There are two general types of white fillings: ceramic and composite. In truth so-called white fillings are tooth-coloured)
Composite fillings represent an ever-evolving technology to repair and restore teeth in a way that is both strong and pleasing in appearance. The word composite implies that the constituents of these fillings are complex. Each ingredient is there for a reason – to enhance its strength, appearance, durability or other properties.
Strength and Durability
These fillings typically last for years. When they first appeared on the scene for use in back teeth in the nineteen-seventies they wore away with use much more quickly than did mercury-based amalgam fillings. They seemed therefore to be less strong. That is a thing of the past. In fact, mercury-based fillings are notorious for causing fractures of teeth as they expand and contract (microscopically) over time. Composite fillings are bonded (“glued”) to the tooth structure it is repairing and makes it less likely to fracture.
Ease of Use
Just like mecrury-based amalgam fillings they are completed in one appointment.
Unlike mercury-based fillings there is no mercury leaching from these fillings, because there is no mercury in them. But they are not perfect. Some of the ingredients are called “plasticizers” and potentially they have estrogen-like effects on the body. Some people, such as those who suspect they have multiple chemical sensitivities, should have compatibility testing done.
One composite, with the trade-name Admira Fusion® looks very promising because the plasticizers seem to be absent from the mix.
We dentists use the term”filling” to imply that we pack a material into a cavity during the same appointment that the hole is created. In that sense ceramic fillings are a misnomer* Instead, we use the term inlay or onlay because these restorations are typically a two-appointement procedure: The site in the tooth is prepared and an impression (“image”) sent to a dental laboratory that makes the restoration. When the restoration is returned from the lab on another day, it can be cemented into the tooth.
Ceramic Pros and Cons
- They are more life-like and colour stable. That is nice but not overwhelmingly important on back teeth. Ceramic on front teeth is an advantage and take the form there of crowns or veneers.
- They are stronger than composite.
- The bulk of the ceramic material will not leach plasticizers but the cements used to bond them in place will. Since the cement forms a very thin film, the overall effect is a great reduction in plasticizer exposure. With the advent of Admira Fusion,® choosing the ceramic option for the purpose of avoiding plasticizers is less valid. The strength and appearance benefits still apply.
- They are much more expensive than composites.
* OK, that is not quite correct. There does exist technology to create ceramic onlays and inlays in the dental office “while you wait.” Expensive CAD-CAM milling machines can accomplish that. At Growing Beautiful Smiles, that technology is not available.