Dental Fillings

A dental restoration or dental filling is a dental restorative material used artificially to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. It is also lost intentionally during tooth preparation to improve the aesthetics or the physical integrity of the intended restorative material. Dental restoration also refers to the replacement of missing tooth structure by restoring dental implants.

Dental restorations may be fabricated out of a variety of materials, Common direct restorative materials include dental amalgam, glass ionomer cement and composite resins. Common indirect restorative materials include acrylic, porcelain, zirconia, gold and other metals.

Dental restorations can be divided into two broad types: direct restorations and indirect restorations. All dental restorations can be further classified by their location and size. If decay is spread beyond dentin, in that case root canal therapy is used, and a crown is fit.

To treat a cavity your dentist will remove the decayed portion of the tooth and then "fill" the area on the tooth where the decayed material once lived.
Fillings are also used to repair cracked or broken teeth and teeth that have been worn down from misuse (such as from nail-biting or tooth grinding).

What Steps Are Involved in Filling a Tooth?
First, the dentist will numb the area around the tooth to be worked on with a local anesthetic. Next, a drill, air abrasion instrument or laser will be used to remove the decayed area. The choice of instrument depends on the individual dentist's comfort level, training, and investment in the particular piece of equipment as well as location and extent of the decay.

Next, your dentist will probe or test the area during the decay removal process to determine if all the decay has been removed. Once the decay has been removed, your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Several additional steps are required for tooth-colored fillings and are as follows. After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that "cures" or hardens each layer is applied. When the multilayering process is completed, your dentist will shape the composite material to the desired result, trim off any excess material and polish the final restoration.

What Types of Filling Materials Are Available?
Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material, patients' insurance coverage and your dentist's recommendation assist in determining the type of filling that will best address your needs.
Cast gold

Direct/Filling restorations



Amalgam filling

Direct restorations are placed in the tooth in situ, while indirect restorations are created away from the tooth, traditionally prepared in a laboratory. Direct restorations are done using materials amalgam(silver color) or dental composite(white color) or suitable restorative materials. If filled by white composite, the filling is photo-polymerised using a blue spectrum light, not to be confused with UV light, and maybe polished also. It is recommended not to chew anything hard for a day or two after fillings, which may dislodge fillings.

Indirect restorations



Usually a dental technician fabricates the indirect restoration from records the dentist has provided of the prepared tooth. Once a proper fit and bite is confirmed the restoration is usually bonded permanently.

While the indirect restoration is being prepared, a provisory/temporary restoration sometimes is used to cover the prepared part of the tooth, in order to maintain the occlusal space and the contact points, and insulation of the pulpal tissues and maintenance of the periodontal relationship.

Removable dental prostheses (mainly dentures) are considered by some to be a form of indirect dental restoration, as they are made to replace missing teeth. There are numerous types of precision attachments (also known as combined restorations) to aid removable prosthetic attachment to teeth, including magnets, clips, hooks and implants which could be seen as a form of dental restoration.

Dental composites



Dental composites are also called white fillings, used in direct fillings. Crowns and in-lays can also be made in the laboratory from dental composites. These materials are similar to those used in direct fillings and are tooth coloured. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discolouration.