Dental amalgam is the traditional silver-coloured filling we are all familiar with. Although there is mercury in dental amalgam, once it is combined with the other materials in the amalgam filling its chemical nature is changed rendering it harmless. Research into the safety of dental amalgam has been carried out for over a century and to date, no trustworthy controlled studies have found a connection between amalgam fillings and any medical problem.
Whilst composite (tooth coloured) fillings are becoming more popular, amalgam fillings represent the most durable and long-lasting form of filling available. (Apart from gold fillings which are more expensive.)
Amalgam fillings are the only type of filling provided through the NHS – composite fillings are considered to be ‘cosmetic’ and therefore must be paid for.
Most people have fillings of one sort or another but today, because we are much more conscious of our smile, we can choose a natural looking alternative – the composite or tooth-coloured filling.
A composite resin is a tooth-coloured plastic mixture filled with glass (silicon dioxide) first introduced in the 1960s. Originally only used for front teeth because of their softer nature, modern improvements to their composition make them generically suitable today.
Composite fillings are more difficult to place than silver fillings so may take your dentist 15-20 minutes longer to complete and because they are considered to be a cosmetic treatment, they are not available on the NHS and must be paid for.
The main advantage of composite fillings is their aesthetic appeal. The main disadvantage is their life expectancy. White fillings have always been considered less long lasting than silver amalgam fillings but there are now new materials available with properties comparable to silver amalgam, and these are proving to be very successful. The life expectancy of your composite filling can depend on the depth of cavity and its position in the mouth; your dentist is best positioned to advise you.
Deep pits and grooves can be found on the chewing surfaces of the back teeth. Such pits and grooves are termed ‘fissures’ and are usually so narrow that toothbrush bristles and streams of water are not able to clean them effectively. These form a favourable environment for bacteria to flourish, often resulting in tooth decay.
What can be done?
Fissure sealants can be applied to the teeth. Fissure sealants are special materials used by dentists to seal off pits and fissures from the oral environment. Sealing the tooth surface protects fissures from bacteria and fermentable foods like sugar and starches to prevent decay from starting deep within the fissures. Any tooth with pits and fissures can be treated, provided the surface to be filled is sound and has not been previously filled. The most commonly treated teeth are the molars and premolars.
How are sealants applied?
Sealants are applied easily and painlessly. No drilling is required. The tooth is properly cleaned, treated, dried, and the sealant applied. It then hardens to form a protective coating over the tooth.
How effective are sealants and how long can they last?
Many studies show sealants to be very effective in preventing decay in fissures. They do, however, require regular maintenance by your dentist. This can be performed with your six- monthly check-up. Recent studies show that a properly placed sealant will last as long as a typical amalgam filling. Even if a sealant is damaged or lost, it is easily repaired and replaced. Regular maintenance by your dentist will help them last. This can be done with your six-monthly check-up.
When should sealants be put on the teeth?
Sealants are most effective when applied after the eruption of the tooth. Early application ensures pits and fissures are sealed before the decay process begins.