For over a century, amalgam fillings made from mercury and silver have been used to restore teeth. The metal content of these fillings gives them strength, and they are used mostly on the back teeth, since they can cope with a heavier pressure when biting. Most dental insurance plans routinely cover amalgam fillings. In some circumstances amalgam fillings represent the best option especially when it is not possible to keep saliva or blood out of the newly cleaned tooth while placing the filling.
With the decline in the use of amalgams by dentists, over 70% over the fillings created today are composed of resin or synthetic composite materials. Composite fillings are made up of acrylic and glass particles, and contain no mercury or other metals. The filling material is white or matched to the color of your teeth. However, it should be noted that these types of fillings are fused or bonded to the tooth, are only a short-term solution as they do not strengthen the tooth and can slow failures as early as 2 years following placement. This type of filling material is also already hard immediately following the procedure, allowing you to chew on the tooth as soon as you like, unlike with amalgam fillings, which need time to harden. Because composite fillings require minimal tooth removal, the dentist also requires a smaller preparation, with less drilling required and more of the original tooth structure can be preserved.
However, composite fillings usually take longer to install than amalgam fillings, so you will require a longer stay at the dentist’s office. While composite fillings are used for back teeth and are perfectly adequate, they are not as strong as metal fillings. Tea, coffee and tobacco, among other things, can stain composite fillings over time and the color of these type of fillings is unaffected if you whiten or bleach your teeth. The composite filling material is also more expensive and some insurance companies will not always pay for composite fillings on back teeth.
Amalgam and composite fillings each have their own particular advantages and disadvantages, and your dentist can help you decide which type of filling best meets your requirements.
Whereas bridges are used to replace one or more teeth, the purpose of a crown is to restore a single damaged tooth. Crowns are usually required when a tooth is so damaged that a filling is a poor option, for longevity and strength. If you have teeth that are suffering from severe decay, are cracked or your dentist has determined that they may soon be prone to cracking, a crown may be recommended.
Crowns are custom fitted to match the exact contours of your own tooth and made from porcelain, stainless steel or gold. Each type has advantages and disadvantages and your dentist will advise you on the best option for your unique requirements.
In the early years of modern dentistry, crowns had to be made of metal. These days, crowns can be constructed from other materials, such as porcelain and other types of ceramics. Crowns are required when a tooth is severely damaged. There could be a great deal of decay or perhaps much of the tooth is already mostly composed of a previous filling, so that a new filling simply is not going to work. Dentists still often recommend metal crowns for back teeth, where they need to be stronger so that they don’t break over time. The back teeth are subject to up to nine times the force and stress that the front teeth typically endure. Although modern porcelain crowns are more resistant to fracture than they once were, they remain more prone to damage than their metal or porcelain fused to metal counterparts. The main advantage of porcelain crowns lies in their ability to effect the most natural looking tooth repair, while not making use of metals.
Unlike porcelain fused to metal crowns, the all-porcelain variety also won’t show any traces of a metal foundation at the gum line. In the case of front teeth, where crowns are going to be clearly visible, most people want something that looks more natural, which is the case with all-porcelain crowns.
The main differences between porcelain fused to metal crowns and all-porcelain crowns are related to their appearance and strength. Porcelain fused to metal crowns are most commonly used on back teeth, where the chewing process demands greater strength. They are also often recommended for the front teeth, for those patients who have a habit of clenching or grinding their teeth on a regular basis.
Due to their content, porcelain fused to metal crowns are stronger than their all-porcelain counterparts, possessing many of the advantages of completely metal crowns. However, the metal content also means they look slightly less natural. These types of crowns also may reveal at least a very thin metal strip at the gum line and although this can usually be hidden beneath the gum itself, this might not always be possible, depending on the individual patient. In some cases, the strip can’t initially be seen, but may become visible later as the gum recedes with age. However, these types of crowns still look pretty good and remain a perfectly acceptable option for many people.
A full gold crown used to restore a tooth is made completely from gold alloy. For many decades, dentists have found gold to be a metal that is very easy to work with, allowing them to fit crowns very precisely. Gold crowns are able to withstand the heavy stress caused by biting and chewing. They won’t chip and it is very unusual for a gold crown to break, making them the longest lasting type of crown. On the very rare occasions that a gold crown does actually break, this is usually caused by decay or a fracture in the tooth structure beneath it.
Metal dental crowns, including gold ones, are not usually placed on those teeth that are visible when a person smiles, such as those closer to the front. Gold crowns are yellow or white gold in color and are mostly used to restore the molars and premolars at the back of the mouth. Your dentist may recommend a gold crown if you show heavy wear patterns on your teeth. Gold crowns are very strong, but their rate of wear is actually almost identical to tooth enamel. This means that a gold dental crown does not cause excessive wear and tear on the teeth it bites against, even for people with a heavier bite or who clench or grind their teeth excessively. In addition, the use of gold may reduce the amount of tooth that must be removed to create the crown compared to other crowns. This means a stronger tooth.
Your choice of crown is in the end entirely your decision, but gold crowns are an excellent choice for patients who are not overly concerned about having an entirely white smile. Gold crowns have the advantage of being extremely strong, unlikely to chip or break and best able to closely mimic all the properties of a tooth, with the exception of natural color. As a patient, this makes a gold crown the most durable option. If its been determined that you need a crown, your dentist will be able to offer you excellent advice and provide helpful information on the different types of crowns available.
When teeth only have a mild to moderate amount of decay or structural damage, dental inlays and onlays are often used for restoration work. Inlays and onlays can be made of porcelain, composite resin, or gold.
Dentists recommend dental inlays for teeth suffering from damage or decay in the valleys, grooves or ‘pits’ of the tooth’s chewing surface. Dental onlays are designed to treat damage and deterioration extending to one or more of the cusps or projections on the uppermost chewing surface of the tooth. Onlays can assist in repairing teeth that are at risk from fracture, by covering over the vulnerable top surface of a tooth, where fractures are most likely to originate. In this way, the onlay serves the same purpose as a crown, on a tooth that does not have sufficient deterioration to warrant the actual fitting of a dental crown.
Both inlays and onlays are customized to fit your teeth, so that your dentist is able to bond them securely to the surface of the tooth with high-strength dental resins. The materials used in the fabrication of inlays and onlays are also considerably more durable than that used in conventional fillings. Consequently, inlays and onlays can act as a sound long-term solution to smaller failing dental restorations. They also strengthen the tooth’s structure and create an effective barrier against bacteria to prevent the formation of cavities. The fitting of onlays and inlays is a relatively routine procedure, with a short recovery time. There may be some slight tenderness in the area of your mouth where the inlay was fitted, but you can usually get on with your day as soon as you leave the dentist’s office.
Inlays and onlays can eliminate tooth sensitivity by sealing over dentin, a very sensitive internal part of the tooth. They can also help reduce the risks that patients don’t require more extensive dental treatment, such as bridges, implants or dental crowns, in the future. Most dentists agree that if a tooth’s structure is generally in good shape, it should be preserved as much as possible. The fitting of inlays and onlays involves much less tooth reduction than is the case with metal fillings, so that much more of the tooth’s natural tooth structure is retained following the treatment process.
Dental veneers are often categorized as cosmetic dentistry, and although they can give you a great smile featuring well-aligned teeth, veneers may also act as a protective shield for the facial surface of damaged teeth.
Dental veneers are thin customized tooth colored shells, that are bonded to the front surface of teeth. They are usually fabricated from porcelain, but can also be made from composite resin materials. Porcelain veneers tend to be more stain resistant and also very natural looking while often requiring less tooth removal before fitting, compared to how much of the natural tooth is lost when placing a crown, for example. Composite resin Veneers are usually completed in one visit and are created by the dentist in the mouth. Porcelain veneers require the use of specialized laboratory equipment and are usually created over a series of 2 to 3 visits to the dental office and as a result carry more cost in fabrication. Your dentist will be able to determine which type of restoration is best suited to your unique dental requirements.
Veneers are designed to correct a number of dental conditions. Teeth and their enamel naturally become worn down over the years as we age. Older teeth are more prone to chips, cracks or an uneven appearance. General wear and tear can also result in misaligned teeth, as can habitual tooth grinding. In addition, over time, your teeth can become discolored, as a result of consuming certain beverages such as red wine, tea, coffee and some soft drinks, as well from tobacco use. Veneers can help to fix some of these issues and improve the appearance of your teeth. Some people are also born with unusual spacing between certain teeth and this gap widens as the person ages. Veneers can help to close the gap.
Veneers have a very natural appearance, don’t need the extensive work on your existing teeth required for the fitting of crowns, plus porcelain veneers are both stain resistant and generally well tolerated by the gum tissue. However, it should be pointed out that the fitting of veneers is unable to be reversed. Veneers will need to be replaced in the future, but should they chip or crack in the meantime, they cannot be repaired. Once enamel has been removed in order to apply the veneer, you may also experience increased sensitivity to heat and cold with food and drinks. Although veneers do indeed look natural, they may still not exactly match the color of your teeth. If you intend to use tooth whiteners later, these will not affect the color of the veneer.
Consultation with your dentist and your insurance provider will help to determine if you are a suitable candidate for dental veneers.