Restorative Dental Options
Current dental fillings include ceramics and plastic resin compounds, commonly referred to as composites. Both ceramics and composites beautifully mimic the appearance of natural teeth. For this reason, these materials are used when a natural, aesthetic result is needed. Cavities involving the front teeth are exclusively repaired using composites. Composites can also be used on the back teeth, depending on the location and extent of the tooth decay. Cavities that do not require significant removal of tooth structure can be easily filled with composites. However, when extensive tooth structure needs to be removed, a ceramic material is indicated to provide the strength needed to withstand chewing and biting loads. Ceramics are stronger than composites, so they are ideally suited to fill large cavities on teeth that are under significant force, as with the molars. These ceramic fillings are referred to as either an "Inlay" or "Onlay". To ensure a perfect fit of the inlay or onlay, these fillings are made by a master ceramist at a dental lab. Consequently, completing treatment requires two visits, compared to a single appointment for a composite filling. In situations where there is very extensive loss of tooth structure or the tooth is fractured, treatment with a filling may be inadequate and a crown may be the proper treatment.
What's Right for Me?
Several factors influence the performance, durability, longevity and expense of dental restorations, including:
- The components used in the filling material
- The amount of tooth structure remaining
- Where and how the filling is placed
- The chewing load that the tooth will have to bear
- The length and number of visits needed to prepare and adjust the restored tooth
Before your treatment begins, your doctor will discuss with you all of your options and help you choose the best filling for your particular case. To help you prepare for this discussion, it may be helpful to understand the two basic types of dental fillings — direct and indirect.
- Direct fillings are fillings placed immediately into a prepared cavity in a single visit. They include glass ionomers, resin ionomers, and composite (resin) fillings. The dentist prepares the tooth, places the filling, and adjusts it in just one appointment.
- Indirect fillings generally require two or more visits. They include inlays or onlays and can be fabricated with gold, ceramics, or composites. During the first visit the tooth is prepared to the proper shape for an inlay or onlay and an impression is taken. A temporary inlay/onlay is then placed and will remain while the dental laboratory makes the final restoration. At the next appointment, the temporary is removed and the custom fabricated inlay/onlay is permanently cemented in the tooth.