Tooth decay is considered a widespread disease, as around 90% of people are affected by it. Tooth decay bacteria eat through the enamel and create holes in the teeth. Dental fillings were developed to prevent them from penetrating the dentin (tooth bone) and possibly the nerve. The dental fillings seal the hole and prevent the tooth decay from spreading further.
The most important thing in brief:
- Ceramic and gold inlays are expensive, but they are safe and long-lasting.
- Health insurance companies only cover the costs of amalgam fillings, except in the front teeth area or in cases of intolerance.
- Plastic fillings are a good compromise in terms of durability and cost.
Gold dental fillings
The precious metal is used to make both small fillings and inlays. For smaller fillings, gold is filled into the hole in very thin layers and then lightly hammered into its correct shape. For inlays, the piece to be inserted is made in the dental laboratory and then attached to the tooth with plastic. For better aesthetics, a gold filling or inlay can be covered with ceramic or plastic.
- Lasts the longest with an average of 10 to 15 years
- Very hard, therefore ideal for the back chewing surfaces
- The patient must bear the costs – if he does not have additional dental insurance for tooth preservation
- Particularly suitable for allergy sufferers and patients with concerns about other fillers
Composite dental fillings
Composite is an artificial mixture of 20% plastic and 80% silica salt or the finest glass particles. It is tooth-coloured and therefore very aesthetic. If the filling is applied in several thin layers, the dentist can adjust the brightness, colour and translucency precisely to the tooth. Composite is also often used to seal molars. A thin layer is applied to the inner grooves of the molars to protect them from caries. Composite fillings are often simply called plastic fillings. Smile Cliniq's Finchley dentist team offers expert guidance in selecting the right option for long-term durability and natural appearance.
- Lasts an average of 4 to 6 years
- Dimensionally stable, suitable for all teeth
- The health insurance company covers the full costs for the application on the front teeth (for a single layer)
- If the filling is applied to molars or in multiple layers, you will have to pay part of the cost yourself. Health insurance companies will provide a subsidy equal to the cost of a comparable amalgam filling. If you have a proven allergy to amalgam or if you have kidney problems, your health insurance company will often cover the full cost.
Dental fillings made of glass ionomer cement
The mixture of polyacrylic acid and calcium aluminium silicate glass is used in many ways in dentistry. Mainly in milk teeth, as a temporary filling before an inlay or as a sealant for molars. The material is also used to attach dental crowns and bridges. It is not robust enough for permanent fillings.
- Lasts a maximum of 1 to 2 years
- Mainly for milk teeth or as a temporary solution
- The costs are borne by the health insurance company
Dental fillings made of compomer
Compomer is a combination of composite and glass ionomer cement. It lasts longer than pure glass ionomer cement, but not as long as composite or ceramic. Due to its ease of use and tooth-coloured appearance, compomer is used for small fillings on the necks of teeth and in the front area of the teeth. In the chewing area, it is only suitable as a sealant, but not for large-area fillings. As a neck filling or build-up filling, compomer can stabilize the tooth before it is given a crown. As with other plastic fillings, allergic reactions can occur in rare cases.
- Lasts 4 to 6 years
- Particularly suitable for small fillings in visible areas
- The costs are borne by the health insurance company
Ceramic inlay
Due to its high degree of hardness, ceramic is particularly suitable for the back chewing surfaces. The dentist removes old fillings or caries completely and polishes a uniform, smooth surface. He then scans the hole with a digital camera. A computer creates a virtual map. Now it is the turn of the dental technician in the laboratory or, in modern dental practices, a computer with a milling machine. He makes a suitable replacement from glass, oxide or zirconium oxide ceramic. The dentist then inserts the resulting denture into the hole using a special adhesive or composite.
Ceramic is visually almost indistinguishable from a real tooth, as the exact tooth colour is recorded during the scanning process and then developed.
- Lasts 8 to 10 years
- Suitable for molars and chewing surfaces
- High costs, because the health insurance only pays a subsidy equal to the cost of an amalgam filling
- That's why additional dental insurance is worthwhile
- Not suitable if you grind your teeth or chew at night while sleeping. This can cause the ceramic inlay to tear
Health insurance benefits and additional dental insurance
Health insurance companies pay for all amalgam fillings. For incisors or proven amalgam intolerance, they also pay for a single-layer composite filling. But be careful: If you want a less noticeable filling just for cosmetic reasons, the dentist will charge you for the additional costs. It is best to always discuss the options with your dentist and your health insurance company.
When is a tooth filling necessary?
Your dentist will always recommend a filling if he or she diagnoses a defect in the tooth's hard substance . You will also notice a hole in your tooth. It makes your teeth more sensitive and may cause pain. If the hole is still small, you can avoid having an immediate filling. In principle, however, this helps to preserve the rest of the tooth without any restrictions and to prevent further damage. As the hole gets bigger, the sensitivity to pain increases dramatically.
The main reason for a filling is not only a carious defect but also a broken tooth - either due to carelessness or an accident. In order to protect the tooth and restore its functionality, your dentist will put in a filling.
Dental fillings due to wear and defects
Erosions can also require a filling: they form on the teeth when they are exposed to acid. They become noticeable as soon as the tooth enamel shows initial damage. A filling closes the erosion and prevents further damage to the tooth enamel.
Another problem that the dentist can solve with a filling: When you grind your teeth too much, a lot of friction occurs. Over time, this leaves defects in the tooth. Your dentist will correct the defects with a filling. Another possibility for using a filling is defects in the neck of the tooth.
How do you know if you have a hole in your tooth?
In most cases, your dentist will point out a hole during a routine examination. If you go for regular check-ups, he will be able to detect even small holes and respond with individual treatment . There are also signs that you can recognize a hole yourself:
- A tooth with a hole reacts very sensitively to different temperatures. Both hot and cold foods can cause pain. Take this seriously and talk to your dentist about it.
- In general, increasing sensitivity is the result of cavities in the teeth.
- A hole can be felt with the tongue. If you gently run your tongue over your teeth, you will feel holes once they reach a certain size. Make an appointment with your dentist.
Treatment with fillings
When using a filling, the treatment process depends on the type of filling chosen. Your dentist distinguishes between direct and indirect fillings. Direct fillings offer a time advantage: your dentist repairs the tooth directly during the appointment. Indirect fillings take two days to complete.
Dental treatment with direct fillings
With a direct filling, your dentist cleans the tooth and disinfects the cavity. To ensure that the filling is applied cleanly, he places a special mold around the tooth. If you choose a plastic filling, the doctor applies a gel. This roughens the tooth surface. The filling then adheres better. To ensure that the filling material does not become unnecessarily moist, the dental staff places cotton rolls and a rubber band, the so-called rubber dam.
To fix the plastic filling, your dentist uses adhesive. He applies a thin layer of this to the tooth. The adhesive is then hardened using UV light. Depending on the size and texture, a second layer of adhesive may be required. Your dentist then inserts the filling and adjusts it to the tooth so that you do not feel it when chewing.
Composite fillings harden in UV light. After removing all aids, your dentist will adjust and check the filling. This is followed by polishing. Your dentist will then inform you whether there are any short-term restrictions.
This is how the treatment with an indirect filling works
If you decide on an indirect filling, plan on 2 days for treatment at the dentist. On the first day of treatment, your dentist will prepare everything for the inlay filling. A dental technician will make the filling to fit you perfectly. Only on the second day will your dentist glue it into the affected tooth.
This happens on the first day of treatment
The process is as follows in detail: First, you will receive a short local anesthetic to ensure that the treatment is as relaxed as possible. The dentist will then expose the existing caries in order to remove it thoroughly. No traces will remain. After the cavity has been cleaned, it will be disinfected. Your dentist will then make an impression. The dental technician will need this to make the filling. To avoid any restrictions until the next day, your dentist will place a temporary filling. This will avoid unnecessary pain and sensitivity.
This is how the second day of treatment goes
The next day, the dentist continues the treatment by removing the temporary filling. As with direct fillings, he now positions cotton rolls and a rubber dam. These aids absorb moisture that develops during the treatment. This creates a dry treatment environment in which the filling can be processed optimally.
Once the tooth to be treated is dry, your dentist will finally insert the filling. After an initial fitting, he will adjust it to ensure an optimal fit . To ensure that the filling lasts a long time, the cavity is cleaned and disinfected again. Your dentist will then attach the inlay with a special adhesive.
He then removes any adhesive residue and any aids. Finally, he checks the fit of the filling again.
Which filling is the right one?
The possible fillings for your tooth differ from one another in terms of composition, properties and use. This makes it difficult for patients to choose the right filling.
In addition, the decision for or against a particular filling material always depends on the position of the tooth to be treated . There are teeth where the filling is subjected to high chewing pressure. This means that the material is particularly stressed. Talk to your dentist! He will help you find the right material.
Conclusion
Amalgam fillings are paid for by health insurance companies. However, due to their color, they are less suitable for front teeth. Plastic fillings offer a good compromise with their subtle appearance and medium durability. Ceramic and gold fillings are an investment because they are significantly more expensive. However, they are extremely durable. In addition, the material does not interact with the body. The best way to find out which dental filling is right for you is to talk to your dentist.