WHITE FILLINGS

Dental fillings are inserted as restorations in the treatment of dental cavities, after drilling out the cavities. The purpose of drilling is to remove  the enamel and dentin that has had its structural integrity compromised by the invasion of acid-producing bacteria. However, once the infected  hard tissues have been removed, the resulting cavity preparation must be filled in order to restore structural integrity to the tooth. This will  prevent further damage to the tooth and hopefully avoid the eventual need for the tooth to be extracted.

A composite resin filling (white filling)

	Mercury free
	Made of a tooth colored plastic mixture filled with glass particles
	Used for restoring decay
	Used for cosmetic improvements

New technological advancements in dentistry has allowed us to do white (composite or resin) natural tooth colored filling.  

The advantages of white fillings are:

	Composite filling integrates with the tooth...it doesn't weaken the tooth as a silver filling does.
	We now can make a smaller hole, since the white material can flow into small places.
	Due to the smaller hole, there is more of your own tooth left, leaving it stronger.
	Secondary decay is easier to spot beneath tooth colored fillings.
	If damaged, they can be easily fixed.
	They are temperature and electrical insulators-resistant to extremes of heat and cold.
	Environmentally safe-no hazardous metal wastes to dispose of and no risk of mercury allergy.
	Allowing us to fix smaller cavities.
	You don't have to wait till a cavity gets "big enough to fill".
	In some cases we can do an almost microscopic filling just when it starts by using air abrasion instead of the drill. These are often done without anesthetic if we catch them early enough.
	They are a more natural, attractive choice.
	Composites bond to the tooth to support the remaining tooth to help prevent breakage.
	Composite insulate the tooth from excessive temperature changes.
	Composites (white fillings) last about 8 years with a range of 7-10 years.

Disadvantages:

	The presence of saliva can compromise the bonding process. The tooth require isolation.
	This matter will not work well on wisdom teeth because there is no adjacent tooth to shore up the outer edge.
	Potential to leak.
	Many insurance companies do not yet cover them.

How Are They Placed?

1. The decayed portions of the the tooth must be removed which leaves a hole that needs to be filled to restore the tooth to its original form and function.

2. The tooth is prepared and etched with a mild acid solution.

3.Than the composite is placed in layers, using a light specialized to harden each layer.

4. When the process is done the filling will be shaped to fit the tooth.

This filling is than polished to prevent staining and early wear. It takes the dentist about 10-20 minutes longer to place a composite than a silver filling because larger the size the longer the filling will take.

Costs

Vary, but are usually about one and a half to two times more than the price of a silver filling. Most dental insurance plans cover the cost at the price of a silver filling with patient paying the difference.

Disadvantages

Some post operative sensitivity can occur. The shade of the composite can change due to staining by tea, coffee or other staining foods. They may to wear out sooner than silver fillings in large cavities however this is changing due to new technology.

Home Care

1. Use a neutral sodium fluoride because stannous fluorides can be detrimental or negative effect on composite resins and ceramics.
2. Use a soft toothbrush or electric toothbrush twice a day
3. Floss once a day, before bedtime is the best time to floss.
4. Use an non-abrasive toothpaste like original Crest or Colgate. Avoid "extra whitening" or "whitening" toothpaste. These toothpaste often are very abrasive and can scratch restorations.
5. Drink tea, coffee or coke through a straw to avoid staining this material.
6. Alcohol rinses may affect the longevity of a restoration. Alcohol is a solvent of resin/resin cements/bonding agents. The result is softening of the composite matrix; which may increase our ability to abrade the resin material, making it rougher and more prone to staining and early breakdown. Recommend switching to alcohol free rinse and mouth spray alternatives.

Sources: Academy of General Dentistry.

Silver Fillings Causing Tooth Fractures?

Silver mercury fillings that were placed years ago, before bonding technology may need to be replaced to prevent fractures. The silver plugged the holes in your teeth where the cavities were but it weakened the teeth because it didn't restore the molecular bonds that nature gave the tooth in the first place.

Your teeth depend on those molecular bonds for optimal strength. No dentist can improve upon the work of nature. However, bonded fillings don't just fill the hole they actually restore 85% of the strength that the tooth had before it had its first filling. The remaining tooth structure is less likely to flex to the point where it breaks away.