Due to improvement in material science, tooth colored fillings are more lasting and esthetic.
Factors affecting its longevity
1 Size- the larger the restoration, the chance of breakage and redo is higher
2 Margins of the restoration- the longer the boundary of the restoration and the deeper it is into the gums, the more risk of breakdown and leakage due to caries
3 Occlusal load- the heavier the bite and especially in night grinders, the greater the incidence of breakdown of the filling
4 Lifestyle-Heavy smoking, wine , coffee and lots of colored drinks eg cola inevitably will result in faster staining of these tooth colored fillings
*These can be alleviated by
1 crowning large restorations to reduce fracture
2 extraction would be recommended for deep lesions where maintenance is not possible- option of denture, bridge or implant ( may be discussed with the dentist as to which is most suitable)
3 Rinsing out colored beverages may delay staining and regular prophylaxis of teeth.
Types of restorations:
1. Composite resin or tooth colored ones are available in many shades and strength. High impact ones may cost more.
2. Inlays and onlays- there are indirect fillings made in the laboratory from impressions of the preparations taken in the mouth. They rarely break as they are fabricated as a piece to be cemented over the cavity prep. Also anatomical grooves have been carved into them to simulate real teeth. They almost never stain.
3 Crowning- the capping of tooth with zirconia or alloy (for back teeth where the tooth is vertically challenged)
4 Veneers- is a porcelain facing that is cemented over usually front teeth that are badly discolored. It has the advantage of being more conservative as there is less tooth reduction and negates the need for temporary fillings.
*The trusty silver amalgam is in declining use but still have its indications. Will update this when MOH issues further notice.