The Best Way To Fill Your Tooth

Can You Just Fill It?

One question that dentists are asked all the time is: “Can you just fill it?” My goal with this particular article is to answer just that question.   And the answer is: That depends on several factors. First and foremost are the needs and desires of the particular patient.  Equally important is the condition of the tooth or teeth in question.

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First, let me begin by explaining that nearly all of today’s tooth restorations are made of ceramic. Ceramic encompasses the materials most commonly used to restore teeth today. This includes porcelain in various forms as well as composite, commonly known as “plastic” fillings.  In our practice, metal is rarely used except in specific cases where achieving a quality bond is impossible (deep under the gum) or the strength of metal is mandatory.  Ceramic materials offer a beautiful, lifelike appearance and can be bonded to tooth structure for strength and longevity.

The choice of whether to use a composite filling or some type of porcelain restoration is dependent upon the following five conditions:

1. The size of the cavity

Composite fillings makes sense when the cavity – whether caused by decay or fracture – is less than one third the width of the tooth and takes up less than 50% of the biting surface. Larger cavities with inadequate tooth to support a filling are best restored using porcelain.

2. A cracked tooth

If the tooth is cracked, a porcelain restoration is needed to protect the tooth from fracturing.  We commonly see cracked teeth when silver fillings, especially large ones, have been in place for many years.

3. Worn teeth

Teeth which are worn can be restored with either material depending upon the extent and location of wear.   Surfaces which receive heavy biting forces require the strength of porcelain to last a reasonable length of time.

4. Root canal

Teeth which have had root canal therapy generally require porcelain crowns to protect them from breakage, as these teeth are brittle and somewhat hollow as a result of the root canal.

5. Tooth Modifications

Sometimes teeth are restored to alter their shape and or appearance. Examples are gaps between teeth, poorly aligned teeth and teeth which are restored to improve the bite.  Larger modifications require the use of porcelain.

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Today’s porcelains are much different from those that were used only 10 to 15 years ago. Newer technology has produced ceramic materials with exceptional strength as well as a lifelike appearance.  In addition, these materials can be used to make crowns, commonly known as  “caps”, which cover the entire tooth.

fillThey can also be used as onlays or “partial caps” to preserve solid healthy tooth structure. These onlays are beautiful and long-lasting restorations which can be less costly than full crowns.

If you have any questions about which fillings are appropriate for you, please do not hesitate to call our office at 908.359.6655 or via our website at www.DesignsForDentalHealth.com

30 Days of Thanks- Dental Technicians and Laboratories

I have had the pleasure of working with several wonderful dental technicians and laboratories and during the past three decades. Since it has always been our goal to provide excellent dental care for our patients, selecting the right dental laboratories to be our partners was critical. In the process of advancing our dental techniques and treatment planning, it was incumbent upon us to find dental laboratories and technicians who shared the same philosophy and passion to do great work. In that regard, to find a good fit, we depended upon word of mouth from our peers. Such has been the case since the late 1980’s and several labs with whom we have worked deserve our sincere thanks.

dental technicians and laboratories

Back in the late 80’s and early 90’s, the use of gold for fine dental restorations was still common. So, to learn how to provide excellent gold inlays and onlays, I took advantage of an opportunity to become a member of the exclusive Richard Tucker Gold Study Club. Members of this club met in dental offices and brought actual patients on whom to practice their technique.  These doctors were very particular; Tucker trained doctors used only Tucker trained technicians.  As a result, I was fortunate to have met a man named Dale Jones who handmade the finest gold restorations I had ever seen. Times have changed, and patients no longer wished to have gold visible in their mouths. So we began doing a similar service using modern dental ceramics for beautiful restorations. The problem was that Dale did not work with porcelain, but I asked him if he knew someone who was as good with porcelain as he was with gold. That is how I was introduced to Krisann Shaler and her lab called Porcelain Designs.

dental technicians and laboratoriesKris and I began working together in the early 90’s and we still work together today. Her lab is in California, but we were able to spend some quality time together around the year 2000.  We arranged to meet while I was taking a course at the Las Vegas Institute and it was then that Kris, Dale and I, along with our spouses, went to dinner and got to know each other on a personal level. Kris actually made the restorations for my wife, Liz, that were being prepared while I was attending courses at the Las Vegas Institute. When I inserted these restorations, the other doctors with whom I attended classes and the teaching doctors commented on how beautiful the porcelain work was. Kris is still providing beautiful restorations like those for my patients today.

As I learned more about restoring patients with major bite problems, the need arose for more complex restorations using increasingly difficult techniques.  As a result, I was introduced to larger laboratories that had both the necessary equipment and knowledge to produce these complex cases.  The two labs which have provided this fine service deserve to be thanked as well and their names are Aurum Ceramic Dental Laboratories and Microdental Laboratory. Each of these labs have several outstanding technicians, but I’d like to call out Ulf from Aurum and Gloria from Microdental who have acted as integral members of our team during the production of many of our larger cases.

dental technicians and laboratories

There are several other laboratories with which we have worked over the years and they deserve our gratitude as well. Many times, it is these laboratories who make us look good because they allow us to provide excellent care and service for our deserving patients. So in closing, I’d like to give a huge Thank You to Dale, Krisann and all of the lab technicians who have taken such great care of us for the last 30 years.