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Silver Fillings

Why Do I Need a Filling? Six Reasons Why Dentists Do Fillings

Oral Health & Hygiene

Nov 2, 2011

Dental Fillings Fix Chipped Teeth — ©Steven Frame/Shutterstock.com

Many people wonder why their dentist tells them that they need a filling. Although having a cavity is the #1 reason we do fillings, there are also many other reasons that people get fillings.

Why You Need a Filling

1 – Cavities

Cavities remain the number one reason that dentists give patients fillings. Even so, not all cavities need fillings. Sometimes very small cavities can be “watched.” When this happens, the dentist monitors the cavity and if it appears to be repairing itself, you won’t need to get a filling.

I’d like to add a word of caution: Only leave a cavity unfilled if your dentist has recommended that your cavity should be watched. Putting off necessary dental work can complicate your dental health and increase your costs.

If you do have small cavities that your dentist is keeping an eye on, check out these 12 weapons of plaque destruction to see how you can help your cavity heal.

2 – Tooth Fracture

Many times, fractured teeth can be repaired with white composite filling material. You can take a look at a tooth that I repaired with a white composite filling before I started working with real patients in dental school.

Prevent your teeth from fracturing by wearing a mouth guard during these 16 activities.

3 – A Slow Loss of Tooth Structure

When you fracture your tooth, you lose a lot of tooth structure quickly. There are other ways that you can lose tooth structure more slowly, such as abrasion, abfraction, erosion, and attrition. You can learn about those in the article about the four ways you wear away tooth structure.

The best way to prevent this type of tooth loss is by avoiding acidic drinks and acidic candy, not grinding your teeth, and not using your teeth as tools.

4 – Tooth Discoloration

Another reason that dentists do fillings is to cover up discolored teeth. Teeth can be discolored for a variety of reasons, such as staining from antibiotics and dental fluorosis.

5 – Replacing Old Fillings

Old fillings may need to be replaced. Over time, white fillings can discolor and the bond between the filling and the tooth can break down. Silver fillings may also fracture after many years of service. One of the first fillings I did in dental school (unbeknownst to my patient!) was the replacement of a silver amalgam filling that had fractured.

Questions About Fillings?

Do you have any questions about why dentists do fillings or why you need a filling? Go ahead and leave a comment in the comments section below. Thanks for reading!

Don’t Wait Until Your Tooth Hurts to Go to the Dentist

Dental Pain

Oct 21, 2011

Dental Pain Toothache — ©Fotovika/Shutterstock.com

This morning I saw a patient who had been in extreme pain for the last couple of weeks. What started as a small cavity grew into a large cavity that eventually made its way to the tooth’s pulp. We were able to take her out of pain by starting a root canal today.

If we end up fixing her tooth, rather than extracting it, it will cost her around $1200. Even then, with the condition of the tooth, it may only last her 5-10 more years.

A bridge to replace that tooth would cost her $1350. An implant to replace that tooth would cost her $2100. And those are dental school prices. It would probably be about twice that in a private practice. You can find the average dental fees in your area here.

Had she come in a couple of years ago, we could have easily removed the decayed portion of the tooth and put in a filling. With the prices at my dental school, that would have cost her only $84 and would have most likely lasted her at least 20 years (she has several amalgam fillings that are still going strong after more than 15 years.)

Find out how long a silver filling lasts.

The Moral of the Story

What I’m trying to get across is that if your dentist recommends getting a filling in a tooth, get it (As long as you trust your dentist!)

If you put it off simply because the tooth doesn’t bother you, there’s a good chance both you and your wallet will be experiencing some pain in the future.

Filling Fell Out? Why You Should Get a Lost Filling Replaced

Fillings and Inlays

Jun 24, 2011

Filling Fell Out of Front Tooth — ©MicroWorks/Shutterstock.com

I got an email earlier this week from a reader named Trish. She asked the following:

“What will happen if the filling comes out of your tooth, and you don’t have it replaced, other than pain trying to eat?”

Before I answer that question, let’s take a look at why fillings fall out. A filling normally doesn’t fall out of your tooth just for fun – it usually has a pretty good reason! Fillings can come out because of decay around the filling, because the filling cracked, or because it wasn’t put in properly.

Basically, if your filling fell out, chances are that there was something wrong and you should get your tooth looked at by a dentist.

If the filling came out and it was recently put in, your dentist might give you a break and put a new filling in. If it was an old filling and it just came out, you may have a cavity under the filling.

Regardless of why the filling fell out, it’s important to replace it. To answer Trish’s question, here’s a list of eight things that could happen to your tooth if your filling fell out and you don’t have it replaced.

Eight Things that Can Happen If You Don’t Replace a Lost Filling

1 – Sensitivity

When you lose a filling, it exposes the sensitive dentin (the inner hard layer of your tooth) to your mouth. Depending on how close the filling was to the pulp of your tooth, it could hurt all the time or only when you eat, as Trish mentioned above. Either way, the pain means that there’s something wrong that needs to get taken care of!

Not sure what dentin and pulp are? Check out my article on the anatomy of a tooth to find out!

2 – Root Canal

The pulp inside of your tooth could get irritated, causing pulpitis. The textbook Clinical Endodontics by Leif Tronstad states, “Factors leading to an infectious pulpitis are conditions that contribute to the exposure of the dentin and dentinal tubules to the oral environment.”

3 – It’s Harder to Clean

Teeth are hard to clean when they have a big gaping hole in them. Even if you can get the toothbrush bristles down to the bottom of the hole where the filling was, chances are that you won’t be able to easily clean out the entire hole where the filling was located.

4 – Bad Breath

When you eat food, the natural contours of the teeth allow you to efficiently chew and grind the food into little, easily-digested pieces. When you have a hole in your tooth and you chew, you push the food down into the hole. Since teeth with lost fillings are more difficult to clean (see #3), that food could be sitting in there for quite some time and cause your breath to be less than pleasant to those around you! Even if you do have bad breath, people probably aren’t going to tell you.

5 – Tooth Decay

Because the tooth is harder to clean and you’re buyonlinegenericmeds.com grinding food into it every time you eat, it’s much easier for you to get a cavity in that tooth. If the reason that you lost the filling was because you had a cavity under it, the cavity will probably get bigger the longer treatment is put off.

6 – The Tooth Could Crack or Break

If the tooth goes for a long time with a lost filling, it may develop a cavity, which can subsequently weaken the tooth structure and cause the tooth to break or crack. Without the filling, the tooth will also experience different forces that end up causing it to break.

7 – Difficulty Repairing Tooth With a White Filling

When you lose a filling and expose the dentin to your saliva, the dentin reacts by trying to fight off the bacteria. The little tubules inside the dentin eventually close off to try to protect the nerve of the tooth. When this happens, it is known as sclerotic dentin. A problem with sclerotic dentin is that it is much harder to get a white filling to bond to sclerotic dentin than it is to get a white filling to bond to regular dentin.

8 – The Tooth May Need to Be Extracted

If you wait too long, the tooth may break and become so badly decayed that it is what dentists like to call unrestorable. That means that just like Humpty Dumpty, nobody will be able to put that tooth back together again, and it will have to come out.

What Are Your Options When a Filling Falls Out?

I assume that Trish wants to know what would happen because she either has a fear of the dentist or can’t afford to get a new filling right now.

If fear is keeping you away from the dentist, take a look at this article about reasons people are scared of the dentist, and then figure out your fear and try to overcome it. There is help available online at sites like Dental Fear Central.

If cost is keeping you away from the dentist, then you can call your dentist and ask how much a temporary filling would cost. A temporary filling would allow you to get the tooth filled fairly inexpensively until you can save up for a permanent filling. An even more temporary solution is to try some temporary filling materials until you can see your dentist. I talk about a few different brands in my article about what you should do when you lose a filling from your tooth.

Conclusion

If you have a filling come out, it’s necessary to get the filling replaced as soon as possible to ensure the long-term health of your tooth. If you can’t afford it, there are temporary solutions available that you dentist may discuss with you.

Do you have any questions, comments, or concerns about losing a filling from your tooth? Go ahead and leave a comment in the comments section below and I’ll get back to you. Thanks for reading!

What’s In an Amalgam Filling?

Amalgam Fillings

Mar 30, 2011

Contents of Silver Amalgam Fillings — ©Steve Heap/Shutterstock.com

Have you ever wondered what an amalgam filling looks like inside?

Many people question how a metal can be soft enough to be shaped into a tooth yet hard enough to endure the force of chewing and other abuse that occurs during its ten or more years in your mouth.

Other people are curious about the amount of mercury contained in an amalgam filling…so let’s get some answers!

I opened up an amalgam capsule (pictured to the left) and took a picture of what I found inside:

Aside from the capsule body, I found three main components:

1 – Mercury Disc – Amalgam fillings are made up of about 50% mercury, and 50% metal powder. The mercury is sealed away in a plastic disc so that it doesn’t evaporate and contaminate the environment. The mercury disc breaks open when the amalgam capsule gets mixed.

2 – Metal Powder – The metal powder is made up of varying metals. In the Dispersalloy brand of dental amalgam (a widely used brand), the metal powder contains about:

69% Silver
18% Tin
12% Copper and
1% Zinc

3 – Pestle – The pestle is simply a plastic rod. When the amalgam is mixed and vibrated quickly back and forth, the pestle breaks open the sealed mercury disc and helps to thoroughly mix the mercury with the metal powder to form a soft metallic mixture. While the amalgam is still soft, the dentist uses it to fill your cavities. The amalgam begins to harden after a few minutes and eventually hardens into a filling that can withstand lots of force.

Conclusion

As you can see, the formulation of amalgam is pretty simple: mercury and metal powder. Fortunately, modern amalgam capsules come pre-measured so that dentists don’t have to worry about mixing up mercury with other metals by hand.

Do you have any questions about the contents of amalgam fillings? I’d love to hear your thoughts int he comments section below. Thanks for reading!

What Do Silver and White Fillings Look Like?

Fillings and Inlays

Jan 7, 2011

What do White and Silver Fillings Look Like? — ©Lighthunter/Shutterstock.com

At my dental school, we recommend silver fillings for the back teeth since silver fillings last longer than white fillings. However, many people are hesitant to get silver fillings because they stand out, and they don’t want other people to notice them.

If you are also wondering what the difference in appearance between white and silver fillings looks like, then this article is for you!

What a Silver Dental Filling Looks Like

In the picture below, you can see see four silver fillings. Two are on the left on the top of two teeth. Two silver fillings are also present on the right: one on the top of the tooth and one in the pit on the side of the tooth.

As you can see, silver fillings are noticeable. However, during your everyday routine, people aren’t likely to see your back teeth. Because of this, it is usually a good idea to get silver fillings on your back teeth because they are stronger and are more resistant to getting new cavities around them than the newer white fillings.

Another thing you may notice in the above picture is that this person’s lower front teeth are worn down. You can learn more about the four ways we wear down our teeth here.

What a White Dental Filling Looks Like

White fillings are matched to your tooth’s color by your dentist. Thus they actually vary from white to gray to even yellowish shades.

As you can see below, the man has numerous white fillings on his back teeth (this is a view of his upper teeth from below). This picture is a good example of how picking the wrong shade of white can make a filling stand out even more. Some of the fillings are easy to see because they are not matched very well to the shade of the tooth.

I have the arrow pointing at one of the more inconspicuous white fillings where the shade of filling material more closely resembles the tooth’s natural shade. If you look closely you can see that in the middle of that tooth there is a big white filling.

Conclusion

As you can see, white fillings are definitely less noticeable than silver fillings. They can be more noticeable if their shade doesn’t exactly match the shade of your tooth.

At my dental school, we generally recommend white fillings in the front teeth and silver fillings in the back teeth. That way, you can have the strength of the silver fillings in the back of your mouth where there is a lot of force every time you chew, and the white fillings in the front teeth so that you have an aesthetically-pleasing smile.

If you have any questions or comments about white or silver fillings, go ahead and write them below in the comments section. Thanks for reading!