In our office, we can replace old, broken down metal fillings, decayed/diseased teeth, or broken teeth that detract from your smile using ceramic, composite or fiber reinforced composites.
In the past, teeth were most commonly repaired with amalgam (silver) fillings or gold restorations. Thanks to advances in modern dental materials and techniques, teeth can be restored with a more aesthetic and natural appearance. There are different types of cosmetic fillings currently available. The type used will depend on the location of the tooth and the amount of tooth structure that needs to be repaired.
The simplest form of 'white filling' is technically called a Composite. It is made up of a composite quartz resin and usually contains some sort of light sensitive agent. These light cured composites are extremely cosmetic and most often bonded into place in one appointment. For this reason, they are often referred to as "bonding". They can be used in both the front of the mouth as well as in your back teeth. These materials come in a variety of shades so that they will match the color of your own teeth. These composite materials have been specifically designed to withstand the incredible forces you can exert when chewing on your back teeth.
In order to bond a filling material to your tooth, it is first necessary to remove any decay, prepare the tooth, and then condition the enamel and dentin. Once conditioned, a thin resin is applied which bonds to the etched surface. The bond strength of these fillings is incredible. Today we can bond plastics and even amalgam (silver) fillings to your teeth. Bonding increases the strength of these restorations far beyond those of only a short time ago.
After placement, composites are hardened by shining an intense light on them for a specified period of time, usually around 40 seconds. Since we tend to look at this light all the time (many times a day) it is necessary for us to protect our eyes from it with an orange shield. It is not necessary for us to protect your eyes since you do not look directly at this light.
We are constantly asked the same question, When can I eat?". Well, after placement, as long as you brought your own food and you are willing to share, you may chew right away. These fillings are instantly hardened by the light. Your teeth may experience some degree of temperature sensitivity for a few days to a week. If it does not disappear within that period of time, contact your dentist.
Indirect Composite/Porcelain Inlay
The other type of 'white filling' is called a Composite or Porcelain Inlay. These fillings are usually placed on front teeth when esthetics is of utmost concern. In order to increase their strength and longevity, they are fabricated in the laboratory and then bonded into position in the office. This is a two visit procedure rather than the one visit required to place a composite filling. However, when it comes to strength and cosmetics, the extra time and expense is well worth it!
Laminate veneers are probably the most esthetic means of creating a more pleasing and beautiful smile. They require a minimal amount of tooth reduction ( approximately .5 mm ) and are, therefore, a more conservative restoration than a crown. Porcelain veneers allow us to alter tooth position, shape, size and color. They are not the only alternative for all esthetic abnormalities but are truly a remarkable restoration when they are the treatment of choice.
Porcelain veneers are thin, hand-sculpted pieces of dental porcelain. They are molded and shaped on a model that is made from an impression of your teeth. Using various colors of porcelain powders mixed with water, the technician molds and sculpts the veneer. The porcelain veneers improve the look of your smile while blending naturally with your other teeth.
Some facts you might want to know about Porcelain Veneers
- Since they require approximately .5mm of tooth reduction, porcelain veneers are NOT considered a reversible form of treatment.
- Occasionally the preparation of a Porcelain Laminate Veneer does not necessitate the use of a local anesthetic. However, for those patients that are particularly sensitive or anxious, a local anesthetic is advisable.
- The laboratory time required for the fabrication of a Porcelain Laminate Veneer is approximately two weeks. Due to the minimal amount of tooth reduction, it is usually not necessary to fabricate any type of temporary restoration. Should a temporary be needed, they can, in most circumstances, be made at the time of treatment.
- Between your preparation visit and the insertion visit, you can expect some sensitivity to hot and cold. This is normal and is due to the removal of a small portion of the enamel covering of the tooth. This sensitivity should disappear after the placement of your Porcelain Laminate Veneer.
- Your second visit, the insertion of your veneer, can be accomplished, once again , with or without local anesthetic. This visit is usually longer in length. The laminates are placed with a light sensitive resin which is hardened by using a white light.
- Once placed your laminates are very strong and will resist most of the forces placed upon them by a normal diet. Porcelain has great crushing strength but poor tensile strength. Therefore, you should avoid anything that will tend to twist the laminate. Opening pistachio nuts with your teeth or biting into apples or corn on the cob is probably not a good idea!! As with most things, common sense should prevail.
Maintenance of Your New Porcelain Veneers
The maintenance of your Porcelain Laminate Veneer is relatively simple. A few suggestions, however, are in order:
- Please brush and floss as you normally would to prevent oral hygiene problems. Once placed, Porcelain Laminate Veneers are typically the kindest restoration to the gum tissues that we currently have in our prosthetic armamentarium. Do not be afraid that you will damage your laminates by either flossing or brushing. Any non-abrasive tooth paste is acceptable. A good home care regimen will insure the esthetic success of your laminate restorations for years to come.
- Some sensitivity to hot and cold may be experienced after the placement of your veneers. This relates to the amount of enamel left on your tooth after preparation, the proximity of the nerve as well as several other factors. Some sensitivity is absolutely normal and usually dissipates after one-two weeks. If this sensitivity should remain or concern you at all, please call your dentist.
- As mentioned before, a normal diet should pose no problem at all. Please avoid anything that will tend to bend or twist the laminates.
- If you are known to be a bruxer or clencher, please let your dentist know. He/she will fabricate a night guard for you to wear to minimize the stresses placed upon your teeth while you sleep.
Approximately one week after the placement of your laminates you will be asked to return to the office for a treatment evaluation. This visit is extremely important. It gives your dentist the opportunity to evaluate the placement of the laminates, the tissue response and to answer any questions you might have regarding your new smile.
Silver Fillings (Amalgams)
- Silver fillings, otherwise known as Amalgams, are an alloy of several metals ( Silver, Zinc, Tin etc. ) and Mercury. Once mixed, they make up dental amalgam. This restoration has been used successively for many, many years and has stood the test of time. Periodically, reports are generated about the possibility of mercury toxicity from old existing silver fillings. To date, it is the opinion of the American Dental Association that there is no substantial proof that dental amalgam poses any threat to the safety of the dental public.
- Initially, the decayed tooth is excavated and all the decay is removed.
- The tooth is then shaped in a specific manner in order to accept a silver filling.
- Finally, a band is placed around your tooth and the amalgam is condensed into the prepared tooth. The final filling is then carved and adjusted to your bite.
- Once placed, it takes almost two (2) weeks for your new filling to become fully hardened. You may, however, safely chew on it after twenty-four (24) hours. But, please, chew carefully!
- New silver fillings can be sensitive to hot and cold liquids and other foods for the first four to six weeks or in some special cases, even longer. If the sensitivity should continue for an extended period of time or if the discomfort is extreme, call your dentist so that he/she can evaluate the situation and prescribe the appropriate therapy.
- Sometimes, due to the effects of the local anesthesia, it is quite difficult to make sure that your bite is exactly right. If you feel any discomfort in chewing, call your dentist. A minor adjustment is usually all it takes to make you comfortable. Don't wait too long! Teeth can become quite sensitive if the bite is " high ". You can generate in excess of 40,000 pounds per square inch when chewing on your back teeth. Fillings which have not had the appropriate amount of time to harden, or are " high", cannot stand this kind of pressure and may break.