Why Bonded Restoration
In the past when patients needed fillings placed in their back (chewing)
teeth, dentists had only one choice of materials for these fillings: silver
amalgam. Amalgam fillings are made of silver and other metals that are
mixed with mercury just prior to placement in the patient's tooth.
Silver amalgam fillings have serviced patients and dentistry quite well
for decades. The material does have its limitations and potential problems:
Recent studies suggest that large silver amalgam fillings can contribute
to the fracture of teeth. Silver fillings contain mercury. Mercury is
used in thermometers because it expands and contracts with changes in
temperature. The mercury in silver amalgam fillings does the same thing.
This expansion and contraction of the silver filling causes stress in
the tooth structure that surrounds the filling. This stress can sometimes
cause the tooth structure to fracture or break away from the tooth.
Over the years, the silver amalgam filling breaks down at the margin where
the filling meets the tooth. This break down of the metal causes the "seal"
to be broken which allows decay causing bacteria to enter the area.
Silver amalgam fillings do not bond to tooth structure. They are held into
place by undercuts that the dentist has to make when preparing the tooth
(drilling) for the restoration. This means that tooth structure other
than the decayed area has to be removed. Also, when a filling is very
large, the dentist may have to place reinforcement pins into the tooth
in order for the filling to be held in place.
Silver amalgam fillings are unattractive, darken with age and cause discoloration
of the teeth they are placed in.
What are the Alternatives to Silver Amalgam Fillings?
With recent advances in dental material technology and bonding techniques,
dentists have alternatives to placing silver amalgam fillings. Two of
these alternatives are Composite Bonding and Composite Inlays or Onlays.
COMPOSITE BONDING (Tooth Colored Fillings)
What are the Advantages of Composite Tooth Colored Bonded Fillings?
- Tooth colored bonded fillings are sealed to the tooth structure which prevents
decay causing bacteria from infiltrating into the inner part of the tooth.
- Composite bonding does not expand and contract with temperature changes
which could aid in preventing tooth fractures.
- Many bonded fillings release fluoride in the tooth which prevents recurrent decay.
- Tooth colored fillings look great!
How is the Procedure Different from Having Silver Amalgam Fillings?
In many cases, the procedure is very similar to having silver amalgam
fillings. The tooth or area is numbed with a strong anesthetic solution.
The decay or old filling is removed and the tooth is prepared to accept
the restoration. Generally, a smaller amount of tooth structure is removed
when preparing for a tooth colored filling. The tooth is then "etched"
with a mild acidic solution. This roughens the enamel surface and allows
the bonding material to adhere. A shade of composite material is chosen
that matches your natural tooth and is placed into the tooth. The dentist
then shines a bright light on the area to harden the material. The filling
is then trimmed to adjust to your bite and to achieve proper contour and shape.
How Long Will Tooth Colored Fillings Last?
How long any filling lasts depends on many factors. First, smaller fillings
that are surrounded by natural tooth structure will last much longer than
large fillings that are not surrounded by natural tooth structure. Secondly,
how much biting pressure is exerted by opposing teeth is also important.
Home care, frequency of check up visits and quality of diet are also factors
that affect the longevity of fillings. Tooth colored fillings can last
years before needing repair or replacement.
What are Composite Inlays or Composite Onlays?
Composite inlays and onlays are tooth colored fillings that are custom
fabricated in a dental lab. They are placed in teeth as replacements for
silver amalgam fillings. Composite inlays and onlays are bonded onto the tooth.
What Advantages Do They Have Over Composite Bonded Fillings?
If the silver restoration is very large, a composite inlay or onlay may
be recommended over composite fillings because they are stronger. Rather
than merely filling your tooth, composite inlays or onlays forms a lasting
bond that reinforces your tooth from every angle. They are custom made
in a dental laboratory. For this reason, composite inlays or onlays are
very esthetic restorations that match the look of natural teeth. The cosmetic
results frequently exceed patients' expectations. Composite inlays
or onlays are wear resistant and wear better than many other restorative
What Advantages Do Composite Inlays or Onlays Have Over Crowns?
When a tooth is prepared for a crown, a good deal of tooth structure has
to be removed by the dentist in order to make room or space for the crown.
When a tooth is prepared for a composite inlay or onlay, only the old
filling is removed and a very small amount of additional tooth structure
is sacrificed. More of your natural tooth structure remains when inlays
or onlays are chosen.
How are Composite Inlays or Onlays Done?
This is a two visit procedure. On the first visit, the area is made numb
with a strong anesthetic solution and the old silver filling and decay
(if present) is removed. The tooth is prepared for the inlay or onlay
and an impression of the area is taken. A temporary filling is placed
in the tooth. On the second visit, the temporary filling is removed and
the composite onlay or inlay is fitted to the tooth prior to permanent
placement. When it meets your dentist's satisfaction, it is then bonded
The materials that we use today are much more esthetic and even stronger
and possibly longer lasting. They look, feel, and function like natural
teeth. Our concern is your comfort and confidence. Our goal is to help
preserve your smile for a lifetime.