Restorative Dentistry - Fillings
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Information About Tooth Colored Fillings
We are very fortunate that in our lifetime dentistry has moved far beyond the days of "drill and fill" for cavities. It used to be if you had a cavity, you could expect an unsightly filling that although functional, was not pleasing to the eye. The traditional amalgam (also known as silver) fillings used for so many years accomplished the goal of filling a hole, were fast and economical to place, and for the most part lasted for many years. However, there were shortcomings to the material. The silver filling packed down into the tooth and to have any strength needed to have a certain amount of tooth removed to make room for the filling. If the cavity was not quite deep enough to provide this minimum tooth removal, then healthy tooth was taken along with the cavity to prepare enough room for the filling. Also, over the years the various components of the silver filling (including mercury, lead, tin, and other metals) resulted in what we refer to as "amalgam creep." This creep manifests itself as expansion in all directions, enough so that an old silver filling will actually appear to lift itself up out of the tooth. As it creeps, it leaves openings along the filling-tooth interface that enable saliva and bacteria to enter into the margin and create decay under the filling and into the tooth. Also, the expansion deep into the tooth creates cracks and fracture lines that weaken the tooth. The older the silver filling, the greater likelihood the tooth will break. Sometimes these broken teeth can be saved with a crown, other times they need to have a root canal to be saved. Otherwise, they will be extracted.
Fig. 1 (before)
Silver Fillings In Back Teeth.

Fig. 2 (after)
Composite Fillings Replace Silver Fillings.
(Silver Filling Left On Outside Of Molar For
Photo Comparison Only: It Too Will Be Replaced)
Now we have materials that allow us to restore your tooth with minimal invasiveness. We are very proud to use bonded composite (tooth colored, metal-free) fillings that can be placed and the teeth will appear natural, life-like, and virtually impossible to tell there was ever decay. Minimal preparation means that when removing decay, only the part of the tooth affected need be removed, therefore leaving more healthy tooth. Composite fillings can be placed very small and because there is no expansion of material, amalgam-altered tooth structure is eliminated. In many cases, beginning fracture lines can be stopped by removing the amalgam filling and bonding composite in it's place. Composite fillings are custom shade matched to blend in with the color of your tooth and are set in place by hardening with an intense curing light--much like a laser. This means the composite filling is ready to chew on the moment you leave the office. Minimal preparation also means there are more occasions when anesthetic is not needed. For small to moderate fillings, composite filling can be a wonderful restorative option.
Other uses for composite filling include the restoring of chips and fractures on front teeth (See Cosmetic Dentistry: Bonding section). If recession has resulted in sensitive root surface exposure, bonded composite can not only make the tooth look more natural but seal and protect the sensitive tooth making cold and sweets enjoyable again. Composite also is used to fill in access openings for root canals, with bonded post and cores, and as a stand-alone core foundation for crowns and bridges. Because it is instantly hard, composite can be used to build up a tooth and the preparation for a crown can commence immediately--no need to wait 24 hours for the metal to get hard like when amalgam is used.

