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.
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.
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.
They 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