What Are the Advantages and Disadvantages of Composite (White) Fillings?
Many people ask us why we do all of our fillings on back teeth using composite (white) fillings rather than silver amalgam.
Silver amalgam is composed of silver, copper, tin, zinc and mercury. The mercury is what allows the formulation to be in a putty-like consistency while it is placed in the tooth, and then harden to a metal consistency. Amalgam has been the filling of choice for about a century. Its advantages include: strength, durability, low cost, and ease of placement.
An amalgam can be contaminated by saliva or blood during placement, and its longevity will not be affected. Amalgam’s disadvantages include: undesirable esthetics (they start out silver/gray and end up black with age), lack of bonding, frequency of tooth fracture, and some concern about mercury toxicity (although this has never been proven scientifically).
Composite fillings are very different from amalgams in many respects. They are made from a plastic resin with varying amounts of glass fillers, depending on the brand. Composites have been in use since the 1960’s, but were initially used only for front teeth.
What sets composites apart from amalgam is that:
- They are tooth colored.
- They are bonded to the tooth. This is the most important feature of composite fillings, and the one that has caused such a revolution in dentistry.
The composite is microscopically attached (bonded) to the tooth by a 3 step process. First, the tooth is treated for 15 seconds with a mild acid. This conditions or “etches” the tooth. It provides microscopic irregularities in the enamel, and opens small tubules in the dentin of the tooth.
The second step is the placement of a bonding agent. This is a very thin type of composite that flows into the enamel irregularities and dentinal tubules. It is then cured (hardened) with a very bright blue curing light. This very thin initial layer is now microscopically locked into the surface of the tooth.
The third step is the addition of a chemically similar composite filling material that then chemically bonds to the first layer. This produces a filling that is actually bonded to the tooth, instead of being simply placed in the tooth like you would pour cement into a post hole.
The two most important features of the composites are a direct result of the fact that composites are bonded to the tooth.
When properly done, composites will last as long as amalgam, they look just like a natural tooth, and they strengthen, rather than weaken the tooth.
For more information on tooth-colored restorations, please call Willowdaile Family Dentistry in Durham, NC.
We have placed tooth-colored restorations in your teeth. The resin material used is a plastic with small “filler” particles of glass-like material – the finest and most up-to-date materials available today. These restorations will serve you well for several years. However, you should be aware of the following.
Chewing: Unlike amalgam fillings, you may chew with your new composite fillings as soon as the anesthetic completely wears off, since they are fully hardened when you leave the office! Enjoy them! As with natural teeth, avoid chewing excessively hard foods (or objects) on the restored teeth (hard candy, ice, raw carrots, etc.) as extreme force can cause the resin material to be broken from the tooth – just as a natural tooth can be fractured. In the event that a breakage occurs, replacement of a restoration is not difficult, but a crown may be necessary.
Your anesthetic may last several hours: please be careful not to bite your lips, cheeks or tongue while they are numb (also watch your child if they were anesthetized for their fillings). Your bite will feel different for approximately 1 week. Your tongue will magnify the tooth shape difference and this too will accommodate itself in approximately 1 week. If your bite or the shape of the tooth is such that you cannot accommodate it after a week, please contact us so we can make an appointment to adjust your filling.
Sensitivity: It’s normal for your teeth to be a bit sensitive to heat, cold, and pressure. That’s because we removed some tooth structure then placed new materials on your teeth. In general, the deeper the cavity was in your tooth, the more sensitivity you will experience. Sensitivity to cold is normal and may last for several months. Some sensitivity to warm/hot is experienced by some people. Most sensitivity disappears once you swallow. If sensitivity to hot cold or pressure increases, be sure to call our office.
Your gum tissue may have been irritated during the procedure and may be sore for a few days. Rinsing three times a day with warm salt water will relieve the pain and swelling. Dissolve one teaspoon of salt in one cup of warm water, gently swish, and then spit carefully. Mild, over-the-counter pain medication should ease your discomfort during the adjustment period.
Recalls: Visit us at regular 3, 4 or 6 month examination periods. We will notify you of the interval that will meet your needs best. Often problems that are developing around the restorations can be detected at an early stage and repaired easily. Waiting a longer time may require redoing the entire restoration and may dictate additional treatment, such as a root canal and/or a crown.
Preventive Procedures: Tobacco products, whether smoked or chewed, will quickly stain your teeth and unattractive yellowish brown. Red wine, cola, berries, coffee and tea can stain your teeth as well as your new restorations, so brush or rinse after consuming them. Also soda and acidic foods (especially soda!) can de-bond your new restorations with frequent consumption. It is best to avoid them. Drinking through a straw and rinsing your mouth with water after you eat them can also help avoid this consequence.
Daily plaque removal is critical for the long-term success of your new restorations. So brush and floss daily, and see us on a regular basis for professional cleanings. We’ll use the appropriate cleaning abrasives and techniques for your specific cosmetic work. We want these to last a very long time!
To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please brush and floss after eating and before bedtime. In addition, swish with a fluoride mouthwash vigorously for at least 30 seconds daily (such as ACT that can be purchased over-the-counter). Also, see us on a regular basis for professional cleanings. We will monitor your restorations and use the appropriate cleaning abrasives and techniques for your specific cosmetic work. We want these to last a very long time! If you participate in sports, ask us about creating a custom mouth guard to protect your new smile.
If you have any concerns or questions please feel free to call Willowdaile Family Dentistry in Durham, NC any time! Thank you for entrusting us with your oral care!
Natural Fillings and Restorations
At Willowdaile Family Dentistry in Durham, NC, we use only natural-looking tooth-colored fillings, crowns and restorations. The old-style amalgam fillings and crowns left smiles with that unattractive metal-mouth look. Modern dentistry lets us replace and repair teeth with materials designed to match your tooth color and look completely natural. There are none of the health concerns associated with the metal fillings, and these new materials are actually stronger and more durable too.