Restorations
We utilize restorative dentistry in order to rehabilitate missing or decayed teeth. If you’ve had a root canal, filling, or veneers, you’ve already seen what amazing things restorative dentistry can accomplish.
Here is some additional information about the restorative treatments we provide for our patients:
Fillings
Fillings are used to treat cavities and to restore your tooth back to its full, functioning form. If you’ve had a cavity before, you are actually in the majority of the US adult population.According to the Centers for Disease Control (CDC) in 2012, approximately 91% of U.S. adults ages 20 to 64 have had a cavity. In most cases, luckily, the treatment for a cavity is as simple as a dental filling.
We utilize modern materials to “fill holes” in the tooth, commonly referred to as “cavities,” caused by decay. By closing the holes, this prevents the bacteria from spreading further into the tooth and damaging the inner root canal. If the infection penetrates the inner root canal, the tooth may require an additional root canal treatment.
Before we fill a tooth, we determine the severity of the decay by taking x-rays and performing an exam. Once we understand the extent of the decay, we determine the best method to restore the area. Oftentimes, a dental filling is the restorative method of choice. First, local anesthetic is given to anesthetize the area for comfort*. Then, we remove the decay from the tooth by utilizing a dental drill or another manual instrument. After the decay is completely removed, we clean the tooth thoroughly and carefully place the filling material to closely replicate the natural tooth.
*Typically, the anesthetic is in the form of an injection. Therefore, if injections give you anxiety, please tell Dr. Brumbach so he can find other means of providing comfort. Many sedative options are available at Brumbach Family Dentistry, including IV sedation if necessary.
What Types of Fillings to Choose From?
Fillings are available in essentially two categories: natural (tooth-colored) or metal. There are advantages and disadvantages to each type, which we will go into further detail on below.
Metal Fillings
- Amalgam — This is the traditional metal (silver-colored) filling that has been used for more than 100 years. Amalgam is an alloy metal, made up of a mixture of mercury, silver, tin and copper. The mercury stabilizes the other metals, making them safe for oral use. While these types of fillings may be cheaper than other options, they are also quite visible. Additionally, they require more tooth drilling in preparation for placement than other types of fillings. These are rarely placed in our office, and only by request.
- Cast Gold — Cast gold contains a mixture of gold and other metals to create a strong, durable and long-lasting filling. This type of filling does not contain any mercury and is typically one of the most expensive but longest options we offer. These fillings are highly visible as well, but are considered the “Gold Standard”.
Tooth-Colored Fillings
- Composite — The composite filling is made up of a combination of plastic and glass that is bonded to your tooth. Many people prefer this type of filling because it matches the color of the tooth and blends in well. The composite filling is built to last long-term, and requires less drilling than the amalgam filling.
- Porcelain — Porcelain fillings have a natural appearance and are very durable. Additionally, they don’t take on stains or abrasions like normal teeth can. However, they can be more expensive because they require more technology to create them.
- Glass Ionomer — The Glass Ionomers are known for being inexpensive and relatively hard to identify from the outside perspective. They are made up of acrylic and glass powders that release fluoride into the tooth to prevent further decay. However, the drawback is that these fillings may not be as long-lasting as other fillings options.
Each material has its strengths, weaknesses, and ideal circumstances for placement success. Dr. Brumbach will happily give you his professional recommendation.
Mercury Free Fillings
This filling matches the natural color of your teeth, doesn’t contain mercury, and does its job effectively. In fact, it might do the job better than other options! Consider mercury-free fillings an exceptional alternative.
Placing a “silver” filling typically requires the dentist to remove adequate tooth structure in order to get it in the correct place. Not only that, but these types of fillings are very easy to see from an outside perspective. However, with tooth-colored fillings, the dentist does not have to remove as much tooth structure for placement. In addition, the filling matches the actual tooth. Most notably, there is no mercury involved whatsoever. These three benefits alone make tooth-colored fillings the most popular choice for the modern patient.
A blend of plastic resins and silica fillers combine to make up the “composite” (the tooth-colored filling). The composite is durable and translucent, similar to the feel of your natural teeth. Yet another advantage to the composite fillings is that they actually help strengthen the existing tooth structure.
Research shows that restorations (or fillings) that are tooth-colored are safe, effective, and aesthetically pleasing. They can generaly last long-term if properly taken care of.
We’ve laid out the many advantages of a tooth-colored, composite restoration. Now, let’s take a deeper dive into how we actually place these types of fillings and what you can expect after treatment.
The Process of Filling a Tooth
Cavities and chipping are two of the most common reasons we utilize fillings and restorations. Even though there are several materials that are used for these restorations, the process for all fillings is relatively uniform.
We start by numbing the area, typically by injection, and then remove existing decay in preparation for the filling placement. After thoroughly cleaning and drying the tooth, we place the composite filling directly onto the tooth structure. We then make sure that the filling is securely adhered to the tooth. Just like that, the treatment is finished!
There is one main contrast between placing a traditional silver filling and a composite filling. Basically, with silver fillings, healthy tooth structure will need to be eliminated in order to make room for the material to be placed securely. Over time, this can cause the tooth to be more susceptible to cracking or chipping. Composite resin fillings, however, are bonded directly to the tooth and salvage healthy tooth structure to provide full, long-term benefits.
What to Expect After Treatment
After we’ve placed the filling, we recommend that you avoid particularly hot or cold food and beverages until the numbness of the anesthesia wears off. Tooth-sensitivity to hot and cold is relatively normal for the first few weeks after treatment. However, if you experience significant discomfort or pain while eating or drinking, please contact Dr. Brumbach. Though rare, this could mean we need to adjust the placement of the filling or further examine the cause.
You should maintain your normal oral hygiene routine – brush and floss twice per day and see Brumbach Family Dentistry for your dental checkups semi-annually. Protecting your new filling and preventing future cavities is our priority, and the best prevention is good oral hygiene!
When Should You opt for a Tooth-Colored Filling?
We typically suggest composite resins for small to medium-sized restorations – which are the majority of restoration cases. As mentioned above, these resins are strong, resistant to chipping and cracking, and able to withstand everyday wear and tear. In most cases, the restoration can be completed in one visit to our office. However, if a restoration is larger than normal, we may need to send the material to a lab to be created. This process would add an additional office visit for the treatment.
If you have questions on whether a tooth-colored filling is the right fit for you, schedule a consultation with Brumbach Family Dentistry today. We can discuss all viable options for your specific case and educate you on the advantages and disadvantages of each treatment. Our highest priority is to provide you with a healthy lasting smile.
Inlays and Onlays
Sometimes a patient will need more than just a filling to remedy tooth decay. If the damage isn’t severe enough to warrant a crown, the answer may be an inlay or onlay.
Inlays and onlays are termed “indirect” fillings. This means that they are created externally by a dental lab, and then adhered to the tooth by Dr. Brumbach. “Direct” fillings, (see “Fillings”), are fabricated and applied by Dr. Brumbach all in one visit to our office.
An “inlay” fits within the confines of the cusp tips, or top edges of the premolar or molar. However, an “onlay” sits on top of one or more of the cusp tips of the tooth. Whether you are getting an inlay filling or an onlay, the process to place an indirect filling is the same. Ultimately, the needs of the tooth determine which process to use and are used conservatively in order to save original tooth structure.
The Procedure
If you’ve ever had a crown, then you’ll find the process of placing an inlay or onlay is very similar. The difference between the two procedures is that with an inlay or onlay, we remove less of your natural tooth structure than we do for a crown placement. We conserve as much of your existing tooth structure as we can with this type of treatment.
In order to place the inlay or onlay, we must start by removing the decay from the tooth. Before we begin removal, we typically numb the area with a local anesthetic for the patient’s comfort. Once the area is numb, we begin removing the tooth decay to prevent it from penetrating further into the tooth.
After the decay has been completely removed, we get an impression by digitally scanning or taking a mold of the tooth. The impression is sent to the dental lab to create the inlay or onlay. The lab can create the filling out of gold, tooth-colored ceramic, or resin. Typically, the patient will decide prior to sending the impressions to the lab.
Applying the Restoration
While the lab is creating the filling, we place a temporary filling on the tooth in order to protect the tooth and prevent further decay. Once your inlay/onlay is ready, you will come back to the office and the filling will be permanently adhered to the tooth. To adhere the filling, we utilize a resin that’s cured under a special light, or use a strong, dental cement.
These are a great option for restoring decay-damaged teeth because they are durable, strong, and provide long-term results. Best of all, they are low maintenance. Inlays and onlays are maintained just like your other teeth – by brushing and flossing twice daily!
Inlays and onlays are also used for cosmetic enhancements. If you’re interested in finding out more about the procedure, please call our dental office!
Call our office today to set up an appointment with Dr. Zach Brumbach and his dental professional team for any restorations you are in need of.