Fillings

There is an increasing demand for white fillings as people's expectations of dentistry increase and they want more natural looking restorations.

Advantages

• White fillings are physically and chemically bonded to the sides of the teeth.

• The intact bond resists secondary decay as the bacteria cannot get between the filling and the tooth. Amalgam does not bond, it corrodes around the margins and the products are too toxic for bacteria thus preventing secondary decay.

• The bond holds the filling in the tooth. This means that only the decayed tooth substance has to be removed during restoration. Amalgams require more extensive removal and undercutting of sound tooth to stop the filling falling out.
  

• The bond is more than adequate to hold the filling in place. Large amalgams often need to be held by pins which have been shown to produce cracks in the dentine and which will corrode in time.
  

• The bond holds the sides of the prepared tooth together and replaces up to 82.3% of the tooth's structural integrity. Amalgam just occupies a space and there is a greater risk of cusps fracturing.
  

• White fillings can be crafted to look like natural teeth. There is little doubt that this enhances the patients self-esteem and self-confidence.
  

• White fillings do not contain mercury.

Disadvantages

• Directly placed white fillings are not suitable for very large cavities. However, it is then possible to use white filling inlays which are prepared in the laboratory and have a greater strength. This often has the advantage of keeping the natural facing of the tooth rather than removing it while preparing a crown.
  

• The world of adhesive dentistry changes very rapidly and it is necessary to spend a lot of time staying up to date with the chemistry, the clinical techniques and making sure the changes have good evidence to support them. A look at the CVs of the dentists at this practice will demonstrate our involvement in under and post graduate dental education.
  

• White fillings cost more than amalgams. This is simply a function of the time we spend producing the desired functional and aesthetic result as well as the high cost of the bonding systems and white filling materials.

Closing a small gap

Many people put up with a gap between their front teeth without realising how easy it is to close with simple white filling.

This lady presented with a small gap between her front teeth, which she did not like. No anaesthetic was necessary as the teeth were not prepared in any way except to clean and polish them thoroughly. White fillings were then bonded and carefully shaped to close the gap and provide a natural and pleasing appearance.

Closing a large gap

This lady presented with a large gap between her front teeth, which she did not like. No anaesthetic was necessary as the teeth were not prepared in any way except to clean and polish them thoroughly.

White filings were then bonded and carefully shaped to close the gap and provide a natural and pleasing appearance. This particular lady was delighted with the result.

Replacing amalgam fillings

The bulk of our restorative work is in replacing amalgams with white fillings. The majority of people replace their fillings when it becomes necessary. However, we do electively replace all existing amalgams on request. Such patients always report that they feel better afterwards although we can only speculate whether this is due to to the removal of the amalgam/mercury, the removal of small amounts of decay hidden under the fillings or the psychological benefit of having natural looking teeth again.