At your dental exam, we check your fillings and may suggest that you replace any loose or broken ones. We also looks for signs of decay, such as brown or black spots and may want to use X-rays to take a closer look at problem spots.
If you have a cavity, we may keep an eye on it (if it’s small) or fill it right away. If a large cavity is not filled, it can get bigger and cause pain. The tooth may even have to be removed and replaced with a false (or artificial) tooth.
If you have a cavity and it needs a filling, there are different kinds of fillings to do the job.
There are several different types of fillings that can be used to fill a cavity, but the final decision on which type of filling is placed in your mouth is yours alone.
METAL
| Material | Description | Advantages | Disadvantages |
|---|---|---|---|
| Dental Amalgam | Sometimes called "silver" fillings, these are the most common type of filling used in Canada today. | Least expensive type of filling. | Silver colour may not appeal to people who want a "natural" look. |
| Used to fill back teeth due to silver colour. | Last a long time. | Tiny amounts of mercury are released from the filling when you chew: For most people, this bit of mercury is nothing to worry about. Studies have shown that amalgam fillings do not cause illness. They have been used on people for more than 150 years. | |
| Mix of metals such as mercury, silver, copper and tin. | They are easy to put in place; because they are a direct filling, one visit to your dentist will do the job, in most cases. | Health Canada advises pregnant women in need of a filling to wait until the baby is born before they go ahead with the procedure. We can suggest other kinds of fillings, if the work is urgent. | |
| Cast Gold | Based on a model (or cast) of your tooth. | Gold is stronger than amalgam. | Gold costs more than other kinds of fillings. |
| Mixture of gold with other metals such as silver and copper. These other metals make it more durable. | Gold fillings last a long time. | Gold fillings and crowns are indirect fillings, so they require at least two appointments. | |
| Made in a dental lab and sent back to us, to cement it in place; you will need at least two visits to get the job done. | The gold colour may not appeal to people who want a "natural" look. | ||
| During the first visit, we clean out all the decay and make a mold of your tooth. The hole is filled with a temporary filling. | |||
| When return a couple of weeks later, the gold filling is cemented in place. |
TOOTH COLOURED
| Material | Description | Advantages | Disadvantages |
|---|---|---|---|
| Composite | Also called plastic or white fillings. | The same colour as your natural teeth. | Break more easily than amalgam or gold fillings, and may not last as long. |
| Getting this kind of filling depends on where the tooth is in your mouth; we bite down hard on our back teeth (molars), so a plastic filling may not be a good choice. | Cost less than gold fillings | Cost more than amalgam fillings. | |
| To place this filling, we clean all decay from the tooth and put a glue (or bonding material) on the inside of the hole. Composite resin is put into the hole in thin layers. Each layer gets hard with the help of a special light that your dentist holds over the tooth. When the last layer of the filling is hard, your dentist shapes the filling so it looks and feels natural. | Direct fillings, so they can be done in one appointment, in most cases. | Recurrent decay is more of a problem than with amalgam or gold fillings. | |
| Glass Ionomer Materials | Only used in teeth where you do not bite down hard. | Same colour as your natural teeth. | They are not as strong and will not last as long as other fillings. |
| There have not been many studies about how long this kind of filling lasts. Newer forms of the filling may be stronger and last longer. | Contain fluoride, which helps stop recurrent decay. | They cost more than amalgam fillings. | |
| Do not have to be put in layer by layer; thus, they are simpler to put in than composite resins. | |||
| Direct fillings and can be done in one appointment, in most cases. | |||
| Cost less than gold fillings. | |||
| Porcelain Materials | Most common type of dental ceramic used by dentists. | Same colour as natural teeth. | For teeth that bite down hard - like molars - ceramics are not a good choice. Fillings can break. |
| Hard and brittle. | Last a long time. | They are indirect fillings, so at least two appointments will be needed. | |
| Porcelain and metal can be combined to make a strong, tooth-coloured crown. | They cost more than most other types of fillings. | ||
| Unless you have a bad tooth-grinding habit or some other problem, a combination of porcelain and metal can be used anywhere in the mouth. | |||
| Dental porcelain is made in a dental lab. |
We care about you and your oral health: If you have any questions or concerns about fillings, talk to us. We will advise you on the type of filling that works best in your particular case, and inform you about the aesthetic and cost implications for each type.
How Fillings Are Done
To fill a cavity, we may first give you “freezing” (or local anesthetic), so you do not feel any pain. We then take out all traces of decay, shape the hole and fill it.
Most fillings are done in two ways:
Direct Filling
These fillings go right into the cavity, after your dentist has cleaned out the decay. Amalgam (or silver) fillings and plastic (or white) fillings are examples of direct fillings. They harden quickly. Most of the time, you will be able to have a direct filling put in place in one appointment.
Indirect Filling
Examples of this type of filling are crowns (or caps) and inlays. They are custom made in a lab to fit your tooth. Your dentist cements the filling in place. Most indirect fillings take two or more appointments to complete.
Dental amalgam is the best-known direct material. Cast gold alloy is the most durable indirect material. However, ceramics are gaining in popularity because of their longevity relative to other tooth-coloured materials.
Remember, your dentist is interested in you and your oral health. If you are concerned about having any particular dental restorative materials placed in your teeth, talk to your dentist and be a partner in decisions about your oral health care.
Health Canada’s Role
One of Health Canada’s jobs is to make sure that dental fillings and dental tools are safe. CDA supports Health Canada’s role in making sure that Canadians receive the best possible care when they visit their dentist.