individuals.

Composite fillings is one of the most effective and widely used dental treatments when it is indicated for its particular use, and can last many years if taken care of and maintained well.

Allergies to Composite Fillings

While there is less sensitivity to composite fillings than the old amalgam ones, patients with allergies must be very cautious.

It is better to err on the side of caution and a screening test for allergies should be performed.

Screening Tests

In order to pinpoint sensitivities to various materials, The Clifford Materials Reactivity Testing (CMRT) was devised.  This is a blood screening technique in the laboratory for the purpose of identifying existing allergies to different chemicals and groups of compounds in a patient.

The CMRT has been added routinely to the Dental panel practice.  Test results are assembled into a single chart and upon review, the skilled dentist can make the decision as to which fillings would be most appropriate and least likely to cause a reaction in an individual.

There is no need to fast or avoid certain foods in the diet prior to having blood drawn for the CMRT. Antibiotics and the majority of medications will also not affect the screening test.

There are more than 11,000 branded dental products and almost 100 chemical compound groups used in dental products that are routinely tested in the Clifford Materials Reactivity Test. The personalized results supply the complete data necessary in selecting the type of restorative materials for each patient.

Sensitivities can change over the course of time.  Yet the CMRT is accurate for 1.5 to 2 years and is accurate in 95% of the tests done.

Anesthesia is not tested in the test however.  If sedation or topical medication is going to be applied, this must be discussed with the patient and a careful history of allergies taken.

Hormone Release

In chemical composition studies, it has been found that a small amount of estrogenic chemicals are released from composite fillings (probably from the sealant used). This can create allergic and health concerns.  However, the amount of these chemicals released, rapidly decreases after the initial few days.

Due to the nature of the hormones released, it would be prudent for pregnant or breast-feeding women to postpone the placement of composite fillings into their teeth until the delivery or such time as the lactation is finished.

While allergic reactions can occur to almost any chemical compound one is exposed to, the toxicity from mercury and amalgams is still viewed as a greater threat than the composite fillings.  Also, depending on the test results, the resin can be applied with a different sealant.