White Composite Fillings Composite fillings are becoming the standard in dentistry while silver/mercury (amalgam) fillings fade into the sunset.  For well over a decade, we have exclusively offered white composite fillings to our patients.  It was a Cosmetic Dentist's dream come true to offer tooth colored fillings that were both durable and cost effective.   Modern composites have improved greatly with the addition of silica (glass) and quart-like substances which have improved the strength of composite resins.  Initially, composites  were used almost exclusively on front teeth that had a low chewing force.   Modern composite resins are routinely used on back teeth as well, and can easily stand up to much higher chewing loads. Advantages The chief advantage of composite fillings is their natural tooth color.  Your dentist can blend the composite to match virtually any tooth shade. The amount of tooth structure removed is far less with composite fillings.  Amalgams required that the cavity be undercut to hold the amalgam in place.  The composite filling adheres to the tooth, making a smaller depression possible. Composite fillings can actually improve the strength of a tooth with significant decay.  The composite resin adheres to the tooth and helps to hold it together.  Large amalgam fillings can expand and contract with heat and cold, compromising tooth strength.  In addition, they do not adhere to the tooth material. It is much more difficult for decay to get under a composite filling because of this adhesion.  With amalgam fillings, shrinkage often took place giving bacteria a pathway under the filling. Composite resins are environmentally safe and eliminate the possibility of mercury allergies, or having to dispose of mercury. Many dentists now report that a properly placed composite filling has a service life equal or greater than that of amalgam fillings.  In addition, composite fillings can be "repaired" when they near the end of their service life rather than be totally replaced.

How are Composite Fillings placed? Your dentist will give you a local anesthetic to numb the area to be worked on.  The decay will be cleaned out and the cavity prepared to receive the resin. An etching material will be used to slightly roughen the tooth's enamel and open the pores of the dentin.  This helps achieve a stronger bond. Composite resins are then applied in thin layers, each hardened with the use of a special ultraviolet light gun or laser.  As the layers are applied, the dentist shapes them to match your original tooth. Once completed, your dentist will check your bite and make any adjustments to the new tooth surface that may be necessary. You will be instructed to care for your new composite filling just as you would your natural tooth. This includes brushing, flossing, and regular teeth cleanings. Generally, it will take about one hour per tooth to complete a composite filling.

typical undercut amalgam prep

Are there any disadvantages to white fillings? Because each layer of a composite filling must be prepared individually, they take more time.  As a result, the cost is somewhat higher than with silver/mercury fillings. While the service life of composite fillings is good, porcelain inlays and onlays still have a superior life. Many insurance companies only reimburse patients for composite fillings at the rate of the older amalgam fillings.  As composite resins have become the standard in dentistry, more insurance companies have been forced to provide fair reimbursement. Composite fillings are slightly more prone to shade changes due to drinking tea or coffee than are porcelain crowns, inlays, and onlays.  A clear plastic coating can be placed over the filling if the patient is particularly concerned about shade change.