“You’ve got cavities”… The words no one wants to hear at the dentist! When cavities are relatively small to moderate in size they are usually fixed with fillings. So what options do you have for fillings?
The dentist will numb your tooth and use a dental drill to remove the area of the tooth that is decayed. Many people ask if they can have the filling done without being numb because they are so scared of shots. My personal opinion is that if the decay is small enough that you don’t need to be numbed, then it is probably not at the point that it needs a filling. I have had patients who are exceptions to this but it is pretty unusual. The decayed area is usually soft and stained and the dentist removes all of this. This halts the decay process and also provides a solid foundation to put the filling material on.
There are several major types of filling material…
Amalgam is the oldest of the filling materials. It has been in use since the early 1800’s and has proven over that time period to be extremely durable and easy to place. It is made of a combination of silver, tin, copper, and mercury. Amalgams have become controversial recently due to concerns about the mercury content and it’s effect on the brain, especially the developing brain. Despite significant long term studies that have demonstrated no related health issues as far as they can tell, it has nonetheless begun to be phased out in most areas.
Composite resin fillings are one of the types of “white” fillings. Composite fillings as we know them today were first developed in the 1980’s and have undergone some significant changes and upgrades in the time since. Composites are made of a mixture of plastic and glass particles. The biggest challenge with composite fillings is that in order to bond them to the tooth, there must be perfect isolation from any saliva, unlike amalgam and glass ionomer fillings. There also tends to be a bit more sensitivity following these fillings than with other types. This has been reduced with better bonding systems over the years but can still be a pretty significant problem. Composite fillings have had some controversy of their own in the last several years when it was discovered that bisphenol-A (BPA) can cause certain types of health problems. Most composite fillings have a small amount of BPA that is released over time. The good news is that the amount released is miniscule (approximately 1/1000 the amount that you receive from other sources daily) and is very unlikely to cause any health problems.
Glass ionomer is another type of “white” filling material that is used for dental cements as well as some types of fillings. Glass ionomer is formed from a reaction of silica glass particles and an acid. It isn’t a strong material but does have the benefit of bonding to teeth on it’s own and releasing fluoride to help prevent future decay. These fillings are generally used on baby teeth as well as when there is decay on the root surfaces of teeth.
Once the fillings have been placed your dentist will smooth them down and make sure your teeth come together correctly. After having fillings done you can expect some sensitivity and soreness for several days to several weeks afterwards. Occasionally you will need the dentist to adjust your “bite” after the numbness has worn off and you can feel exactly how you are biting together.