Composite fillings (Procedure, advantages and disadvantages) 

composite fillings

Dental composite fillings are tooth-colored fillings used to restore/fill teeth that show signs and symptoms of tooth decay. They are also known as white fillings. White fillings are also used for cosmetic improvement of the smile by restoring the color and reshaping disfigured teeth.

What Are dental composite fillings Made Of?

The white fillings are composed of hard filler particles (finely ground glass, quartz, or silica), surrounded by a set matrix of another material that binds the filler particles together.

The fillers in dental composites are obtained from large rocks that are processed into a microscopically fine powder. There are different varieties of dental composites available based on the content, shape (spherical, fibers, or flakes), and size of filler particles. 

The matrix in the composite fillings is generally composed of monomers of resin that lack strength and is, therefore, mixed with fillers to provide strength to the material. These monomers polymerize into long chains of polymers on exposure to UV radiation. 

Are composite fillings strong?

Different composite materials used in dentistry have varying properties and differ in strength, and are used accordingly. 

The composites used for the front teeth should have enamel-like properties, so these materials contain small-size filler particles that are polishable and give good optical properties. However, they are not strong enough to bear the long-term chewing strokes at the back of the mouth. 

The composite used to fill molar cavities (back teeth) contains more densely packed and varied-sized fillers of relatively larger diameter to make them strong. These posterior composites are darker and less polished than the front teeth composites, as appearance is not a prime concern in molar teeth.

What are the advantages and disadvantages of composite fillings 

Composite fillings has some pros and cons. However, its advantages supercede its disadvantages.

Advantages of composite fillings

The following are the several advantages of dental composites:

  • It is tooth-colored and is available in different shades to exactly match your natural teeth. 
  • It doesn’t contain mercury, so there is no risk of mercury toxicity caused by mercury leaching in the oral environment. 
  • It bonds to the tooth, and hence less amount of tooth substance removal is required to retain it in the tooth. Even a small cavities are easily restored with a composite filling without much tooth structure removal. 
  • It doesn’t corrode (rust) in the mouth as it lacks metals. 
  • The composite fillings are resistant to fracture because they bond to tooth substance. 
  • It takes 15-20 min to fill a tooth. 
  • The material is fully set when you leave the dental office. 
  • It can be placed in both the front and back teeth.
  • You may not experience any sensitivity with composite fillings as commonly seen in amalgam fillings.  

disadvantages of composite fillings (problems with composite fillings) 

The following are some problems associated with composite fillings:

  • They tend to stain over time if you are a habitual tea or coffee drinker. 
  • Staining of composite fillings in the front teeth may require replacement to improve their appearance. 
  • The fillings in the front teeth are supported from two sides only and thus require great care while eating. Biting on hard food can fracture it. 

Can you whiten composite fillings 

Composite fillings cannot be whitened. The disadvantage of teeth whitening treatment in patients with composite filling is that it doesn’t bleach the Composite fillings, and you may need to replace it with a lighter shade after the whitening treatment. 

Are composite fillings safe?

Yes, composite fillings are safe. However, there is a growing concern about the BPA present in composite fillings. 

Composites contains Bisphenol A (BPA) as a monomer. These monomers polymerize to long chains of polymers in the tooth cavity. The trace amount of free residual BPA may leach into the mouth from the recently placed composite filling. The BPA levels rise in the saliva and urine 24-48 hours after the filling placement and are barely seen 2-4 weeks post-filling. 

BPA-free composite fillings

BPA-free dental composite fillings are also available in holistic dental practices. Also, if you want to avoid composites, you can opt for ceramic inlays, onlays, and crowns, but they may be expensive than direct composite fillings.

Can you get composite fillings for receding gums?

Yes, you can get composite or white fillings for receding gums. Teeth with receding gums decay faster as the exposed root is not hard (mineralized) enough to sustain the harsh oral environment. These areas can be easily restored with composite fillings. 

Are composite fillings better?

Yes, composite fillings are way better than other fillings as they don’t contain mercury, are tooth-colored, and bond well to the tooth structure. 

How long does a composite filling last?

If properly taken care of, a composite fillings in the front teeth last 7-10 years. The fillings in front teeth may discolor. If they discolor, you may need a replacement. 

Posterior (molar or back teeth) fillings last longer (10-12 years) if they are supported by tooth walls from all sides. However, they may not have a long life span if there is greater destruction of tooth structure (loss of two or more walls).

How much do composite fillings cost?

The dental composite costs you between $100- $250. The price varies based on the size of the cavity.

What is the composite Filling Procedure?

The white fillings are technique sensitive and requires adequate moisture control for the longevity of the filling. The following are the step by step details of the composite filling procedure:

  • The first step of the filling involves selecting the composite shade from the shade guide that matches your tooth color.
  • Based on the cavity depth, you may or may not require anesthesia to numb the tooth. Deep cavities, however, require anesthesia to numb the tissues. 
  • The next step involves the removal of decay with a motorized drill. The tooth is thoroughly rinsed with water and dried with air blown with a triple syringe.
  • Rubber dam or cotton pellets are placed around the treated tooth to isolate the tooth from moisture contamination. Rubber dam is a plastic sheet and a hole is punched with a plier in the rubber dam sheet. The rubber dam is placed and retained with a retainer on the tooth that needs isolation.
  • An etchant is applied to the enamel and exposed dentin for 30 seconds. The etchant is then washed, and the tooth is dried. A bonding agent is then applied and cured with UV light. 
  • The final step is the placement of a composite filling. The filling is placed in thin sections and is adapted to the walls of the cavity with an instrument. Every composite increment is cured individually to avoid any voids in the cavity.
  • The set composite is finished and polished with the burs, disks, strips, and pastes sequentially.
  • The last step is checking the bite. You will be asked to bite on an articulating paper. The articulating paper leaves marks on the tooth that will be trimmed. Finally, you will be asked how you feel about biting with a filling. Inform your dentist if it feels high on clenching.

What are Composite Filling Aftercare And Precautions?

  • The filling is fully set when you leave the office, unlike amalgam, which requires 24 hours to gain its full strength. Avoid eating until the anesthetic effect wears off so you don’t bite your lips, cheeks, or tongue.
  • You may experience some sensitivity to hot or cold for a couple of days after the filling in deep cavities. If you experience severe pain, call your dentist’s office.
  • Children should be kept under observation until the anesthetic wears off. Due to the unusual feeling of the anesthetic, the children may chew the inside of their lips, cheeks, or tongue, which can cause severe damage.
  • The finished restoration has a varied texture than the original tooth. Your tongue detects this slight difference, and it will take time to get accustomed to this change.
  • After leaving the office, if you feel that you cannot bite properly and the filling feels high on biting, call the dentist’s office. This problem can be fixed with the dental drill so don’t hesitate to ask.
  • If the filling is placed on the front tooth, avoid biting on hard foods with the filled tooth. Yet, you can chew on soft foods. The filling, in most fracture cases, is supported from two side only, and biting on hard foods can fracture it.
  • Restored or filled tooth requires the same oral hygiene measures as other teeth. 

FAQ’s

Are composite fillings worth it?

Yes, it is worth getting a composite filling because it saves your tooth from further decay. Also, the tooth is restored to its normal color and shape, and no one recognizes the filling. 

Which is better composite or porcelain fillings?

Composite fillings are frequently used to fill teeth because they require less chairside time. They are direct fillings (require no lab step) and need a single appointment to fill a tooth. Porcelain fillings, on the other hand, are tougher, durable, and costly and are made in the lab. They are reserved for large cavities that require strong fillings to strengthen the lost tooth substance. 

What is the healthiest tooth filling?

Porcelain fillings are considered the best but are not suitable for all cavities as they are prepared in the lab according to the shape of the prepared cavity and luted to the tooth. 

What is the alternative to composite fillings?

Silver, cermet, and glass ionomer cement (GIC) are direct fillings that can be used as an alternative to composite fillings. GICs are less commonly used for fillings because they lack strength. However, they are used in baby teeth that are temporary.

Are composite fillings as strong as teeth? 

Composite fillings are less hard than tooth enamel. The hardness value of enamel is 274 MPa, and that of composite is 100-108 MPa. They can resist chewing forces without much abrasion and last for 7-10 years. 

It is better to have a filling whose hardness value is less than natural teeth because stronger material is prone to abrade the oppossing natural teeth. This is a common problem seen with porcelain fillings and crowns.

How do I know if my composite filling is leaking?

A leaking composite filling tooth shows pain or sensitivity to eating or drinking hot or cold foods. You may also notice a black discoloration around the filling. Leaking composite filling results from the contraction of composite filling, leaving space between the tooth wall and filling. Continuous leakage in the space between the tooth wall and filling creates ideal conditions for tooth decay. 

Secondary decay around filling tends to spread deep into the tooth layers. Therefore, get an appointment with your dentist to fixed it.

Why does my composite filling hurt?

Small or moderate-sized cavities don’t hurt after the filling. Deep fillings may cause discomfort for a couple of days on chewing. The pain is mild and usually resolves in a week. However, if you experience severe pain or swelling in the tooth, you need to see the dentist asap. 

How many times a filling can be replaced?

Composite fillings usually require replacement due to discoloration. If it discolors and needs replacement, it can be replaced many times. It is difficult to say the number, but if there is no decay around the filling, it can be easily replaced.  

Why do composite fillings fail?

Frequently, front teeth composite fillings fail. The failure is due to inadequate support for the filling from the tooth. Biting on hard foods can dislodge it. Therefore, it is advised to eat soft foods from the teeth with white fillings. 

Should I replace my silver fillings with white fillings?

Yes, you should if you want to. However, if the silver filling is adequately retained in the tooth with no complaints, it is okay if you keep it. 

Do composite fillings harden immediately?

Yes, composite fillings are set and hardened when cured with a blue light. UV light initiates a polymerization reaction in the filling that polymerizes resin monomers into long polymer chains. The fillings are exposed to the blue light for 30 sec to 1 min. The fillings are entirely set when you leave the dental office. 

Why does my tooth hurt years later after a filling?

A pain-free filled tooth that has started hurting now could result from recurrent (secondary) decay around the filling. Black discoloration around the filling or pain in the tooth is a sign of secondary tooth decay.

Do white tooth fillings have mercury in them?

No, white fillings contain no mercury. They are mainly composed of resin monomers and filler particles.  

Are white tooth filling cancerous?

No, white fillings don’t cause cancer. However, they contain BPA, which is an endocrine disruptor. Most fillings release trace amounts of BPA for a few weeks after the fillings. BPA in high quantities is known to cause hormonal cancers such as breast and ovarian cancer. 

Can I drink after white tooth fillings? 

Yes, you can drink water after a white filling; however, it’s best to avoid solids for two hours after the filling until the anesthetic wears off. 

Can I get allergic reactions to white fillings?

Allergic reactions to white fillings are rarely seen. Most people tolerate white fillings well, with no redness or other allergic reactions. However, if you develop any unusual signs and symptoms after the filling, call your dentist.

Does insurance cover white fillings?  

Yes, dental insurance covers white fillings. If you have insurance that covers major and minor dental procedures, your 70-80% cost will be covered. However, there is a limit to it. For instance, some insurance policies will cover the cost of your fillings up to 500$. If you require two or more fillings that cost more than 500$, you have to pay the additional cost from your pocket. 

Also, some dental offices offer you to pay your bills in installments, if you require several fillings and can’t afford to get them.

How often does white need to be replaced? 

Front teeth fillings require replacement due to staining. The discoloration of a filling depends on your dietary habits. If you’re a habitual black tea, coffee, and red wine drinker, you will probably need replacement faster than the ones who occasionally consume these drinks. A frequent coffee and red drinker may require replacement after 3-4 years.  

Why are white fillings so expensive? 

White fillings are more expensive than silver fillings. However, they are cheaper than a root canal treatment or crown. The white filling kit and the blue light used to cure the material are expensive. The price of a single filling is charged according to the type and brand of material used and the size of the cavity. 

Conclusion 

Dental composites are white fillings that are used to restore front or back teeth destroyed as a result of tooth decay. They are superior and most accepted by the patients due to their color-matching properties and high strength, unlike the other filling materials. 

Composite placement is technique sensitive and requires adequate moisture control for the bonding and longevity of the filling. It is a direct filling (takes 15-20 mins to fill a tooth), done in a single appointment and is covered under private dental insurrance.

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