Apart from their annual teeth cleaning appointment, people often go to the dentist for minor dental repairs. Most of these can easily be done within an hour. Other appointments can be made for a routine exam, a preventative follow-up or to monitor an ongoing or potential problem.
However, up to 80% of these common repairs are done on cavities, on teeth that are cracked, damaged, chipped, gapped or yellowed, as well as on old fillings. These procedures are meant to restore proper masticating, and to bring back a new shine to decaying or diminished teeth.
What is a filling?
A filling is basically how you repair a decaying or damaged tooth. That is done by the dentist removing the decayed part of the tooth and filling the leftover space with restorative material to prevent future damage. Gold, porcelain, composite resin – which is the same colour as our teeth – and an amalgam of metals can all be used as filling materials.
What is the best filling?
There is no particular filling that is best for everyone. The most appropriate one for you will depend on the size of your cavity, any potential allergy you might have to a material, the location of the decaying tooth as well as the cost of the filling.
What are metal amalgam fillings?
Metal amalgam fillings have been used in dentistry for over 150 years. Contrary to popular belief, they don’t contain any lead but rather a mix of mercury, silver, copper and tin. It’s known for its durability, low cost and ease of handling, and is used for a wide variety of repairs.
Do I need to worry about mercury?
The presence of mercury in amalgam fillings has been met with criticism due to its potential toxicity. The Canadian Dental Association acknowledges that a small percentage of the population – about 3% – is sensitive to mercury but it maintains that it generally does not cause problems for most people.
According to the Ordre des dentistes du Québec, there is no reliable and proven data that would support claims that metal amalgam fillings have any impact on our health. While denying the amalgam’s toxicity, it acknowledges that “more research is needed”.
The Régie de l’assurance maladie du Québec (RAMQ) only covers dental amalgam for posterior teeth for patients on welfare and on children under 10. The latter can also get composite resin fillings if their parents are willing to pay for them or if their private insurance covers them.
You can most certainly keep any existing intact metal amalgam fillings you already have. However, if you suffer from certain health problems, such as kidney disease, or if you are pregnant or breastfeeding, it is recommended that you do not get any further dental work done using metal amalgam, if only for a period of time.
Porcelain fillings or inlays are a more aesthetically-pleasing and resistant alternative to amalgam and resin composite fillings that can be used on molar and premolar teeth. The dentist takes an imprint of the cavity and then moulds a casting from a porcelain block, which in turn gets filled into the tooth.
The walls of an emptied out tooth might be too thin to act as proper support, in which case it is not recommended to use amalgam or composite. These materials would weaken the already fragile tooth. Restoration using castings of any kind is an effective way of preventing the need for a root canal or a crown down the road.
Gold fillings or inlays produced in a laboratory can effectively be used instead of amalgam or resin composite fillings. While a costly and precious material, gold is exceptionally resistant and long-lasting – and will never oxidize. Indeed, they can protect the tooth from fracture for up to 20 years by improving the masticating process.
Benefits of inlays
- Inlays are more durable than amalgam and composites
- In the case of porcelain inlays, the result is more aesthetically-pleasing than fillings
- In the case of porcelain inlays, they make the tooth less sensitive to the heat and cold
- They help in making the tooth more resistant to fracture and wear and tear.
What are veneers?
Veneers are small shell-like covers that are made of porcelain or resin composite that are affixed to the front of the teeth to improve their look. Porcelain veneers are more resistant and they do not stain or change colour. Their application generally requires two visits while resin composite veneers can be apposed in a single appointment.
The dentist needs to remove some of each tooth’s surface in order to take a mould of the area to cover in a laboratory. Temporary veneers are apposed until customized ones are ready. At the next visit, after the temporary ones are removed, the dentist applies a gentle chemical solution to roughen up each tooth’s surface, which will in turn help the porcelain veneers adhere to it. He will then affix each porcelain veneer using a resin composite cement.
Resin composite veneers are different from porcelain veneers in that the resin is applied directly to the tooth. The dentist still needs to remove some of the surface of the tooth with a mild chemical solution to make it a bit rough, but the resin is then simply applied in layers while being sealed in and hardened using an adhesive and a bright light. The resin – chosen to match the colour of your teeth – is then polished and shaped to look natural and smooth.
What is bonding?
This is how bonding is done. The dentist puts a thin, clear plastic film to separate the tooth being worked on from its neighbouring teeth. As with the application of veneers, the surface of the tooth needs to be rough to enhance adherence. That is done with the help of a gentle chemical solution. The resin is then applied in thin layers and hardened by light. After the last layer has been sealed in, resin is polished and shaped to match your other teeth.
If needed, your dentist can touch up your bonding at a follow-up visit. If the resin shows some wear and tear down the line, he can also simply add more composite.
- Resin composite can be made to match your teeth
- It can be made to look exactly like the rest of the tooth
- Increases the size of a tooth and/or fill up space between gapped teeth
- It can be used to bring a damaged tooth back to its original size
- It can be applied to an otherwise healthy tooth so it’s colour matches your other teeth
- On average, it can last 3 years.
Tips for dental repairs
On the day of your appointment
- Avoid chewing on the side where your new filling is for 24 hours – unless it is made of white composite.
- Avoid eating hard foods for 24 hours after your appointment – unless it is made of composite.
- Wait until the anesthesia wears off before eating or drinking anything hot, you risk biting or burning yourself.
Following your appointment
- Increased sensitivity to hot and/or cold is normal for up to 2 weeks in some cases. It’s a frequent symptom for up to 50 % of cases. If needed and if your condition allows for it, take an anti-inflammatory such as ibuprofen (Advil).
- Unless your dentist says otherwise, you can go back to your normal oral care routine of brushing and flossing.
Daily oral care
Repair and restoration work can improve your smile and increase your confidence. However, according to Dr. Barry Dolman, the easiest and cheapest way to ensure oral health is the daily use of floss. “It costs almost nothing, it keeps teeth and gums healthy and it prevents cavities. And yet, only 30% of Québecers use it,” laments the former president of the Ordre des dentistes du Québec.
Contact the professional staff at Dr. David Côté Dental Clinic. They’ll take a personalized approach to ensure your smile will be good to go in no time.