Is a Crown or a Filling the Best Option For You?

May 3rd, 2012 Posted in Fillings
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Crowns and fillings are both types of dental restorations that can be used to repair a tooth that has been chipped or damaged by decay.  Typically, small restorations call for a filling and a crown is placed when so much of the tooth has been removed that it would not be structurally sound with just a filling in it.

In some cases, the damage falls in the middle of these two alternatives and your dentist will give you the option of whether to restore the tooth with a dental filling or to place a crown.  A filling will be far less expensive and can be completed in a single visit, but a crown has some significant advantages that should be considered before making a decision.

The main advantage of a crown is that the result will be a much stronger tooth that should last a long time.  A filling is placed within the walls of the tooth and relies on the tooth for strength and support.  If the tooth has been removed, the walls will be thin and there is a significant likelihood that the tooth wall will eventually crack.  If the filling occupies an entire corner of the tooth, there is less tooth material for the filling to adhere to.

A crown is like a cup placed over the top of the tooth.  Unlike a filling, a crown if made in a dental lab outside the mouth and is made of more durable material than a filling.  In addition, a crown has more tooth area to adhere to than a large filling and is less likely to come off.

If given the option between a crown and a filling, you will need to weight the risk that the filling will cause the tooth to crack, further damaging the tooth and requiring additional dental work against the cost of a crown.  If you go with the large filling and the tooth cracks, you will end up paying significantly more than going forward with the crown in the first place.

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Replacing Fillings

April 11th, 2012 Posted in Fillings
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Regular dental cleaning and checkups are very important for maintaining good oral health.  If tooth decay is identified during a check-up, your dentist will repair the tooth by removing the decay and placing a dental filling.  Dental fillings normally last for many years.  The length of time varies depending on the patients’ oral hygiene habits, how well the placement was done, and other variables but in general an amalgam (silver) filling can be expected to last 10 to 15 years.  Composite (white or tooth colored) fillings don’t last quite as long – about 5 to 7 years.

Dental fillings are under a lot of stress from chewing, grinding teeth, and clenching.  Over time, a filling can wear away or it can chip, crack, or fall out of the tooth.  Fillings can wear around the edges and leave a small space between the filling and the tooth enamel.  Bacteria can enter this space and cause tooth decay around the filling.

Good oral hygiene including good brushing habits will help reduce the incidence of tooth decay around fillings.  Brushing twice a day and daily flossing will reduce the amount of decay causing bacteria and help prevent tooth decay.  Regular dental check-ups can identify a damaged filling or tooth decay around a filling before extensive damage occurs.

Worn, chipped, and cracked fillings should be replaced promptly.  In most cases, the filling can be replaced but if the patient waits until the tooth hurts or the filling falls out, the tooth may have too much damage to repair.  In this case, your dentist will need to install a crown instead of replacing the filling.

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Direct Dental Restoration Alternatives

April 6th, 2012 Posted in Fillings
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Direct restorations refers to fillings that are placed in your teeth during a single visit such as amalgam (silver colored) fillings and composite (tooth colored) fillings.  Indirect restorations usually take more than a single visit because the restoration is made in a dental laboratory and include crowns, caps, inlays, and onlays.

Advances in dental materials and techniques have given you and your dentist more options for direct dental restorations of damaged or decayed teeth.  Most traditional materials such as amalgam and gold still have a place in modern dentistry due to their lower cost, strength, and durability.  Future developments will likely result in even better materials with attributes that rival their traditional counterparts.

Choosing the right material for dental fillings depends on various factors including the patient’s oral health, the strength of the tooth after the decayed material has been removed, where the filling will be placed, and the chewing load that will be placed on the tooth.

Amalgam is the silver colored material that has been used for dental fillings by dentists for over 100 years.  It’s durability and relatively low cost assures that it will continue to be a popular material for restorations, especially in back teeth where the silver color will not be as obvious.  Amalgam is strong and can tolerate high chewing loads which makes it a great choice for molars.  The silver color can be a negative for many patients, especially for front teeth that will show when the patient smiles or talks.  Amalgam can also be sensitive to hot or cold.

Composite fillings are made from a resin mixture and are dyed to match your tooth color.  They are not as strong or as durable as amalgam, but they are an attractive option for front teeth that are visible when a patient speaks or smiles.  These teeth have lower chewing loads which makes composite fillings ideal.  Composite fillings take a little longer to place and are usually a little more expensive than amalgam.

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Advantages of White Fillings

February 23rd, 2012 Posted in Fillings
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Composite fillings, also called “white” fillings are made of a tooth-colored material. They blend very well with the natural tooth and are able to be placed in a variety of areas that traditional silver fillings are not. The color of the filling is chosen from various shades to match the teeth surrounding it.

Because they bond directly with the tooth, white fillings require less tooth preparation than silver amalgam fillings. They can be used on smooth areas like root surfaces in areas of gum recession or enamel abrasion. Composite fillings help to recreate lost tooth structure or protect areas of the teeth that should not be exposed. Because silver fillings are wedged into the tooth, they treat the decay but do not help regain lost strength from the missing tooth enamel. However, white fillings do because they bond and repair the tooth.

White fillings can be used in any area of the mouth. While they are obviously used for the front teeth, they may be used for back teeth as well, so they won’t show when you laugh, talk or smile. You can also have your silver fillings replaced with a white composite filling for a whiter smile.

As fillings become old and need to be replaced, it is easier to replace white fillings than silver ones. Each time a tooth needs to be re-prepped for a silver filling, the tooth becomes less and less stable. Composite fillings are less invasive, so this means the tooth can be retreated easier without necessarily having to place a crown on the tooth.

There is no risk of white fillings leaking metal color into the surrounding enamel or gum tissue. They hold their bond very well. As silver fillings age, the discoloration often leaks into the tooth and is difficult to treat with whitening products.

Simple bonding procedures such as correcting a gap or misshaped tooth also use white filling material. It is a fairly inexpensive cosmetic procedure that can make a huge impact.

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What Causes Cavities?

November 9th, 2011 Posted in Fillings
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Tooth decay or cavities are caused by acids that erode the surface of the tooth.  Naturally occurring bacteria in the mouth build up and form a sticky substance called plaque. Plaque tends to collect in cracks, pits or grooves in the teeth, around the gum line, and between the teeth.

Some of these bacteria create acids that eat at the enamel of the teeth and form tiny pits.  These pits grow over time and eventually cause the entire tooth to decay and fall out if left untreated.  Cavities often have no symptoms, but in some cases they cause sensitivity to hot and cold food and drinks.

Daily brushing and flossing will reduce the amount of plaque on your teeth as will regular dental checkups and cleanings.  Fluoride strengthens teeth and helps prevent cavities from forming.  In addition, sealants can be applied to permanent teeth to provide additional protection.

Cavities are treated by removing the decayed material and filling the cavity.  Dental fillings can be amalgam (silver colored), gold, or composite resins.  Composite resins are tooth colored so they are particularly appropriate for front teeth where the appearance is more important.  If the damage is too extensive or the tooth is too weak to hold a filling, you dentist may protect the tooth with a crown.

If the tooth is damaged internally or if the tooth pulp is infected, you may be referred to an endodontist for a root canal.  Then a protective crown will be placed by your dentist.

Cavities that are detected and repaired early have the best prognosis.  A small cavity that has been filled by your dentist may last a lifetime.  Since small cavities usually have no symptoms, regular dental checkups are very important for finding and treating cavities.

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Types of Fillings

August 25th, 2011 Posted in Fillings
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If you need a filling, you will need to choose the material your dentist uses to fill the cavity.  There are several types of materials commonly used in dentistry today and your dentist will probably offer you one or more alternatives.  Gold, silver amalgam, and composite resin are the most commonly used materials for fillings.  Each has certain advantages and disadvantages.

Silver amalgam is a mixture of silver, mercury, tin, zinc, and copper is a very common material for fillings.  Amalgam is a strong, durable, inexpensive filling material.  It is relatively easy to use and the filling can be done in a single visit to the dentist’s office.  Many patients don’t like the silver color and teeth with amalgam fillings tend to crack at a higher rate than other types of fillings.

Gold is also a good material for fillings.  It is strong and durable and can last 10 to 15 years or longer.  Many patients prefer the look of gold fillings over silver amalgam.  However, gold fillings are more difficult to place and usually require more than one visit to the dentist.  In addition, they are much more expensive than silver amalgam. 

Composite resins are tooth colored material so the filling match your teeth.  They can usually be installed in a single visit, although the process takes a little longer than amalgam fillings.  Composite resins are more expensive than amalgam, but not nearly as expensive as gold fillings.  The main drawback to composites is that they are not as durable as gold or amalgam.  Composite fillings only last 5 to 10 years. 

Your dentist will help you choose the best material for your filling.

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