All Fillings Are Not Created Equal

Posted by: Jason Hui, DDS, on March 25, 2013

Almost everyone at some point in life has undergone a dental filling procedure.  Dental fillings are required to replace missing tooth structure when bacteria in the mouth induces a cavitation (hole) in the tooth.  But did you know that a filling done at one office may not be the same as a filling done at another office?

Dental materials are often not a topic of discussion with patients by many dental providers, but is one of the most important topics to understand when assessing the value of a procedure.  For composite resin (tooth-colored) fillings alone, there are hundreds of choices and brands of materials for your dentist to choose from, all with varying degrees of physical properties and cost.  The most expensive filling material on the market (as a cost to the dental practice) is about three times that of the cheapest filling material, so what kind of filling are you getting placed into your mouth?

The important physical properties of composite resin fillings to consider are wear resistance, polymerization shrinkage, and aesthetics.  The highest quality filling materials tend to have very high wear resistance, low shrinkage, and beautiful aesthetics.

High wear resistance is very important for the longevity of the filling.  The harder and stronger the filling material is, the longer it will last under function in the mouth where it endures very high chewing forces; the weaker the filling material is, the sooner it will break down and require replacement.

In regards to the property of polymerization shrinkage, it is important to understand that the filling material is initially a soft consistency to allow us to mold, shape, and adapt it into the tooth cavity.  In order to harden the material, we use a blue light to initiate the polymerization (hardening) process; however, with the hardening process inevitably comes shrinkage (meaning, the filling material shrinks and pulls away from the tooth).  High quality filling materials have low shrinkage rates, and this is an important property because fillings that suffer from high levels of shrinkage lead to poor marginal seal.  We always want the margins—the area where the filling meets the actual tooth—to be sealed tightly to prevent bacteria from seeping through and colonizing under the filling where they are able to fester and cause another cavity.

defective, leaking, and broken white tooth colored filling

The image above illustrates the concept of high polymerization shrinkage of the filling material leading to poor marginal seal. One can clearly see where the filling meets the tooth (the filling margin), and that this margin is defective, allowing bacteria to seep under the filling and cause further decay, as evidenced by the darkness under the filling.

 

Lastly, the highest quality of filling materials offer the most natural and pleasing aesthetics.  They tend to match the natural tooth color better and polish nicely for a beautiful shine.

cosmetic white tooth colored fillings replace old amalgam silver fillings

The image above illustrates before and after shots of three teeth that presented with amalgam (silver) fillings, and then restored with a high quality filling material for optimal aesthetics and marginal adaptation.

 

In summary, there are many aspects to a filling to consider when assessing the true value of the procedure.  Patients generally do not enjoy undergoing dental procedures, so the use of a high quality filling material performed with good technique and attention to detail will allow the restoration to last longer in the mouth without premature failure necessitating early replacement!  Paragon Dentistry is focused on the highest quality materials and service for ALL our patients, with NO exception. Give us a call or email us to learn more!

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