We customize treatment for each patient and will recommend the types of fillings you require. There are a number of techniques we use to restore teeth to optimum health and function.

White fillings placed directly in your mouth (composites)
Indirect white fillings (porcelain inlays/onlays)
Indirect white fillings (made of composite)
Crowns

1. White Fillings placed directly in your mouth (Composites)

Composite resins are tooth coloured fillings that are made of a plastic material mixed with filler and are suitable for small to medium sized fillings. Due to economic reasons, sometimes this material is used on larger back teeth at the patient’s request, understanding the limitations and weaknesses of the material. The material is inserted into a cavity in the paste form and set hard with a special light.

Advantages of Composite Fillings

Composite fillings are more attractive than amalgam fillings.
Teeth may be strengthened as it bonds to the surrounding tooth, while an amalgam may sometimes weaken a tooth.
Composite fillings can be fitted into very small holes, avoiding more drilling for the preparation of the tooth.

Disadvantages of Composite Fillings

In larger fillings, composite fillings can wear out sooner than amalgam and porcelain fillings. This is not the case if the cavity is very small.
A tooth filled with composite material may be sensitive for some time after the procedure. This is because plastics shrink when they polymerize, causing white lines between the filling and tooth, which can eventually fill with stains. Shrinkage at the base of the filling can cause sensitivity when biting on crunchy foods. Shrinking can also pull on the tooth and may crack thin tooth structure.
Some food and drinks can stain composite fillings.
Composite fillings are not as strong as porcelain or amalgam and may fracture more readily.
Food can get jammed between the teeth if the filling does not touch the adjacent tooth tightly. Composite fillings can not be packed into a cavity with the same pressure as an amalgam. At times, a fine gap may open when chewing fibrous foods such as meat.

2. Indirect White Fillings (Porcelain Inlays/Onlays)

Porcelain or ceramic is a hard, ceramic material with tooth-like appearance. Inlays and onlays are used to repair moderately damaged back teeth and need to be strong to withstand the grinding pressure of these teeth. When a filling is very wide or deep it becomes almost impossible to make a good quality filling without taking moulds of your tooth and making the filling outside of your mouth. lnlays and onlays are then cemented into place with a special cement to increase the strength of the filling to the tooth.

Inlays and onlays may two dental visits. The first visit involves removing the old filling or decayed tooth structure and preparing the surface for the new filling. An impression is made of the area and sent to the dental laboratory so the filling can be constructed. A temporary cover will be placed over the tooth until the next visit.

At the second visit, the filling is removed and the inlay/onlay is fitted and bonded into place then polished.

In most cases at our practice the two visits can be done together thanks assistance from the computer generated design and milling of the ceramic also known as” CAD-CAM dentistry”. This will save you time and also give optimum outcomes for bonding the ceramic onlay/inlay to the tooth.

Advantages of Inlays/Onlays

Strength is the major advantage. Fillings usually weaken teeth. Inlays/onlays are bonded directly into the tooth and can increase the overall strength of the tooth.
They are durable.
They can be a good alternative to a crown.
High accuracy also means there is less likelihood of loose contact between adjacent teeth and hence can avoid food getting stuck between the teeth. Such food traps can lead to decay and gum disease.
Unlike composite fillings, they do not shrink while being placed and have a less incidence of sensitivity.

Disadvantages of Inlays/Onlays

They are more expensive than direct fillings due to the high-quality materials required to manufacture them and the precision required in their fitting.
Occasionally they can fracture because the porcelain is brittle. Some people’s bites are heavier and stronger leading to fracture. Accidents, such as biting into a stone whilst eating, can cause a sudden hard impact in the porcelain and may initiate a crack.

3. Indirect White Fillings (made of Composite)

Indirect composite fillings are made similarly to a porcelain inlay/onlay however the material used is composite resin instead of porcelain.

Advantages of Indirect White Fillings

They are more accurate than direct composite fillings.
The fillings have better physical properties and anatomy because they are done outside of the mouth.
They are cheaper than porcelain fillings.

Disadvantages of Indirect White Fillings

They are still made of a plastic material and therefore can wear out sooner and can fracture.

What about Amalgam fillings?

Amalgam is a metal alloy of silver, tin, copper and mercury. It is made by mixing equal weights of mercury and a powder of silver, tin and copper. After mixing, the material sets hard over a few hours.

Advantages of Amalgams

They may not take as long to place as a white filling.
They can be more durable and stronger than a composite filling.
Over time, products are released from the amalgam which seals the microspace between it and the cavity. This can reduce the likelihood of sensitivity and seal out bacteria.

Disadvantages of Amalgams

They are not environmentally friendly.
Mercury is an integral part of an amalgam, however it is not in the liquid form but rather it forms compounds with silver and tin.
Medium to large sized amalgams can weaken a tooth and lead to fractures and cracks to the tooth.

Crowns

Crowns are often required:

When the existing filling in your tooth takes up more room than natural tooth structure, the entire structure is compromised. A crown assists with holding the filling and tooth together.
When the tooth is severely discoloured which can not be addressed with tooth whitening or porcelain veneers.
When the tooth has fractures.
After root canal therapy. These teeth almost always require crowns as they lose a great deal of tooth structure from previous fractures, decay, or the root canal process and are furthermore prone to fracture.
As an anchor for a bridge to replace a missing tooth.

Crowns can be made from several different materials. These include porcelain fused to Zirconia, porcelain fused to gold or entirely of gold.

The crown procedure involves:

Preparing (drilling) the tooth into a shape acceptable for the device.
Taking moulds of the prepared tooth and the teeth that bite into the prepared tooth.
Selecting a shade for tooth-coloured crowns.
Fabricating a temporary crown that will remain in place while the crown is being constructed.
Cementing or bonding the completed crown into position.

This procedure can take from two appointments, but in more complicated cases we may require as many as four appointments.

How do I look after my crown?

As is true with your natural teeth and especially with teeth that have fillings, you should avoid chewing excessively hard or sticky foods. It is especially important not to bite down on hard foods with just one tooth. The porcelain material can fracture under extreme forces. Anything you chew that could break a natural tooth could break a crown!

Which filling type should I have?

We will recommend the best material to meet your specific needs. Longevity of any of the restorations depend on the quality of the materials and the technical skills in construction and placement (we continually review our techniques to ensure we have the best possible technical skills), and how you maintain the fillings or crowns once they are in your mouth.

Clenching and grinding habits will significantly shorten the useful life of any restoration placed. Food and clenching can break your natural tooth and likewise break any restoration. We recommend six monthly check ups and cleaning appointments as problems can be identified and corrected when it is small and simpler to fix.

What is the difference between a crown made at Pyrmont Dental Specialist and elsewhere?

Many crowns have metal lined on the inside for strength. We do not offer inferior metals as an option for any crown, bridge, or implant-supported structures. We also ensure that all materials used by our technicians are of the highest quality and approved by the food and drug administration. This means that in the case of crowns lined with metals we use only high noble metals such as gold, palladium and platinum blends. Base metals are widely used in dentistry as an inexpensive alternative to the noble and high noble metals. Base metals are composed of metals that can have high allergenic, toxic or even carcinogenic properties. An alternative to metals is a white coloured ceramic called Zirconia. A/Prof. Max Guazzato completed a PhD in Zirconia and is world leading in the recommendations for use of Zirconia for teeth. We have made a decision in our practice to provide you with the best and most appropriate procedures and materials that dentistry has to offer and we consider your overall medical health.

Want know more or book an appointment? Please contact us.