You may have good oral hygiene, but still, you end up with a cavity. If you have caries, the next step is going to your dentist for a checkup. After consultation, you may have to decide one of material from different types of fillings available in the market. So, how do you choose between different types of dental fillings such as amalgam, composite resin, cast gold fillings, ceramics, etc?

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All the filling materials used by the dentist are biocompatible and won’t cause harm. But they differ from an esthetic point of view and cost, which is the primary concern of people.

In this article, I will walk you through various options available, talk about advantages, a few disadvantages. Read on to know more.

What is a dental filling?

Dental fillings help to restore back damaged tooth (due to caries) to their normal function and also prevents further decay. When you visit your dentist, you will be given you various options depending on the location of decay, the extent of decay and also aesthetics.

Different types of permanent fillings

I will discuss different types of fillings like silver amalgam, resin composite cement, glass ionomer, etc. Let’s deal with them one at a time.

Amalgam

There are different types of fillings but this “classic” filling has been around for over 150 years. Amalgam is also called silver fillings and this is the most affordable option with good durability.

The advantages of amalgam filling are –

  • They last 10-15 years and are known to outlast composite fillings.
  • This material is cheaper than all other dental materials.

The main disadvantages of this material are –

  • It is not at all esthetic.
  • large cavity required to hold the filling material (mechanical bonding).
  • allergic reactions (for 1% of the population).
  • Considered safe by the FDA for adults except for pregnant women and children above the age of 6 (1)(2).

Types of fillings

Composite resin

It is the next cheap option after amalgam. Also, composites are tooth-colored.

The advantages of amalgam filling are –

  • The composite resins can be made to match the color of the tooth-a big plus of this material.
  • This filling is preferred in case of front teeth or visible tooth surface.
  • The chemicals present in composite resin bond with tooth structure, rendering extra support.
  • It can also be used to build-up broken tooth or chipped tooth surfaces.
  • Composites do not need huge cavity since they bond with tooth structure chemically. It involves small cavity preparation works.

Disadvantages are quite a few –

  • Longer time required compared to amalgam filling due to the process involved.
  • The filling only lasts for 5-7 years.
  • It cannot be used as filling material for the tooth which might be involved for chewing purposes. Even in larger cavities, this filling is avoided since it tends to fracture under pressure.
  • It costs almost twice as much as amalgam and might chip off earlier than expected if excessive accidental force is applied.

Glass ionomer cement

This material is used as a lining material under composite or amalgam restorations. It is also used as a filling material for young children and pits and fissures or cervical abrasions in adults.

This material is weaker than composite and lasts for 5 years or less. Cost is comparable to that of composite resins. One particular variation of the glass ionomer cement which contains fluoride is used as a sealant for kids who are prone to caries.

A thin layer of the cement is used to cover the pits and fissures of the molar teeth as and when they erupt- helps protect the tooth surface from decay (3).

Cast gold fillings

This material is durable; may last more than 15 years if you maintain proper oral hygiene; extremely durable- no wear and tear will take place, but it is ten times costlier than a silver amalgam filling.

Some people find gold colored tooth more appealing than silver colored tooth. Also, if money is not a concern, gold teeth could be the choice filling.

But many do not like either gold or silver. Some people prefer tooth-colored filling material. Proper placement of this filling material requires at least two dental visits. Also, a silver and gold filling cannot exist adjacent to each other because it may cause galvanic shock, which is though rare (4).

Ceramics

This is a porcelain based filling and resistant to staining but abrasive, last for 15 years but can cost a bomb.

Temporary fillings

Sometimes if the procedure involves multiple visits then the dentist might fill the tooth with a temporary filling material. These filling materials are supposed to fall off or wear out.

This type of filling material is used during multiple sitting root canal treatment. If the cavity is too deep, then the dentist might want to use a temporary filling and check the progress of the tooth for a few weeks. After the procedure, a temporary filling is replaced with a permanent one accordingly.

Indirect fillings

Inlay or onlay are indirect fillings that are used for tooth restoration in case of extensive damage. Indirect fillings are made in the dental laboratory and require mostly two visits to the dentist.

The inlay lies on the chewing surface of the tooth whereas onlay is extensive and covers one or two cusps. Onlay is also called partial crown. Both inlay and onlay can be made of gold, porcelain, and composite resin.

They can last for 30 years. Inlay or onlay depends on the amount of tooth structure remaining and cosmetic concerns (5).

Problems with dental fillings

After you get your filling done you might experience sensitivity or mild pain. It is advisable to avoid food items causing sensitivity. Usually, analgesics are not required and hence not prescribed either. If tooth pain persists after a few days, visit your dentist.

Your dentist will advise you desensitizing toothpaste. In case, the cavity was deep already, and your dentist had mentioned the need for root canal treatment in case restoration fails, you might have to undergo further treatment.

Some people with a history of allergy might be allergic to silver amalgam (albeit rare). In such cases, it treads upon other options. According to ADA, fewer than 100 such cases were reported.

How to care for teeth fillings?

Whether you have tooth fillings or not- always maintain good oral hygiene. With fillings in tooth become extra careful.

  • Every time you eat something sticky- rinse your mouth with water if possible.
  • if it is a composite filling, then do not bite too hard on the side which has the filled tooth.
  • Brush twice daily and floss thrice weekly at least.
  • Rinse with mouthwash once daily.
  • Go for regular dental checkups and get oral prophylaxis done twice a year.
  • Anytime you feel pain or increased sensitivity which doesn’t diminish in a few days; you should fix an appointment with your dentist right away.

Cost of dental filling

The cost of dental filling depends on various factors namely –

  • The extent of decay – You tooth condition will decide the requirement of direct filing or indirect fillings like inlay or onlay. Also, if the tooth needs root canal treatment then the overall cost will substantially increase. Root canal treatment is only required when the pulp is affected.
  • Location of your teeth – It is hard to reach tooth at the back of your mouth such as molars. The cost is higher for such teeth visible front tooth.
  • Use of a sedative – If the dental fillings involve the use of sedatives then it will also affect the cost to some extent. The dental filling material being the major contender which will impact the cost of your filling.

Does insurance cover the cost of dental filling?

Since it is not a cosmetic or elective procedure, your dental insurance should cover a part of your costs. Even if you don’t have insurance, a dental filling is relatively inexpensive compared to other dental procedures.

Check how much cost will be covered by your insurance provider before choosing which filling material you want to go with.

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Caution note: don’t compromise on important factors mentioned by your dentist to save a few bucks.

Over to you on types of fillings

There are different types of fillings available and all options are safe. It all depends on your choice and budget. All in all, it is vital to maintain a good oral hygiene. Eat less sugar containing items.

Use a fluoride-based toothpaste. Include flossing in your daily regime. Most importantly, if you notice any sign of a cavity, immediately visit your dentist for a checkup. Ideally, you should visit your dentist twice a year without fail.

After consultation, you may have to decide one of material from different types of fillings available in the market. So, how do you choose between different types of dental fillings such as amalgam, composite resin, cast gold fillings, ceramics, etc.
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