Special Content

Fillings

It used to be that ‘drilling and filling’ was the staple part of dentists’ work. Today, better diet, dental hygiene, fluoride toothpoaste, regular trips to the dentist and the proven benefits of chewing Orbit sugarfree gum to help prevent tooth decay mean fewer fillings but they are still a common procedure. Fillings are carried out when decay has caused damage in a tooth, when a tooth fractures or an existing filling wears out, breaks or leaks, allowing new decay to start. The dentist removes the decay and then fills the cavity from a wide range of available filling materials.

Filling materials

Silver based fillings have been used for a long time, are simple to use and relatively inexpensive, but they require drilling to create ‘undercuts’ to hold the filling in place and are unsightly. They are made of a number of metals, including silver and liquid mercury, combined into amalgam. There is continuing controversy about the use of amalgam in the mouth. The greatest risk from mercury occurs as the filling is being inserted or removed, but your own dentist is best placed to discuss the risks and benefits in your case. Tooth coloured/white fillings called composites are made of plastic material and ceramic or glass filler which are bonded to the tooth substance and allow light to pass through them, looking much more lifelike than metal. Gold inlays can be made when greater strength or durability is required. They are expensive and not to everyone’s aesthetic taste, but they can be the crème de la crème if made well. When very extensive fillings break or need replacing it may be that a more complex restoration, such as a crown, is required.

Other issues to consider

Composites are more expensive than amalgam and are not available on the NHS for back teeth. Private fees are payable for tooth coloured fillings at the back of the mouth, and these vary with the dentist, the choice of the material and the complexity of the restoration. Modern materials are now longer lasting and more robust than earlier generations, and there is a huge choice of different products. Inserting them, however, requires more skill from the dentist as they are not as easy to handle as amalgam and there can be problems of shrinkage, especially in larger restorations. You should, however, expect any filling to last several years.

Having a filling

Removal of decay and the insertion of the filling is usually carried out in one session. There is no reason why this procedure should cause any pain if effective local anaesthetic is used. Some fillings using bonding technology where decay is absent and no drilling is required may be done without any need for local anaesthetic.

Potential problems

Problems can arise if an amalgam filling breaks or cracks and falls out. White fillings are bonded onto the tooth so should not fall out, but they can crack and leak, causing tooth sensitivity and possibly new decay. Overpreparation of a filling can also undermine the tooth, causing it to break at some point in the future. If a gap forms under a filling, allowing bacteria to enter, this may cause decay under the filling, so it will need to be removed, the decay cleaned out and the new, larger cavity refilled. The fewer times a filling needs to be replaced, therefore, the better. Decay is also possible under amalgam if a rough, uncleanable edge has been left, and a possible problem is that the original decay has not been fully removed, and so continues to develop.

Maintenance

The rules of good oral hygiene apply to fillings as to the rest of the mouth, and it is essential to follow the main principles of the oral healthcare routine to prevent decay occurring and further fillings becoming necessary:

• Brush and floss thoroughly
• Have regular dental check-ups
• Cut down on sugary snacks
• Chew Orbit sugarfree gum after eating.

First aid

If a filling is cracked or falls out, Orbit sugarfree gum can be used as a temporary measure to pack the hole. See a dentist as soon as possible to have the filling replaced.

For more information on this and many other dental topics, please visit betteroralhealth.info.