Whilst most patients try to maintain a good oral hygiene and reduce their frequency of sugar intake, from time to time we may need a dental filling to restore a decayed or fractured tooth.
Tooth decay is caused by acid producing bacteria that are found in plaque producing acids after dietary sugar intake. These acids break down the enamel and dentine of teeth and can cause serious damage to the tooth.
Mouth saliva clears away bacterial produced acids from tooth tissue and has a protective effect but in patients who suffer from low saliva flow, this protection maybe reduced and the risk of tooth decay developing will be higher.
In order to prevent tooth decay it’s advised to floss once daily, brush twice daily and limit dietary sugar intake to no more than 3 occasions per day. Sugar is found in many different foods such as fruits, processed foods, fizzy drinks and confectionery.
Those patients who are at high risk of developing tooth decay should also consider using a fluoride mouthwash or high fluoride toothpaste to reduce the risk of tooth decay developing.
Early tooth decay also known as Enamel decay can be treated conservatively with daily flossing, brushing and fluoride mouthwash use with six monthly reviews by a dentist. Patients are usually not even aware of any symptoms if they have early enamel tooth decay.
Moderate tooth decay known as Dentine decay will need a filling as dentine decay will advance further unless it’s treated by a dentist. Moderate tooth decay can cause tooth sensitivity especially on drinking cold water.
Very advanced tooth decay that’s reached the nerve (pulp) of the tooth will need Root canal treatment in order to maintain the tooth without pain. Advanced tooth decay can cause pain and swelling and other symptoms such as pain on chewing.
A white composite filling is the most commonly used type of filling these days as it looks very natural and bonds to the remaining tooth tissue very well. A composite white filling can be provided for patients in a single visit.
Porcelain or composite Inlays or Onlays are indirect white fillings that are more appropriate for larger cavities. An Inlay or Onlay take two visits to be made as a dental technician constructs them in the dental laboratory.
In the immediate period after a filling is carried out, that side of the mouth maybe very numb and there is a risk of damage to the lip and tongue on that side by chewing on them during function. It’s advisable not to use the tongue and lip on that side of the mouth too much until the numbness has stopped.
Daily Flossing and brushing of the tooth and filling is essential to prevent bacterial accumulation around the filling margins which can lead to bacterial leakage.
There can be some tooth sensitivity after a deep white filling is carried out. This usually settles down within days or a few weeks after the filling is carried out.
Very rarely, if the sensitivity and pain persists due to having a very deep filling, then root canal treatment may become necessary.
In time white fillings can stain, debond, chip or fracture. Occasionally if the filling is very large it’s advisable to have a dental crown instead of a filling to reduce the risk of tooth fracture or filling fracture.
White fillings bond to the tooth tissue far better than silver fillings and look much more natural and more closely resemble tooth enamel. As white fillings bond to tooth tissue very well, this has some protective effect against further tooth wall fracture. However metallic silver fillings are stronger than resin white composite resin fillings and have a longer average lifespan.
Silver amalgam fillings contain mercury and the use of mercury in silver fillings has raised some controversy over the years within the dental profession. Although the health risks of mercury within fillings, is as yet unproven, some patients prefer not to have any silver fillings in case health risks come to light in future.
White fillings are more technically demanding than silver fillings to do and require more surgery time and hence usually cost more than silver fillings.
With good aftercare and maintenance white fillings should last for many years. Studies show that the average lifespan of a white composite filling is around 3-5 years. Studies show that a composite or porcelain inlay or onlay last on average from 5-10 years.
Patients can increase the lifespan of their fillings by brushing and flossing daily, reducing the frequency of dietary sugar intake and seeing their dentists every 6 months so that their fillings can be closely monitored.