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Alan L. Stott, DDS

White Dental Fillings

Composite Filling Material

What are White Dental fillings?

White fillings are plastic resin materials filled with finely ground glass particles. They are not usually a pure white because teeth are not a pure white. This is why a more accurate description would be tooth-colored fillings. The material comes in various shades to match your teeth. White fillings are also called composite fillings since they are a composite or combination of several different materials to make a stronger material.

What are the different types of fillings?  What is the difference between the white fillings and the silver fillings?  What are the pros and cons of each material?  What do they cost?

There are basically three types of filling materials:

1) White or Tooth-Colored Fillings The white fillings are made of a plastic resin material filled with finely ground glass particles. They are in a putty form and placed in the tooth. A special light will make them turn hard. The pros are: they look like natural teeth, so they will not be a dark gray color, they do not require as much tooth removal as other fillings, they bond to the tooth better, they do not expand and contract like other silver fillings do, and they have less sensitivity. The cons are they cost a little more than silver fillings and they take more time to place. Approximate cost: $100-300.

2) Silver Fillings Silver fillings are made with mostly silver and mercury with a few other metals. They are mixed into a putty, placed in the cavity, and set up hard in a few minutes. The pros are: they are a little stronger than the white fillings, and they cost less than the white fillings. The cons are: they look terrible (dark gray), they require more grinding of the tooth, they expand and contract, weakening the tooth, they are more sensitive than other fillings, they do not bond to the tooth, and they contain mercury (a very toxic substance in liquid form). Approximate cost: $80-250.

3) Temporary Fillings Temporary fills are a putty-like material that is placed in the tooth to seal it and protect it for a short period of time (a few days to four weeks). They are a soft material, so they can be easily placed and quickly removed. They are used when there is no time to place a regular filling or dental crown. They will be replaced with permanent restorations at a future date. The pros are: they can be quickly placed and removed, they have a sedative effect on the tooth, and they do not cost much. Approximate cost: $50-150.

Why don’t you do silver fillings in your office? Why are white fillings better?

Silver fillings contain mercury, which is a very toxic substance in liquid form. In fact, several European countries have banned silver fillings. They are more sensitive than white fillings and can expand and contract, causing some tooth fractures. Silver fillings are an ugly dark gray color. No one likes the look of silver fillings. White fillings bond to the tooth, have less sensitivity, and they have a natural tooth-colored appearance.

 How long do white fillings last?

I have seen white fillings last two years up to twenty-five years. The average life span is about 10 years. They will last less time if a person grinds and clenches his/her teeth a lot, chews hard foods and items like finger nails often, does not brush and floss well, and consumes a lot of foods and beverages that are very sugary and acidic. Well maintained white tooth-colored fillings can look great and last a long time for most people.

Are white fillings safe?

Bisphenol A is one of the substances in white fillings that may have a negative effect. I do not see any conclusive studies that they are harmful to the body. Overall, the white fillings are considered safe and effective to restore decayed teeth. They are much better than the silver fillings that contain 50% mercury. The other alternative would be to place crowns on all decayed teeth. But, that is not being very conservative, and some crowns have metals that some people are allergic to.

Does it hurt to put in a filling?

It should be painless to place dental fillings. Some people are harder to numb than others, but with our current local anesthetics like lidocaine, dental treatment should be a comfortable experience. The most you should feel is some push and pressure and a cool water spray. After the anesthetic wears off, there may be muscle soreness at the injection sites of the anesthetic and maybe some soreness around the gumline of the teeth worked on.

I had some fillings done and they are still sensitive. What can be done?

Teeth that require dental restorations like fillings or crowns, have been traumatized due to deep decay, fractures, and heavy clenching. As we go in and remove decay from teeth, we are creating more trauma to the nerves. The nerves have to get used to having the decay gone and the new fillings in place. We use special bonding techniques to try to minimize post-op sensitivity. We tell all our patients that with any new filling or crown, there can be some sensitivity for a few days up to several weeks. Some people, due to thin enamel or exposed root surfaces, have teeth that are always sensitive to cold, even without any new fillings or crowns.  Some people that are heavy grinders and clenchers, can experience increased sensitivity. When patients ask about sensitivity after some recently placed fillings, we ask them to give it a a few weeks to see if the tooth nerves calm down. If that doesn’t help, we look at the teeth to see if the bite is high due to some excess filling material. If it is, we adjust the bite. Sometimes we add a coating of thin bonding material to the surface of the new filling or root of the tooth to try and protect those areas from cold foods and drinks.

 How many fillings can be done at one time?  Dental Filling Drying

It all depends on how well a patient does with extended dental treatment. Some patients can sit in the chair for two hours and have no problems. Others have jaw muscles that get tired quickly and they cannot have their mouths open for too long. Some have small mouths and prefer to have only a few  fillings done at one time. We can adjust to your comfort level.

 Can you eat after a filling is placed?

Yes. With the white fillings we use, the material is set up and firm at the time we place the fillings. So, you will not damage the fillings with eating right away. However, you need to be very careful with the numbness. With the mouth muscles still numb, it may be a little hard to chew and some patients may bite their cheeks and tongues. It may be advisable to wait until the anesthetic wears off before eating anything too hard. The numbness will usually be gone in 1-1 ½ hours.

What happens when a dentist fills a tooth?

First of all, the dentist will numb the tooth. He has already found the decay with a visual exam and the use of x-rays. When the patient is numb, the dentist will drill out the decayed areas while the dental assistant retracts the cheek and tongue. The assistant will also be rinsing the mouth and preparing the filling material for placement. Since some decay is hard to see, the dentist will often use a decay indicator solution, which is a red dye that stains the decayed areas. After the decay is removed, if the decay is in between the teeth, the dentist will place some metal or clear plastic strips around the teeth to be filled. These strips help hold in the filling material during placement. The dentist will then pack into the preparation areas the putty-like tooth colored material. A special high intensity light is used to cure or set up the material. Next, the excess material is removed, the bite is adjusted, the tooth is smoothed. The last step is to polish the fillings in order to make them feel smooth and natural.

Can white fillings re-decay?

The fillings and crowns do not actually re-decay, but the tooth structure at the margins or edges of the fillings and crowns can still decay. This is why it is important to floss and brush well to remove the decay-causing bacteria. Minimizing the use of sugary and acidic foods and drinks will help reduce future decay.

Is it OK if I wait a while before I have my fillings done? How soon do cavities have to be filled?

There are different sizes of cavities made by tooth decay. Each person’s tooth decay grows at a different rate. It is best to get cavities filled before they get larger. If you wait until the cavities are moderate to deep in size, they can become painful and are harder to fill. If you wait until the cavities are into the nerve of the tooth, you will need a root canal treatment and a crown. If this latter happens, instead of the cost of $100-$250 to place a filling, the cost to fix the tooth will be close to $2000. Avoid the pain and higher costs by filling cavities while they are small.

Are white fillings pure white? That may not look like my tooth.

White fillings are also called tooth-colored fillings. They are not a pure white. Even our lightest shades have some tints of light yellow, orange, gray, or blue. We pick a shade and color that will match your teeth.

Can you place a white filling instead of a dental crown? When does a cavity require a crown?

Each dentist is going to recommend treatment in a different way. We can easily place regular white fillings in small to medium size decayed areas. As the decayed areas get bigger, some dentists may recommend a big filling while other dentists may recommend a dental crown. If the decayed area is very large or if a a portion of the tooth has fractured off, the tooth will need a full dental crown.

How can I find out if I have cavities that need fillings? How do I know if I need a crown versus a filling?

Give us a call. We can do a complete exam with x-rays to see what you need to have done. It is best to treat dental problems while they are small and not wait until the teeth hurt and the repair costs are expensive. We are an in-network provider for most dental insurance companies, so that will save you money.


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