Posts for tag: fillings
For over a hundred years dental amalgam — a combination of silver, mercury, tin and other metals — has been an effective filling material for teeth damaged by decay. But it has one major drawback — its metallic appearance stands out in stark contrast to the natural color of teeth.
As an alternative, composite resin fillings can match the color, shape and texture of natural teeth. These materials and the techniques used to bond them are proving just as effective as and more aesthetically pleasing than dental amalgam.
Fillings help protect and preserve a decayed tooth. By first removing decayed tooth structure through drilling, the resulting void is filled with durable material that strengthens the tooth and provides it protection from further decay.
The ultimate goal for restoration is to return the tooth to as near normal form and function as possible. Dental amalgam serves well in terms of function, providing the tooth strength in the face of the daily biting forces it encounters. In contrast, composite resins excel in appearance, but haven’t always matched the durability of amalgam. They’re material construction has improved over time, though, as well as the techniques used to bond them to teeth.
Most of these bonding techniques incorporate layering. The first step is to seal the dentin (the porous, living tissue just below the enamel); we then build up the composite material layer by layer within the tooth using special bonding adhesive and curing lights. In some cases where a large volume of tooth structure must be replaced, the restoration is first formed on the tooth and then removed for curing before being cemented into the tooth or a separate restoration is formed by a dental lab.
The end result is a tooth which both looks and functions like a fully intact tooth. Though care must be taken not to subject composite resin restorations to undue forces (no cracking open nutshells, for example), your new filling should continue to serve you and look great for a long time to come.
If you would like more information on metal-free restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”
Metal amalgam fillings for dental caries have been used since the mid 19th Century. Although newer, “natural color” filling materials have become available, amalgam remains a standard choice among dentists.
Dental amalgam is a metal alloy created by carefully combining exact proportions of mercury, silver, tin and copper. Though quite pliable when first mixed, the alloy eventually sets into a very hard substance that stands up well against the forces produced by the mouth’s natural chewing function. The presence of mercury, however, has raised concerns for some that the metal’s toxic properties pose a risk to the patient’s health.
But after decades of research, the American Dental Association and other health organizations have concluded that dental amalgam “is a safe, reliable and effective restorative material.” Studies have determined that any free molecules of mercury that could potentially enter the bloodstream are trapped in the set amalgam. And although the amalgam can release mercury vapor during chewing, the amounts are well below the levels considered harmful.
Dental amalgam has proven to be versatile, effective and economical. It doesn’t create an allergic reaction, is quite durable, and doesn’t interfere with normal chewing function. It does, however, have its drawbacks. Its use can require more tooth material to be removed to keep the fillings in place, and they can increase temperature sensitivity during the initial four to six weeks. And, of course, their metallic appearance, especially when used in more visible front teeth, reduces their aesthetic appeal.
Other, more cosmetically appealing types of filling material have been developed over the years. These include composite resin fillings, a mixture of glass or quartz in a resin medium; glass ionomers, made of acrylic acids and fine glass powders and best used in areas not subject to heavy chewing; and resin ionomers, similar to glass ionomers but with the addition of acrylic resin. Each of these has their advantages and disadvantages (as well as cost considerations), but they’re main advantage over amalgam is their mimicry of natural tooth color.
The choice of either dental amalgam filling or one of the tooth-color alternatives depends on what you may need and can afford. Rest assured, though, that if the choice is dental amalgam, this restoration workhorse can provide you years of safe and effective service.
If you would like more information on your options for tooth fillings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Silver Fillings.”
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
How the anatomy of a tooth determines color
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
The language of color composition and reflected light
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”
It used to be that when it came to treating tooth decay (cavities), your primary option was to have the tooth decay removed and filled with a metal amalgam (silver-colored filling). This treatment sometimes requires a special shape cut called an “undercut” to be drilled into the tooth to hold it in. Unfortunately, it can also involve removal of some healthy tooth structure. Silver amalgam fillings still have limited applications and are still used in back teeth where they don't show in the smile. This is because they are strong and resist biting well; however, over time they can fatigue and fracture.
Older restorative concepts were based upon the development of strong and stiff materials such as gold, which tends to be unyielding and therefore contributed to failures of the remaining tooth substance around restorations (e.g., decay or cracking). Newer concepts tend to get away from the “stronger and stiffer is better” concept and have moved towards safety principles using materials that involve mimicking the properties of natural tooth structure. In fact, it is now clearly established that a new “biomimetic approach” (“bio” – life; “mimetic” – mimicking) to dentistry is possible through the use of tooth-like materials such as composite resins and porcelains. And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, which both stabilize and strengthen teeth.
These techniques are also suitable for children's teeth and can incorporate fluoride to reduce further decay. But perhaps best of all, using these materials and more modern technologies can restore proper tooth function and normal wear while producing results that appear indistinguishable from natural teeth.
To learn more, continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” You can also contact us today to schedule an appointment to discuss your specific questions about replacing your metal fillings with tooth-colored ones.
While the goal of restorative dentistry is to return all of the destroyed or lost dental tissues of the teeth to full form (shape) and function, when you blend this goal with the artistry of cosmetic dentistry, the results can be dazzling. Today's modern techniques and materials enable replacement of missing tooth structure that allows bonding directly to the tooth so that it not only is an exact color match but also actually strengthens the tooth. And tooth-colored fillings are not just for front teeth. They can dramatically improve the appearance of all teeth — even your back molars — so that it appears you've never had tooth decay at all!
All of this is accomplished through the use of either tooth-colored dental porcelain or composite resins. Porcelains are a form of ceramic material formed by the action of heat. They are available in many colors and shades made from a powder corresponding to the primary color of the natural tooth structure that is mixed with water and placed into an oven for firing (hence their ceramic nature). When built up in layers by highly trained dental ceramicists, they can be made to mimic the exact natural translucency, staining and contours of tooth enamel.
Dental composite resins are the most common materials used for tooth-colored adhesive restorations today and have properties similar to tooth structure. They consist of resin or special plastics and fillers that are made of silica, a form of glass. The fillers give the composites wear resistance and translucency (see through properties).
It is important to note that besides providing the appearance of beautiful teeth, properly restored teeth function and wear better. But most important to you, they appear indistinguishable from natural teeth! Furthermore, scientific studies and clinical experience have validated their use as both safe and predictable. In fact, these techniques are also suitable for children's teeth and can incorporate fluoride to reduce decay. Together, all of these changes have so significantly impacted the way modern dentistry is practiced that many believe we may have entered into the so-called “post-amalgam (silver metal-colored dental fillings) era.”
Contact us today to schedule an appointment to discuss your questions about tooth-colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”