Thanks to improvements in material science, tooth-coloured fillings have become more lasting and more esthetic.
Factors affecting how long a filling lasts
Size – the larger the restoration, the higher the chance of breakage and redo.
Margins – the longer the boundary of the restoration and the deeper it sits into the gums, the greater the risk of breakdown and leakage from decay.
Occlusal load – the heavier the bite, especially in night grinders, the greater the incidence of breakdown.
Lifestyle – heavy smoking, wine, coffee and coloured drinks such as cola inevitably stain tooth-coloured fillings faster.
How these can be reduced
Crowning large restorations to reduce fracture.
Extraction for deep lesions where maintenance is not possible – with the option of a denture, bridge or implant, discussed with the dentist.
Rinsing out coloured beverages may delay staining, along with regular prophylaxis of the teeth.
Types of restorations
Composite resin – available in many shades and strengths. High-impact versions may cost more.
Inlays and onlays – indirect fillings made in the laboratory from an impression of the prepared tooth. They rarely break because they are made as one piece, and anatomical grooves are carved in to mimic real teeth. They almost never stain.
Crowning – capping the tooth with zirconia or alloy (for back teeth where the tooth is vertically challenged).
Veneers – a porcelain facing cemented over front teeth that are badly discoloured. It is more conservative, with less tooth reduction, and avoids the need for temporary fillings.
The trusty silver amalgam
Silver amalgam is in declining use but still has its indications. It has been used for more than a century and has been controversial because of the presence of mercury. It is also not esthetic, and its margins creep over time, leading to leakage and decay.
When replaced with a high-impact tooth-coloured composite resin, the restoration has a better marginal seal thanks to the use of a dental bond.
Before – decayed pits
After – tooth-coloured filling
Silver amalgam use will be updated here when the Ministry of Health issues further notice.
