The different fillings

In general, a distinction is made between rigid and plastic filling materials. Rigid materials are made outside the mouth in the laboratory and then inserted into the tooth. In the past, this required the complex process of taking an impression of the teeth, the “impressions” were poured into models in the laboratory and the rigid filling material was made from the tooth template.

For some time now, however, this is no longer absolutely necessary, the dentist can carry out some steps much more cost-effectively and easily in his own practice. Ultimately, this means that caries healing by means of rigid filling materials can be offered at much lower prices. However, rigid filling materials are hardly used for small carious defects because they are still quite expensive compared to plastic materials.

In addition, more healthy tooth substance must be removed when preparing the tooth. However, these materials are more reliable in terms of strength and durability. Plastic materials (especially composites/plastics and amalgam) are placed directly into the tooth, shaped there and then hardened.

They are particularly suitable for small dental defects. Nowadays, composites/plastics are the material of choice, which is due to the fact that amalgam fillings are said to have properties that are hazardous to health. However, experts are still in disagreement as to whether in the long run so much amalgam will be removed from the fillings to pose a real danger to healthy people.

Cost absorption

The caries healing is basically covered by the public health insurance, but both plastic fillings and treatment with rigid materials require co-payment by the patient. Patients with diagnosed renal insufficiency or known amalgam intolerance (allergy) are the exception, because in these cases the health insurance company must cover the costs of each plastic filling in full. In the case of deep dental caries (caries profunda), where more than 2/3 of the dentin is affected, it is important to protect the pulp (the “tooth nerve“) in addition to the actual healing of the caries.

Therefore, before the filling of the tooth, a so-called underfilling is performed. It is the insertion of a calcium hydroxide containing medication, which is supposed to stimulate the dentin reproduction in the depth of the hole.Only then is the actual tooth filling carried out. If the outer wall of the tooth has been damaged by the caries and/or the preparation of the tooth (“drilling”), so-called matrices are used for shaping. These matrices help the dentist to reproduce the natural wall of the tooth and to create a relatively even surface.