COSMETIC FILLINGS

Dental cavities mean holes in the teeth. They are caused by dental decay also called as dental caries. This means wearing away of the surface of teeth. All dental cavities must be filled up with an appropriate filling material which restores the shape, function and aesthetics of the tooth

Previously, many a times a dental surgeon was faced with the questions like: Doctor, can you do something about that ugly looking filling? Can you not do a white filling? Doctor, I don’t want any repair work to be evident. Can it be unnoticeable? Can you not do a white filling instead of a silver filling? and so on.

This used to place the dentist in a predicament. Silver fillings were the only filling material available for the load bearing back teeth. Silver fillings have served dentistry for more than a century now. These are economical and can be placed easily. Unfortunately these require more drilling for the tooth structure, there may be some sensitivity after their placement. These may appear unaesthetic. Sometimes they also cause pigmentation in the gums. They do not match with the shade & color of the tooth. This demotivates many patients. The idea of a steelish color filling is not very appealing especially in these days when aesthetics is a prime consideration.

New Dental Fillings
Now a days a new group of filling materials have been developed which are known as light cured composites. They harden by a special kind of light. They can be used to fill up cavities in front and back teeth.
The front teeth are mainly used for cutting the food particles and the molar teeth are used for grinding them. The molar teeth are larger in size and bear the brunt of the chewing load. Therefore, any filling which is done on the biting surface of the back teeth must be able to withstand the masticatory load. New generation of white filling materials have improved resistance to masticatory load. They are now being placed routinely for cavities in the back teeth. The good old silver filling is being phased out.

Advantage of all cosmetic fillings is that they provide better aesthetics; also, less drilling of the tooth structure is required. There remains very little residual sensitivity after the placement of the filling. In properly selected cases, white fillings are expected to provide years of aesthetic service. Yet another advantage of the composites is that they adhere to the tooth structure chemically. This is not the case with silver fillings. The retention of silver fillings is purely mechanical.

Composite fillings can be done in two ways. Directly and indirectly. In the direct method, the composite filling is placed in the tooth directly after cleaning the dental decay. The tooth is chemically treated and fillings harden by a special kind of light.
The indirect method is used mainly for back teeth. In this method a model of the patient’s dentition is prepared. The filling is fabricated on the model. It is then heated or put in a special oven for enhanced strength. Then it is stuck to the tooth by a special adhesive cement. Composite fillings done by the indirect method have better strength.

After some use some composite fillings may take up stains. The fillings may then differ very slightly in shade with the original tooth shade. Therefore it is advisable to polish and reseal the composite fillings once a year. This problem is considerably less in the newer generation of composite filling materials.

Composite fillings are more expensive than silver fillings. These cannot be used in areas subjected to heavy masticatory stress and in large cavities. White fillings are avoided in large and broad cavities and where the teeth are subjected to heavy chewing load like in pan chewers or those who grind their teeth.

In moderately large cavities, ceramic inlay or onlays can be placed. Ceramic restorations are fabricated in the laboratory on the model of the patients teeth. There fore, they take some more time to be fabricated and this also adds to the expense. They are then stuck to the tooth with an adhesive cement which chemically adheres to the tooth structure.

Ceramic inlays and onlays are stronger than composite fillings. These do not take up stains as some composites do. They provide excellent aesthetics.

White fillings and ceramic inlays or onlays are smoother than silver fillings and less or plaque gets accumulated around these. They do not cause pigmentation in the gum.

Glass ionomers are another group of cosmetic filling materials. Their unique advantage is that they release fluorides which is incorporated in the tooth & this makes the tooth resistant to dental decay. However, it is difficult to obtain an exact shade match with them. Like composites they are not placed in areas subjected to heavy chewing pressure. They are used especially in patients who are more prone to dental caries like very small children, elderly patients, patients with reduced salivary flow etc.

Dentistry has kept pace with the times. Now, there is no need to settle for an ugly looking filling which mars the smile. Various types of cosmetic fillings can be placed to fill up cavities and provide better aesthetics. A new bunch of dental therapeutics has been developed which is known as cosmetic dentistry. Advances in cosmetic dentistry have made it possible to fill up dental cavities without compromising on aesthetics, strength and longevity.

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