Tooth-Colored Fillings

What is a cavity and how does it form? 

A cavity (tooth decay) occurs as a result of four necessary factors: bacteria, fermentable carbohydrates, time, and teeth. Every day, within 4-12 hours after brushing, a sticky film of bacteria called dental plaque forms on our teeth. As we consume foods called fermentable carbohydrates, our saliva breaks them down into simple sugars including glucose, fructose, maltose, and lactose. 

Fermentable carbohydrates include sugary foods such as cookies, candy, cakes, and soft drinks, but surprisingly, also include bread, crackers, potato chips, bananas, and breakfast cereal. As we indulge in these foods, the bacteria are also feasting, and within 20 minutes, these bacteria produce acids. Over time, the acids start to gradually dissolve the outer tooth structure (enamel). If this process continues, a visible cavity or hole will form. In order to prevent and/or halt this process, daily brushing, flossing, rinsing with water during meals, and attention to diet are strongly recommended.

How does diet influence cavity formation?

Research has shown that the longer food remains near bacteria on teeth, the more acids will be produced, and the greater the chances of cavity formation. Sticky carbohydrates (raisins, candy, bananas, etc.) and those that can easily get stuck in small spaces (potato chips) can increase the risk of tooth decay. 

Additionally, people who sip on soda, soft drinks, or coffee throughout the day or frequently snack between meals are providing constant nutrients for the bacteria. This increases the amount and duration of acid production, as well as the likelihood of cavities developing. The take home message is that frequency of consumption is a critical factor. If you are going to eat or drink carbohydrates, try to do it during meals while drinking water. In this way, the acids are being rinsed and diluted and the bacteria are unable to constantly metabolize sugars and produce acid throughout the day. 

What are dental fillings? 

Dental fillings seal cavities (holes) in the teeth caused by certain acid-producing bacteria. They prevent the cavities from spreading deeper into your tooth and, if left untreated, reaching the sensitive inner pulp (nerve) tissue located in the root canal. If this were to happen, you would likely need root canal treatment. 

What can I expect during a dental filling procedure? 

First, a clinical examination is performed in conjunction with digital X-rays to determine the presence and extent of any tooth decay. During the filling procedure, your tooth and gums will be anesthetized for your comfort. After removing the decay with dental drills, the tooth is roughened with an acidic gel, adhesive is applied, and the composite resin filling is placed. A special light is used to harden the filling, your bite will be checked and adjusted until it feels comfortable, and the filling will be polished until smooth. Although the filling will be fully set, we recommend waiting until the anesthetic wears off before eating (usually after two hours). 

What are the different types of fillings that exist? 

There are two broad categories of dental fillings: metal fillings and tooth-colored fillings. Each type offers advantages and disadvantages. 

Metal Fillings

1) Amalgam - The classic "silver" filling, dental amalgam is composed of mercury, silver, tin, and copper. The mercury combines with the other metals to make it stable and safe. These fillings are strong and inexpensive, but are also quite noticeable. They often last 10-15 years. However, since they do not chemically bond to the tooth (like composite resin), they often require more tooth preparation (drilling) than other types. 
2) Cast Gold - Cast gold combines gold with other metals for a very strong and long-lasting filling. It is also highly noticeable and expensive. 

Tooth-Colored Fillings

1) Composite - A filling capable of blending naturally with and chemically bonding to existing teeth, composite is a mixture of plastic and glass. They may last 5-10 years before needing replacement. Less preparation (drilling) of the tooth is necessary when placing composite as compared to amalgam. 
2) Porcelain - Porcelain ceramics are strong, lifelike, and do not stain as composites can. They are usually more expensive than composites because they require a dental laboratory or specialized computer-generated technology for fabrication. One of the most aesthetic filling types, they can also be somewhat brittle due to their high glass content. 
3) Glass Ionomer - Made of acrylic and glass powders, these inexpensive, translucent fillings have the advantages of blending in relatively well with natural tooth color and releasing small amounts of fluoride to help prevent decay. However, they generally do not last as long as other restorative materials.

Do you offer safe amalgam (mercury) filling removal? 

Yes, our office utilizes a combination of materials and equipment that permit the safe removal of amalgam (mercury-containing) fillings. These include an IQ air filtration unit which removes mercury vapors and drill aerosols, a rubber protective barrier (dental dam) around your teeth to prevent accumulation and ingestion of amalgam particles, and high volume evacuation to capture the mercury vapor and residue. 

What can I expect after getting a filling? 

The numbness caused by local anesthesia should wear off within a couple of hours. Until then, it is best to avoid drinking hot or cold liquids and eating on the side of your mouth with the new filling. This will prevent accidental cheek, lip or tongue biting. Some sensitivity to hot and cold is normal in the first couple of weeks after a filling and should gradually dissipate. If it persists beyond that, or you have pain when biting, it could mean that an adjustment to your filling needs to be made. 

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