Let's Talk Dental Fillings: Procedure and Costs
A dental filling is a type of restorative dentistry treatment used to repair minimal tooth fractures, tooth decay or otherwise damaged surfaces of the teeth. Filling materials, which include composite, porcelain and silver amalgam, may be used to even out tooth surfaces for better biting or chewing.
Enamel loss is a common component of tooth decay, and may result in tooth sensitivity. In many cases, sensitivity caused by enamel loss will be significantly improved or completely eliminated once an appropriate dental filling material is placed. But in some cases, depending on the extent of tooth decay or damage, the affected tooth may require additional or alternative procedures, including:
- Dental Crowns: Teeth requiring more support than offered by a traditional filling may require a dental crown.
- Dental Implants and Dental Bridges: Irreparable tooth damage requiring tooth extraction may require an implant or bridge.
- Root Canals (perhaps along with antibiotic treatment): Infected, abscessed or nerve damaged teeth may require a root canal procedure.
The dentist begins the procedure by preparing the tooth and necessary surrounding areas in order to restore the decay or damage. The decay or damage is removed with a dental hand-piece or laser, and the area is cleansed to remove bacteria or debris before the restoration is completed.
The first step in performing a composite filling procedure involves isolation of the tooth. Tooth isolation is critical in a composite restoration because it prevents moisture from interfering with the bonding process. This requires the placement of various adhesives followed by the composite material, which is then hardened with a special bonding light. The completed composite restoration is both functional and natural looking.
Recovery and Aftercare
After the cavity has been filled, your dentist will discuss steps you can take to prevent decay from forming under or around the filling, or in other teeth.
Brushing twice a day with fluoride toothpaste and flossing with dental floss or an interdental cleaner once a day is advised. Keep appointments with your dentist and hygienist for routine check-ups and teeth cleanings. Depending on your risk for caries, your dentist also may suggest sealants that can be placed over your molars to prevent the build-up of plaque and decay, as well as the use of fluoride mouth rinses as an additional preventive measure.
Also, since diet and nutrition affect oral health, it will be important to maintain a balanced diet and limit your intake of sugary foods and drinks, and between meal snacks.
Porcelain or Composite?
There are a number of pros and cons associated with both composite and porcelain, and amalgam.
Safety and Appearance: In addition to having a more pleasing and natural tooth-like appearance, porcelain and composite fillings have the potential advantage of not containing mercury or other metals that may contribute to sensitivity or toxicity. Mercury toxicity from amalgam fillings is a controversial subject, though no research to date has been able to show any risks of having mercury as a component of amalgam fillings. However, many patients do have metal sensitivities and some have reported a metal taste after the placement of amalgam.
Durability: Porcelain and composite previously were not as durable as amalgams. However, dental manufacturers have made great strides in improving the strength of composite resin materials, to the effect that composite fillings now have the potential to be used for all teeth, including molars. Furthermore, composite materials often require less tooth preparation and may not weaken the affected tooth as much as amalgam, which often require more extensive tooth preparation. However, amalgam fillings do have a long-term track record and may last longer than porcelain and composite.
Tooth Shaping: All fillings require preparation of the affected tooth, but less preparation is usually required for porcelain or composite. Typically, this means that less healthy tooth structure has to be removed when placing a composite.
Technique and Time: More than amalgam, the success of porcelain or composite depends on your dentist's technique. Porcelain or composite restorations also require the use of additional equipment, and the procedure itself requires up to 50 percent more time than the amalgam filling procedure. These factors contribute to the higher costs associated with porcelain and composites. In addition, most dental insurance companies do not cover the additional costs associated with porcelain and composite.