Dental Fillings
 

What about White Fillings?

As we mentioned there are two different types of white filling:
  • Composite, which is the filling most widely understood to mean white filling (especially in a cosmetic context).
  • GIC (glass ionmer cement) .

There are other variations of these two materials currently available that combine the advantages of each one. The technology is advancing all the time to produce, better, stronger, more attractive and easier to use materials.

Tell me about Composite?

Composite is the most aesthetic (best looking) material we have and the process for its placement is discussed in filling procedure. It bonds to your tooth so we do not need to remove any more tooth than is necessary – just enough to remove the dental decay and allow space for instruments to fill it up.

This is an advantage over silver fillings which require a cavity to be shaped in a certain way so that the amalgam stays in. Because of this, placing a white composite filling is often referred to as ‘tooth bonding’ or ‘teeth bonding’. Generally these phrases apply to using the material in a more cosmetic situation instead of crowns and veneers. It can adjust the shape of teeth and change their colour.

Composite comes in a range of shades to match the colour of your tooth. A general dentist will achieve a good result, but there are certain dentists for whom using this material has become an art form. Procedures can take a long time, but the results are fantastic. In the dental magazines, every month or so there will be articles on achieving cosmetic excellence with this material.

A cosmetic dentist by the way is not a specialist, it is a merely a title suggesting a focus of the practice is to make teeth and smiles look better. It is important to check out which associations the dentist belongs to and to see examples of previous cases to gauge a more accurate idea of their experience in the cosmetic field.

All general dentists perform some 'cosmetic' type dentistry but smile transformation is much more involved and expensive. There are many options for such makeovers and each case is different and unique. A good overview is presented in alternatives to dental veneers.

So What is Composite Used For?

  • To fill cavities in anterior (front) teeth
  • As a tooth coloured filling material for posterior (back) teeth- An alternative to amalgam fillings
  • To correct and repair all manner of tooth imperfections such as:
- Chipped and fractured teeth

- Stained and discoloured teeth

- Improving the shape of teeth

- Closing the gaps between teeth

- Exposed roots.
  • For retention of orthodontic wires.
  • To open up the bite to make space for more complex treatment.

Its bonding technology is also used in:

  • Bonding in- 'sticking in', crowns, bridges, inlays and onlays.

As you can see it is a rather useful material… in fact I don’t think many dentists would argue with the statement that it is the most useful material in dentistry today.

Composite is most effective in smaller cavities and in very large cavities an inlays/onlay
or a crown, if the tooth has had a root canal, would be a better long term solution. It is sometimes difficult to get really good tooth contacts in large fillings and food packing may be a problem, which will need one or more of the above treatments to help solve it. That said, introduction of certain new matrices (bands that help the dentist pack filling material into the tooth, restoring it's shape and preventing it from sticking to the tooth next door) have helped this situation considerably

An advantage of composite is that it can often be added to- if part of the tooth breaks away or your filling chips.

A disadvantage of composite is that as it sets, it shrinks, putting stress on the natural walls of the tooth. If only a thin wall of tooth remains, the stress can cause that vulnerable part of the tooth to fracture off with time.

Composite also expands and contracts at a slightly different rate to the natural tooth so it can come away slightly from the cavity walls and leak over time. Staining can be a problem in these areas between the composite filling material and natural tooth.

Composites can be set in two ways: either on their own (chemically) once mixed or more commonly in small sections with a special blue dental light (light cured).

These special lights can only set hard a few mm of composite material, so large cavities often need many layers which can take some time. Different setting lights are available, some of which set the layers in only a few seconds speeding up he whole process considerably.

Tell me about GIC?

Glass ionmer attaches to the tooth in a very different way to composite described here replacing some of the calcium and phosphate ions in your tooth. The major advantage of a glass ionomer filling is that is has the ability to store and release a small amount of fluoride over time and can therefore be very useful if you are prone to decay, particularly root caries.

It has a very white appearance so is not generally used in the areas where you would see it in your smile. It also doesn’t wear too well and has only half the strength of composite- so it is only used in certain situations.

GIC makes a very good temporary material and can come in various colours such as pink, blue or silver to make viewing the difference between tooth and filling easier.

Other applications include using it as a lining material under both composite and amalgam to seal the dentine, as a fissure sealant and as a cement for putting in crowns, bridges and orthodontic bands.

It is also a very useful material in children's dentistry as it is quick and easy to use. Children often have short attention spans, lots of saliva and small mouths making composite fillings less than ideal. Since the deciduous (baby) teeth are going to fall out anyway the material doesn't have to be that strong and wear resistant- it just needs to stay in long enough till the tooth falls out.