If tooth decay has been diagnosed, then patients need a filling as a suitable substitute for the tooth material that has been destroyed. Tooth decay primarily occurs in the spaces between teeth, directly beneath the point where two teeth meet. Caries-type defects can also occur on teeth that have already been replaced (dentures or prosthesis) or fillings. This occurs due to poor dental hygiene or defects in the fillings that are already in place.
Dentists have different treatment options available to them:
composite fillings are a tooth-coloured replacement option for defects caused by caries. After removal of the destroyed tooth material, these modern composite materials are applied to the caries-free cavity of the tooth in a plastic form (like a cream), and subsequently set hard using a UV lamp. Before this, a sticky material (bonding and acid-etching technique) is applied to the tooth in order to achieve a suitable surface for application of the composite material. Once hardened, the material forms a chemical compound with the natural layers of the tooth. This process is very quick and leaves you with a filling that remains stable for a long period of time.
This treatment is easy to apply in cases of both smaller defects and larger fillings and the patient receives a treatment which matches the natural tooth colour, as well as being fast and, at first glance, good value for money.
When compared with amalgam fillings, composite fillings can offer significant improvements in terms of aesthetics. Amalgam fillings have been the subject of criticism for over 30 years now. Some of the reasons for criticism include environmental pollution due to mercury, allergy risks, and the fact that the dark-coloured amalgam fillings are not aesthetically pleasing. Composite fillings do not, however, represent a better alternative in terms of health,
as they pose a high risk of allergic reactions, can lead to long-term intolerance effects, and in some cases have long-term effects on oestrogen. Amalgam even provides far better protection against secondary caries than the composite fillings do. A secondary caries forms when bacteria establish themselves in the fissure between the filling and the natural tooth material, and are able to restart their destructive processes. In this case, the dentist has to carry out a further treatment and remove more, once healthy, tooth material. This is why what was originally an inexpensive treatment with a composite filling can turn into a more expensive option over the long term. In terms of the environment, too, this composite material poses a problem due to the nano-particles and oestrogens it contains.
A fissure forms between tooth and the composite material, and that’s where the problem lies
Despite tooth-coloured composite fillings being a good solution in terms of aesthetics, they may surprise you in terms of how long they last and the quality of the material. Scientific articles and studies have shown that composite fillings generally last just 7 years. Nowadays, with modern dentistry, this is no longer sufficient.
The disadvantages of composite fillings, particularly in the side teeth areas, include a marginal fissure susceptible to caries and the likelihood of intolerance to the material.
When the soft, plastic filling material is inserted and then hardened, the material shrinks, pulling inwards towards the centre of the filling. This shrinking effect is referred to by dentists as “polymerisation shrinkage”: even in the case of the highest-quality composite fillings, the distance is still about a hair’s breadth for an average filling.
The effect is due to the chemical nature of the material and cannot be avoided: an age-old problem of composite fillings. To reduce this shrinking effect, attempts are made to add the material in layers, hardening each layer in turn. Despite this, when the hardening process occurs, the filling that has been set contracts away from the tooth wall surfaces (particularly in the deeper areas that are harder to see), resulting in the formation of a hidden micro-fissure. Bacteria can find their way into this micro-fissure and work undisrupted on forming the next caries. In this case it is impossible to remove the bacteria by cleaning your teeth. Is there a better, high-quality option for the dental treatment of caries?
Ceramic inlays – Top
Where the greatest issue with composite fillings is dealing with recurrent caries, fillings using a natural material, ceramics, are the best possible treatment option for caries. This material can offer a range of different advantages over composite fillings.
Ceramic is made entirely of natural products. This treatment solution, called “inlays”, are far higher in quality and longer-lasting than all the alternatives, whether it be amalgams, gold inlays, glass, or composite materials.
Advantages of ceramic inlays
- Natural tooth colour
- Seals without shrinking
- Wears at the same rate as enamel
- Stabilises fissures, prevents tooth fractures
- Bio-compatible with no oestrogens, solvents, nor allergens
Disadvantages of ceramic
- More complex treatment for dentists
- Longer treatment duration
- Greater one-off costs
Advantages of composites
- Rapid Treatment
- Cheaper treatment over the short-term
Disadvantages of composites
- Seal lost due to shrinking effect
- Excessive Wear
- Gap forms around border with tooth
- Colour becomes less aesthetically pleasing over time due to brown margin