Fillings

Dental fillings replace parts of a tooth that has been damaged due to injury or decay. Also known as dental restoration, a filling preserves the integrity of the tooth and prevents further damage from cavities. Fillings can also restore the chewing surfaces of teeth that have become worn. Avoiding damage from decay or injury is preferable, but fillings are a good way to prevent the eventual loss of a tooth. Most cavities and fractures that are caught early are good candidates for restoration with fillings.

If your teeth are chipped, cracked or damaged by tooth decay, they need fillings. Large cavities are obvious and often painful, but small pinhole cavities and hard-to-see areas between teeth may also need attention. Your dentist can find cavities and sites of tooth decay that you may not see in the mirror. X-rays, dental probes and dyes can reveal areas that need dental restoration. Your dentist can also see areas that you may not be able to spot, which is one reason why regular dental check-ups are vital for your oral health. Regular visits allow the dentist to see small problems before they become large ones.

Although cavities are the most common reason for fillings, they are not the only reason your dentist may recommend reconstructive work. If you grind your teeth, bite your nails or use your teeth as tools, you may erode the chewing surfaces enough to require a filling to restore a healthy bite. Signs that you may need a filling include:

Visible holes or dark spots on teeth

Visible chips or cracks

Sensitivity to heat and cold

Sharp pain when biting down on the affected tooth

Fillings used to be made of precious metals because they could withstand years of use. Today, gold and silver amalgam fillings are still available, but new options include tooth-colored resin composites, porcelain and glass ionomer cement. Your dentist will recommend a filling type for you based on the amount of restoration that must be done, the location of the filling, your personal preferences and your budget.

Gold and silver amalgam fillings have the greatest longevity, often lasting 10 years or longer with normal maintenance. Although gold is the more expensive option for precious metal fillings, it offers extraordinarily long wear; gold fillings can last decades or even a life time. Silver amalgam fillings contain silver, tin, copper and mercury. They are an inexpensive option and are most often used to fill small cavities.

Composite resin fillings resemble a specialized epoxy and contain particles of silica or ceramics in a polymer matrix. They can be blended to match the color of the surrounding tooth material, making restoration less noticeable than it is with metal fillings. They also spare more of the original tooth during the filling process. However, resin fillings do not have the longevity of metals and may need to be replaced in under 10 years.

Porcelain fillings may be made entirely of the ceramic material or bonded to metal. They look natural and have greater longevity than composite fillings, but they are costly. Also called inlays, porcelain fillings are a good solution for worn teeth.