Tooth fillings are a treatment option for filling cavities or cracks of decayed, cracked, or broken teeth. The materials used for dental fillings are diverse, including amalgam, gold, ceramics, composites, and glass ionomer. These materials have different properties, advantages, and disadvantages. Composites are fillings that can be adapted to match the color of your existing teeth. Therefore, composite fillings are becoming a popular choice for people concerned about the appearance of their fillings. If you are not sure about the type of fillings suitable for you, consult us at the Northridge Dentist for evaluation.
Overview of Composite Fillings
For a long time, silver fillings have taken their place as a dental restoration material, joining the strength of the metals in the amalgam. While it is still used among patients, the use has declined compared to previous years.
Health, cost, and aesthetics are the major concerns that led to the development of alternative filling materials.
Composite fillings, also called resin-based composites, are restorative dental materials made of synthetic resins. Composite fillings are also known as tooth-colored fillings as they can be adjusted to match the color of your teeth.
These filings were introduced in the 1960s. They have gone through numerous improvements over time, increasing the superiority of their qualities. Some of the qualities that have improved include their tensile strength and shrinkage. They have therefore grown from a filling that wears out quickly to one that can last up to seven years; some studies show that, with proper dental practices, the filling can last more than ten years.
Composite fillings are composed of an organic resin polymer matrix, pigments, initiators, or accelerators, coupling agents, and inorganic filler particles. The ratio and quantities of each component determine the stability and durability of the composite filling.
Filler particles are important in giving the composite material the mechanical strength, resistance to wear, polishability, and shrinkage characteristics. The particles can be macro, micro, macro, and hybrid, depending on the composite.
Composite fillings have a combination of MicroFil and MicroFil components, which influence the property of the filling. The dentist will adjust the ratio of these components depending on the tooth that requires filling.
Molars require more compressive strength; therefore, the dentist will use a larger portion of MicroFils. The filling will provide the necessary cushion to allow grinding and chewing while leaving the filling in place.
The popularity of composite as dental filling material has grown due to the advantages of composite, including:
- Aesthetics are the most significant advantage of composite fillings. The dentist can match the exact shade and translucency of your teeth, making it hard to detect the presence of the filling. Their adaptability makes them ideal for patients who have cavities on their visible teeth.
- Composite fillings also bond to the tooth structure, thus creating better support for the filling.
- The ability of composite fillings to bond with the tooth structures makes it possible to remove less tooth tissue for the fillings. Fillings such as amalgam require extensive removal of the tooth tissue to provide support structures for the filling. This means that the dentist will remove some of the good tooth tissue.
- Composite fillings have diverse uses, including repairing damaged teeth, filling cavities, and repairing worn out teeth.
- Composite fillings can save your tooth from extraction. A tooth that has suffered extensive decay cannot qualify for an amalgam filling.
- These filings are also a cost-effective alternative to dental crowns that also leaves your healthy tooth intact
- Repairing composite fillings is also easy unlike in amalgam fillings where the dentist has to redo the restoration
- Using composite fillings can be a great alternative if you are concerned about the release of mercury from amalgam fillings. While dentists say amalgam is a stable component, composite fillings give you peace of mind, as they do not contain any mercury content.
- Composite fillings do not have issues with corrosion
Composite fillings come in different types to cater to the diverse needs and desired outcomes in patients. The common types include:
- Anterior composites or aesthetic composites are designed with aesthetics in mind. The composites achieve and retain a high polish that is similar to that of natural teeth. These composites are readily color-matched to your natural teeth, making them ideal for the visible teeth.
- Posterior composites, on the other hand, are those adapted to meet the masticatory needs of the patient. These filings are designed to fill cavities or restore molars and premolars. They, therefore, have a longer lifespan and better shrinkage properties.
- Fluid composites are those with higher adaptability and fluidity. They are easy to handle, making them ideal for small cavities or cracks in the teeth.
- Universal composites make the other category of dental composites. These are ideal for both posterior and anterior teeth, where the aesthetics are the desired outcomes. These composites come in a diverse range of shades and can be in syringes, capsules, or fluid form.
- Self-curing composites are those that do not require light curing after placing. They are ideal for core buildup in restoring the support for a dental bridge. They are also great for filling cavities in posterior teeth since systematic curing would take a long time.
- Orthodontic composites are those used in orthodontic dental treatments
- Bulk fill composites
Direct and Indirect Composite Fillings
Composite fillings can be direct or indirect. Direct composite fillings are those that the dentist places directly onto the required tooth. They require curing using handheld curing lights.
Direct composite fillings are ideal for several applications including:
- Filling cavities
- Filling gaps between teeth
- For minor reshaping of a tooth
- As partial crowns on a single tooth
The dentist usually places a direct filling in a single office visit.
Indirect composites, on the other hand, are those cured outside the mouth. These are ideal for applications such as:
- Filling dental cavities
- Reshaping teeth
- Fillings gaps between teeth
- As full or partial crowns on a single tooth
- As dental bridges for two to three teeth
Indirect fillings are exposed to curing lights of higher intensities and for a longer time. This makes them stronger and more resistant to shrinkage.
They are also great for patients whose teeth have lost most of their structure. In such cases, the dentist will remove any old filling or decay before taking an impression of your tooth to make a restoration.
Indirect composites require at least two appointments to place. The dentist will fabricate the restoration in a lab before fitting it into the tooth. Meanwhile, he or she will place a temporary filling to hold the place of the final restoration. Indirect fillings can also be classified as Inlays or Onlays. Inlays lie within the cusps of the teeth while Onlays cover one or more cusps.
Placing a Composite Filling
Understanding the process of placing a composite filling can set you at ease when the dentist performs the procedure. You might also know what you might do to prepare yourself for the procedure. You can take preparative steps such as:
- Informing your dentist about any medication you are taking
- Following the dentist instructions such as stopping the medication before the procedure
- Asking about the duration of the treatment session so you can stay organized
While composite fillings have diverse uses, including repairing damaged teeth or improving their appearance, your dentist will adopt the same basic procedure when placing the filling.
Before the process begins, the dentist might numb the tooth or isolate it depending on the case. Numbing the tooth depends on the activities that the dentist has to perform. For instance, a filling that does not require trimming might not need numbing.
The dentist might also isolate the teeth to prevent contamination by saliva or blood in the mouth. The dentist might surround the tooth with rolls of cotton or place a rubber dam. The first step in the procedure is shade selection based on the color of the existing teeth. Dentists have a shade guide made of different colors from which he or she will choose.
The dentist will hold the shades against the tooth that requires filling. He or she will compare the color as well as the translucency of your teeth to ensure that the composite material chosen matches your tooth. Sometimes the dentist might have to use different composites for different layers of the tooth.
The final shade of the filling will also depend on several factors, including:
- Whether the dentist uses different composites for different layers of the tooth
- The type of light source
- The effect of tooth dehydration (dental procedures require the mouth to be open, which could cause the teeth to appear brighter due to dehydration). Most dentists prefer to conduct the shade selection process at the beginning of your appointment for accurate results.
The second step involves cleaning the tooth. The surface of the tooth must be clean before the placement of the composite filling. Your dentist will remove debris, plaque, and tartar or remove any decayed material in a tooth cavity. Once clean, the dentist will proceed to prepare the tooth by drilling and trimming. The extent of the drilling and trimming will depend on the extent of damage on the tooth. A tooth with extensive damage will require more drilling and trimming.
Often, decayed teeth require more drilling and trimming, which might involve both the enamel and dentin layers of the tooth. In some cases, trimming is not necessary. Generally, dental composite requires less trimming since the material can adhere to the enamel easily.
The next step involved etching the tooth surface with an acidic tooth conditioner. The etching acid is a gel that comes in small syringes. Your dentist will spread this gel over the tooth surface where he or she will place the composite. He or she will leave the gel on the tooth for a minimum of fifteen seconds before washing it off thoroughly.
Acid etching takes advantage of the mineral composition of the enamel to create a rugged surface to which the composite can attach. Dentists usually use phosphoric acid to etch the tooth’s surface.
The etched surface is irregular at a microscopic level, which makes it possible for the bonding agent to attach to the enamel. Etching allows composite fillings to damage less tooth structure. It instead creates microscopic attachment points that allow the composite filling to form a mechanical bond with the tooth.
Your tooth is now ready for the application of the composite after etching. Your dentist will use a small brush or applicator to apply the bonding agent. The agent is usually in liquid form to allow ease in its application. It must be spread evenly on the surface of the tooth.
After the application of the bonding agent, the dentist will cure the bonding agent using a curing light. The curing will activate the catalyst contained in the bonding agent, causing it to harden. Curing takes about ten to twenty seconds to complete.
Curing can take longer for posterior teeth, which are hard to reach. However, the dentist can ensure a successful process by following certain principles, including:
- Choosing the right curing light that will cure the composite to the required level
- Exposing the curing light for the recommended time to prevent thermal damage to the oral tissues or pulp
- Monitoring curing lights to measure their effectiveness in curing the composite which also includes determining when to move the light closer or further from the tooth
- Delivering adequate light energy to the restoration for proper polymerization by placing the light guide closer to the surface of the tooth that requires restoration
- Using the curing light correctly for optimal results
- Adjusting the patient so that he or she can have better access to hard to reach areas
- Air-cooling the tooth and restoration after every curing cycle
After placing and curing the bonding agent, the dentist will apply the composite filling. The layers will provide the bulk and shape of the tooth. The filling is usually in the consistency of patty, so the dentist will place a bit of it into the cavity and pat it gently into place. Once again, the dentist will apply the curing light to cure the composite. Curing the composite will require exposure of between ten and forty seconds, sometimes more.
The next step will involve building up the restoration, in case the shape of the final tooth is not established. Normally, dentists place the composite in successive layers since the curing light cannot penetrate numerous layers of the material. Once the dentist sets in the required layers, he or she will trim and shape the filling to the desired shape.
Finally, the dentist will check your bite to determine whether the restoration interferes with the normal motion of your teeth. Your dentist will make any necessary adjustments to ensure the tooth is ready for use.
During the filling procedure, you might experience pressure as the dentist works on your teeth. However, you should notify him or her if you feel pain.
After the Procedure
Unlike other tooth restorations such as implants, a composite filling is ready to use as you leave the dentist’s office. Nonetheless, you need to exercise some precaution.
If the dentist numbed your teeth, the anesthesia might take some time before it wears off completely. Therefore, be careful when biting to avoid injuring yourself. You might also have trouble speaking, chewing, or drinking. Some people report experiencing a tingling feeling as the anesthesia wears off.
You should also check the bite of your filling to ensure that it is okay. Make sure that you do not apply too much pressure on the restoration. Checking the bite immediately you leave the dentist's office can help you identify areas that need correction.
The accuracy of the bite affects the quality and longevity of your filling. Therefore, if you notice an issue, tell your dentist to avoid future problems such as broken restorations or teeth damage.
Do not bite down hard or chew on hard foods immediately after the procedure, as it could dislodge the filling. Even with the curing process, you need to care for the new restoration to ensure that it serves you for a longer time. Proper oral hygiene is key to caring for your filling and increasing its longevity. Brush and floss your teeth at least daily. Make sure to remove all food particles, debris, and plaque.
Your teeth might be sensitive a few days after the procedure, but this should correct itself in about a week. However, if your teeth remain sensitive, visit your dentist to check whether the filling is irritating your nerves. You should also visit your dentist regularly to check on the condition of your filling.
Do not grind your teeth, as it will wear down your new filling. Grinding also increases the chances that new cavities will develop in the chips and cracks that form. You can use a mouth guard to protect your teeth and filling for added protection if you grind your teeth.
Complications and Disadvantages of Composite Fillings
Composite fillings are becoming a popular choice over fillings such as amalgam. While people still go for amalgam due to its durability, more people are choosing composite for aesthetics. Composite fillings have some disadvantages, however.
One of the disadvantages of composite fillings is their propensity to shrinkage. Such shrinkage allows saliva and bacteria to seep through the filling into the teeth. Such leading is the primary cause of secondary caries, which can also cause complications such as infections.
You can prevent secondary decay by establishing good oral hygiene practices and having regular checkups with your dentist. Regular checkups will help the dentist identify cracks or spaces left by the shrinking composite. Most dentists also reduce the possibility of shrinkage by adjusting the components in the filling to reduce polymerization shrinkage.
Composite fillings also have a shorter lifespan compared to other fillings such as amalgam. A composite filling can last an average of five years before they need replacing or repair. The longevity of composites declines significantly for fillings on large cavities in molars and premolars. Since the teeth bear the greater force of chewing, the filling will also wear out faster.
The longevity of these fillings can be increased up to ten years with proper oral hygiene and dental care. Composite fillings require considerable skill and expertise to install. For instance, the tooth to be filled must remain dry for accuracy and better anchorage to the tooth. Therefore, the procedure will take a little more time, which could also raise the fee the dentist charges.
Insurance companies also offer limited coverage for composite fillings, with most paying up to the price of amalgam fillings. This means that you have to pay the difference and the entire sum, depending on your insurance company.
Composite fillings might also crack or chip under the pressure of chewing, especially those used to fill large cavities in the molars or premolars. Such cracks can allow bacteria to seep into the teeth leading to infections.
You also face the risk of suffering damage to your dental nerves or the surrounding teeth. Such injuries are common where the restoration is on the posterior teeth. You could also develop allergies due to the use of anesthesia. However, you can avoid this complication by notifying your dentist about potential allergies you have. You must also inform your dentist if you suspect or are pregnant.
Find General Dentistry Services Near Me
Filling or repairing a damaged tooth can save it from extraction. Fillings also prevent further damage to the tooth and the periodontal tissues.
Dental fillings are great options for restoring teeth, but they come in different materials with diverse properties. The choice of the best dental material can be frustrating. However, with the advice of your dentist, you can come up with the best option based on your needs and expectations.
Dental composites are ideal if you want fillings that protect your teeth and match the color of your teeth. The installation of such composites requires the skills and expertise of a dentist, to ensure that they last longer with few to no complications.
Reach out to the Northridge Dentist at 818-875-0216 for a consultation.