123Dentist Answers your questions

Composite and Amalgam Fillings

Strong bonding material, either amalgam (silver-coloured) or composite (white), used to fill cavities and repair teeth.

Fillings are a common dental procedure used to repair decayed, cracked, and broken teeth. Fillings can help save the natural tooth, even when mild tooth decay has already set in.

Why Are Fillings Used

Fillings are often used to treat the natural teeth when they are affected by tooth decay. When the tooth enamel is worn down, small holes in the teeth known as cavities form. As bacteria and other substances settle into a cavity, a tooth may begin to decay.

If cavities are not filled while they are minor, further decay may cause them to become bigger. At a certain point, tooth decay may spread. The tooth may need to be pulled and replaced with dental implants, bridges, or other dental work. Fillings are often used to prevent or delay these procedures.

By treating decay and preventing further damage to the tooth or teeth, fillings can also reduce tooth sensitivity felt in the area of the tooth that is decaying.

What to Expect During Filling Procedures

Your dentist will apply a local anesthetic to the area around the tooth or teeth to be filled. Next, the decayed area of the tooth will be removed using a dental handpiece and other dental instruments. Once the cavity has been fully rinsed and cleaned out, your dentist will apply the filling and harden the material with a special bonding light.

The specific steps for filling the tooth and completing the procedure depend on the type of filling you’ve selected. If the damage is near the root of the tooth, a liner may also be used to protect the nerve before the filling is placed.

Types of Fillings

Dental fillings can be made of various materials, including:

  • Gold
  • Porcelain
  • Dental amalgam
  • Composite resin
  • Ceramics
  • Glass ionomer

Dental amalgam fillings used to be the most commonly used type of filling in Canada. However, bonded composite resin fillings are now the most popular choice of restorative material.

Composite resin is an acrylic tooth-coloured material that is often used when patients want their fillings to match the colour of their natural teeth. Resin fillings are often more expensive than dental amalgam fillings because they require more tools and work. Resin fillings do strengthen the teeth due to them being bonded to the tooth.

The type of filling you choose with your dentist may depend on several factors, including the level of tooth decay and its specific location within the tooth structure, and the costs of the materials and whether they are covered by dental insurance. If you have an allergy to mercury or other metals, your dentist may recommend composite fillings instead of amalgam, as amalgam fillings contain small amounts of mercury.

You may also choose a specific type of filling based on aesthetics. For example, composite resin may be more desirable for a lower molar because the tooth is more visible than an upper molar.

Dental Fillings FAQs

What is the difference between fillings and inlays and onlays?

Inlays and onlays are most often used on larger cavities. Unlike fillings, inlays and onlays are applied as single, solid pieces. Depending on the level of decay and its location, your dentist may recommend inlays or onlays, or other dental procedures such as dental implants or dental crowns.

Learn More About Inlays & Onlays

Are there health risks associated with fillings?

Although there have been concerns about health risks associated with amalgam fillings (which use mercury), scientific evidence has not shown that fillings are dangerous to human health. According to the Canadian Dental Association, “Scientific studies have not verified that dental amalgam is causing illness in the general population. It has been known for some time that amalgam fillings release minute amounts of mercury vapour, especially with chewing, and that this mercury can be absorbed, reach body organs, and cross the placenta. This is also true of mercury absorbed from natural sources, such as food.”

Do I need to have fillings replaced?

Fillings may need to be replaced if they become worn down, loose, or broken. It is also possible to replace fillings with different materials. Many people with amalgam fillings choose to have them replaces with composite fillings for a more aesthetically desirable look.

How can I care for my fillings and prevent further cavities?

Although cavities can’t always be avoided, a regular dental hygiene routine at home can help keep bacteria and other substances from breaking down the protective tooth enamel. You can achieve this by brushing and flossing every day and following any other instructions from your dentist or dental hygienist. You may also receive dental sealants for small fractures that have the potential to grow into cavities.

Pregnant women who suffer from morning sickness may be at greater risk of oral health issues such as gum disease and tooth decay, as the gums and tooth enamel are exposed to stomach acid more frequently. If you vomit due to morning sickness, be sure to rinse your mouth with water or a fluoride mouthwash and brush your teeth as soon as you’re able to.

Learn More About Dental Sealants

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