A hole in the tooth as a result of caries occurs sooner or later in most people. In the course of dental treatment, one then receives a dental filling. However, you are often confronted with a variety of dental filling materials and have to decide which material suits you best. To help you make an informed decision regarding cost, durability and duration of treatment, this article will provide you with the information you need.
What are the different types of dental fillings?
There are different types of dental fillings:
- Temporary dental filling (for example, Cavit).
- Cement (glass ionomer cement)
- Amalgam
- Plastic (composite)
- Gold
- Ceramic
In addition, there is also tooth-colored filler compomer, a mixture of composite and cement. However, it is not suitable as a long-term dental filling and is only used in the neck of the tooth, for temporary fillings or as a filling for milk teeth.
Types of dental fillings
A distinction is made between dental filling materials:
- Plastic fillings, which are shaped in the mouth and harden in the tooth, and
- Inlay fillings (inlays), which are made outside the mouth and then fitted into the tooth and fixed there.
What is the best material?
Which material is best for a dental filling depends, among other things, on the tooth for which the filling is needed and the size of the area to be filled. The various materials also differ in terms of cost and durability. The following overview presents the main advantages and disadvantages of the different materials. Temporary fillings, such as Cavit, are used in emergencies and are designed to last a maximum of one week until the final filling is placed. A cement filling is slightly more durable than Cavit, but it is also not designed for long-term therapy. It is often used for deciduous teeth, as they will be replaced by permanent teeth after some time anyway. Fillings made of glass ionomer cement are light-colored and visually inconspicuous. Amalgam is inexpensive, has excellent mechanical properties and is extremely resilient. It is a very accurate fit, easy to work with and often lasts for several decades. The disadvantages are that it is controversial because of the mercury it contains and that it appears silvery, i.e. it has no natural tooth color, which makes it unsuitable for anterior teeth. Plastic or composite is tooth-colored and represents an inexpensive solution among the “white'” dental fillings. The advantages are therefore the color, the price and the relatively good durability (on average about four to six years, although shorter or much longer durability is possible). The disadvantages, however, are that the fit, hold and longevity of the filling are not optimal, depending on the extent of the tooth damage. The treatment takes a relatively long time due to the many steps involved, and the material discolors over time.
Gold and ceramic inlay fillings
Strictly speaking, a gold inlay consists of a gold alloy and is practically unsurpassed in terms of material properties. If the inlay is cast to fit perfectly, it holds excellently, is extremely stable and thus designed for the many decades. The disadvantages are that a relatively large amount of tooth substance has to be ground off during the preparation (technical term for preparing the tooth for the filling) of the tooth in order to achieve an optimum result. In addition, a gold filling is aesthetically striking due to its golden color. The thermal conductivity of gold can also cause sensitivity of the tooth. A ceramic inlay is even slightly more expensive than a gold inlay. Ceramic is white and its color can be matched exactly to the neighboring teeth, so this filling material is the best solution aesthetically. In contrast to gold, less tooth substance has to be ground during preparation. The treatment is gentler on the teeth and the material is very well tolerated. Due to the rigidity of the material, a ceramic inlay can nevertheless break if it is subjected to the wrong stress. Due to this fact, ceramic is not recommended for people who grind their teeth frequently (bruxism). In addition, it does not close perfectly at the edges and must be cemented in place with plastic.So a porcelain inlay is not as stable and precise a fit as gold, but it should last for years if the dentist is careful and the patient takes good care of it.
Which dental filling is the healthiest?
Strictly speaking, dental fillings can never be described as healthy or healthier, as they are always materials foreign to the body. Nevertheless, from a health perspective, there are differences among materials. In terms of intolerances, ceramic is the most suitable, but intolerances with the other materials are also rather rare. From a health point of view, fillings made of amalgam are controversial – but according to current scientific knowledge they do not require acute removal. On the contrary, they are often better than they are said to be.
Is a dental filling made of amalgam harmful to health?
Anyone with an amalgam filling in their mouth need not worry at first. The mercury, which is part of the amalgam alloy, is present in bound form and thus cannot lead to mercury poisoning in the classic sense. However, this only applies to an intact filling made according to the rules of dental art. The material is controversial, but a health hazard has not been proven. When inserting and removing such a filling, a small amount of mercury may be exposed, so the material must not be used in children under 15 years of age, pregnant or lactating women, and people with kidney dysfunction. There are also problems when an amalgam filling and a gold filling touch each other in the mouth. A so-called local element can form. This creates a flow of electrons between the two metals, oxidizing the less noble metal (in this case amalgam) and dissolving mercury. The more noble gold filling is then reduced and can become discolored.
How much does a dental filling cost?
The cost of a temporary, cement or amalgam filling is fully covered by health insurance as a so-called benefit in kind. In addition, the costs for a composite filling in the area of the anterior teeth (from canine to cuspid) are covered, as amalgam is not suitable here for optical reasons. In all other cases, the health insurance company pays the amount that the amalgam filling would have cost. The difference must be paid by the patient. To be paid by the patient himself are approximately (depending on the size of the filling) the following costs:
- Amalgam: 0 euros
- Plastic: 20 to 100 euros per tooth
- Gold: 200 to 500 euros per tooth
- Ceramic: 300 to 600 euros per tooth
A special position take pregnant women and children or adolescents up to the age of 18. For them, a plastic filling in the posterior region is also considered a benefit in kind and is fully covered by the health insurance.
How long does a dental filling take?
With the Cavit and cement temporary solutions, you usually only sit in the treatment chair for a few minutes, as the material is placed in the tooth in one step and hardens relatively quickly. Treatment with amalgam also takes relatively little time: once the alloy has been mixed, it can be easily shaped and pressed into the tooth. After a few minutes, the metal hardens. During the hardening process, the dental seal is modeled and adapted to the chewing situation. As mentioned above, when amalgam is placed, a small amount of mercury exposure cannot be ruled out. In a second session, the filling must then be highly polished to achieve a high-quality surface. A resin filling is rather time-consuming for the patient. Since the resin does not adhere well to the tooth, the tooth must be prepared beforehand by acid etching and a procedure known as bonding. Then the resin is applied layer by layer and cured with UV light. During the treatment, the tooth must be kept dry at all times, which can make the treatment more difficult depending on the patient’s salivary flow. Afterwards, the composite filling is directly polished and functionally adjusted. The composite filling is fully inserted within one session, even if the patient has to spend a little more time.
What is the procedure for gold and ceramic fillings?
Gold and ceramic inlays are dental works that – after the tooth has been prepared by the dentist in the office – have to be made in the laboratory. Gold is cast and ceramic is usually milled. As a rule, therefore, the patient must expect two sessions.In the first session, the tooth is prepared and an impression is taken. In the second session (usually a few days later), the work is then placed. Between the two sessions, the milled tooth is sealed with a temporary filling. The duration of each of the two sessions will not be much longer than half an hour. However, a gold inlay requires more extensive preparation of the tooth than a ceramic inlay. The ceramic inlay is bonded into the tooth with a plastic adhesive. The tooth is prepared beforehand (similar to a plastic filling) with a bonding agent. The gold inlay already holds by friction (friction of the precisely fitting surfaces) but is additionally bonded with a cement. Before an inlay is finally bonded, it must be checked for chewing function. At the end of the treatment, only minor changes can be made. The preparation of a tooth – regardless of the type of filling – is usually absolutely painless, as the tooth can be anesthetized by local anesthesia.
Pain after tooth filling – causes and tips
Pain after a tooth filling can have various causes. If the tooth was so severely damaged that the dentist had to prepare relatively close to the nerve, there may be permanent sensitivity and pain afterwards. In this case, you should definitely go to the dentist. In the worst case, the nerve is irreversibly damaged and one must consider root canal treatment. One should also seek advice from one’s dentist if there is extreme sensitivity to cold or heat. If the tooth filling is too high, this leads to incorrect loading of the tooth and possibly to considerable pain. This is often only noticed in everyday life, but can be quickly remedied by targeted grinding by the dentist. Even an optimal tooth filling does not protect against caries if dental hygiene is poor. It is serious when plaque and thus bacteria settle on the filling edges and migrate under the filling. A caries disease then develops under the filling, which can lead to toothache under certain circumstances. The disease cannot be seen externally, so the complaints should be clarified with the help of an X-ray at the dentist. If the filling has fallen out or broken off, you should see your dentist immediately so that he can close the hole with a temporary, if necessary.
Sports after tooth filling
If no discomfort occurs, sport after a tooth filling is harmless, even if a local anesthetic was placed for this purpose.
