What are fillings?
The replacement of missing tooth structure caused by disease or trauma is possible in almost all situations, and this is termed a dental restoration, or filling. The aim of restorative treatment is to return appearance and function – including speech and chewing – to as normal as possible.
Factors that our dentists need to consider include the location, size, shape, colour and biting forces applied to the tooth. For this reason, the dental profession has developed several different materials that are useful to repair a tooth and our dentists may recommend certain materials over others based on your individual needs.
What materials can be used for a filling?
The first materials that could be directly placed into a patient and then set were gold foil, followed by the invention of dental silver amalgam in the late 1890s. Amalgam had the advantage over gold by being cheaper, but also much easier to work with in a patient’s mouth. It has proven its worth many times over, and though now in decline, remains a durable and cost-effective filling material.
Of course, most of our patients today not only want their teeth to function well, but to look great too. This has led to the development and rise of tooth coloured materials. Prior to the mid-1970s there was not a lot of choice. The first composite resins didn’t have many different colours, did not adhere well to teeth and didn’t last very long.
Alongside composite, glass ionomer cement materials developed. They have the advantage of releasing fluoride to protect the tooth surrounding the filling. This is a great feature, but also makes the material prone to acid wear and failure.
Our dental scientists have continued to improve not only the materials themselves but to refine the techniques for our dentists to produce better results for our patients and we can now deliver highly aesthetic, long lasting fillings.
I’ve heard amalgam isn’t safe?
Despite what you may read on the Internet, amalgam remains a mainstay for fillings. All available research has demonstrated it to be safe, effective, strong and durable. It is a powdered alloy of silver, tin, copper, with trace amounts of zinc and indium mixed with mercury to make the powder set. It does have limitations, including its colour, which is the main reason patients would prefer something that looks natural.
How long do fillings last?
Firstly, though a new filling will last for some time, it will not last a lifetime. There are multiple factors that will decide how long a filling will last. These include the type of material used; how big the filling was to start with; how well you as the patient brushes and flosses to look after it; the skill and experience of the dentist who placed; the forces applied to the filling itself in use and many more.
The dental research on fillings tells us that the annual failure rate for fillings is between 0-15% dependent on the factors listed above. So some may only last one to two years, whilst others are still perfectly useful after 20 or more. We believe that if get one of your fillings to the 10-year mark, then we have all done pretty well.
Crowns, Bridges and Other Considerations
If the entire tooth is missing then replacement with an implant, bridge or denture can be considered. When several teeth, or even all teeth are missing then implants, or a denture, can be used to restore appearance and function.
Endodontic treatment, or root canal therapy, can help save badly broken down teeth or teeth which have an infected pulp. In most circumstances, we would recommend the tooth be restored with a crown to increase its longevity.