Fillings

What is a filling?
A filling restores a tooth that has been damaged by decay to regain its normal function. Your dentist will remove the decayed tooth material and thoroughly clean the cavity before filling it with suitable filling material which can also make the tooth look natural again.

Which Type of Filling is Best?
No type of filling is best for everyone. What’s right for you will be determined by the extent of damage to the tooth, the shape of the cavity, the position of the tooth (front or back tooth), how you bite together, whether you have any allergies and the cost of certain materials.

• Composite (plastic) fillings are colour matched to your teeth so that they blend in naturally with your own tooth colour. They can be used when a natural appearance is desired, especially on front teeth but it is also a very good material to use when a more adhesive filling material is required as they are bonded to the tooth structure. In some cases composite may not be ideal for the posterior teeth as these teeth can take a lot more force when chewing and composite can be slightly softer than some other materials so a stronger and more durable filling material may be indicated. However, composite is a lot stronger and more durable these days and is frequently used for posterior fillings but it still might be avoided if a patient has a very strong bite. Also if there is extensive tooth damage then a different material may be a better option. Composite fillings can last 10+years.
  Composite can also be used for cosmetic reasons, such as for 'Bonding'. This is when composite is added to the face of the tooth, like a veneer, to improve the appearance by changing the colour or shape of the tooth.
  
  The picture below show an example of how composite can be used and how well it can be colour matched to your tooth. The tooth in the picture belongs to a young boy who fractured his front tooth in a accident. We used composite to build the tooth back up to its normal size.
  
                                                        
                        BEFORE                                                                          AFTER
  
• Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, they are dark in colour and so are not as aesthetically pleasing as a porcelain or composite restoration.
   
• Porcelain fillings are called inlays or onlays. They match the colour of the tooth. A porcelain restoration is made at a laboratory and requires two visits in the dental chair. It can cover most or just part of the tooth and is bonded to the remaining tooth structure whilst strengthening it. A porcelain restoration may be indicated when an amalgam filling is not desired by the patient but a composite restoration is not suitable for the size or shape of the cavity.The tooth preparation is often minimalised. Porcelain restorations are more expensive then composite fillings material but they are very durable and can last many, many years.
   
• Gold fillings are made in a laboratory and then bonded into place. Gold material is well tolerated by the gum tissues and may last more than 20 years. However, it is an expensive material and requires two visits.

If decay or a fracture has damaged a large portion of the tooth then a crown may be indicated to hold the tooth together. A crown fits over the tooth like a helmet does to your head, protecting it from wear, tear and further breakages.

Decay that has reached the nerve may be treated in two ways; through root canal treatment (in which dead nerves are removed) or through a procedure called pulp cap if treated early enough (this attempts to keep the nerve alive).  A tooth that has been root treated will most likely need crowning at some point as in most cases a large portion of the tooth has already been lost to decay or the tooth will become brittle over time as the tooth has lost its vitality.