Cerec has superseded conventional laboratory made porcelain. It is an extremely durable material with long term data indicating it has durability surpassing that of gold. It provides excellent aesthetics, is completely biocompatible and requires only one appointment to place. Unlike laboratory made porcelains Cerec has no inherent stress fractures from firing and is thus not brittle. It is suitable for practically any restoration in the mouth and is preferable to composite even for small fillings on the biting surface of teeth. This is because small white fillings can be the most problematic as composite has a setting shrinkage. This shrinkage can pull on the sides of the tooth or even pull the restoration away from the sides of the tooth creating problems with sensitivity.

Before After

With Cerec we can often prevent the need for a full coverage crown which minimizes both the amount of tooth tissue which we need to remove and the trauma to the pulpal tissue. Because Cerec is bonded to your tooth tissue it can also confer strength and long term protection to existing tooth structure. ...more on CEREC

Gold
Gold is very durable as well as inert in the mouth. When restorations run very deeply under the gum line, or very little tooth tissue remains, Gold can still be the material of choice.

Composite Composite is a resin material filled with silica particles and other fillers to increase its toughness and provide colour. Composites may be placed directly into the cavity by the dentist or made by a technician in the laboratory from an impression taken by the dentist. Composite placed directly in the mouth enables us to provide an aesthetic, quick restoration for cavities within enamel. As composite does not wear well it is most suitable for anterior teeth and small fillings in back teeth which will not be under too much pressure in the bite.

Before (Silver Filling) After (Composite Filling)

Glass lonomer
Glass lonomer is a mixture of polyacrylic acid and silica. It is the only material we have available which will actually bond to tooth tissue and has a special benefit of very slowly leaching fluoride into the tooth to prevent decay around the filling. It is quite a soft material which means that it is suitable only for children, the elderly, and cavities on the facing surfaces of teeth. It is also commonly used in adults as a temporary filling material.

Amalgam
The main constituents of amalgam are silver, tin, copper and mercury. The mercury is added to 'wet' the particles of silver and tin so that they will mix together.
Amalgam is reasonably resilient in the mouth and lasts quite well. The main disadvantages with amalgam are:

1. The poor aesthetics
2. The mercury content- 50 % by weight
3. Amalgam fillings expand and contract quite differently to your tooth and can thus act as a wedge within the tooth leading to weakened tooth structure and eventually fracture.

The use of amalgam is slowly declining as other materials are developed for use in the mouth which are superior; tooth coloured, and do not contain mercury. However there are still some instances, where due to lack of enamel and financial considerations, it is the only material which will serve in the medium term.


Sensitivity after placement of a restoration
It is not unusual to have some initial sensitivity after a filling is placed. Often the gum around the tooth can be a little tender- in particular when decay has gone between the teeth- necessitating the use of bands or strips. It is not uncommon for a tooth to be sensitive to cold immediately after the placement of a large or deep restoration, Provided the pain is of short duration and gradually lessens over the next few weeks the tooth should eventually settle.

It can also be difficult to establish the correct bite when teeth are numb and when the muscles round your jaw are tired, making it difficult to close in the correct position. Teeth which are high in your bite, will become tender to bite on and may also become temperature sensitive. It is important to come back for an adjustment should your bite feel incorrect.

Occasionally after the placement of a restoration a tooth can become non-vital and require root canal treatment. Each time we replace a filling there is trauma to the pulp (nerve, blood supply). This trauma is caused by a combination of the drilling itself, toxins released by the bacteria that cause decay and the reaction of the pulp to the filling materials themselves. Other factors such as tooth grinding and fracture lines within teeth also affect the health of the pulp.

The accumulation of this trauma over time can result in a 'stressed pulp', that is a state of chronic near-death. As a result, a tooth which was seemingly fine prior to dental treatment may require root canal treatment afterwards because the pulp of that tooth, having already been compromised, is unable to withstand any further stress.

Teeth that are, or are becoming non-vital generally become sensitive to hot and cold, as well as being tender to bite on. Pain will often arise spontaneously and last for a long period of time, perhaps even be constant and will often be throbbing in nature. Should this occur please contact us immediately.