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Home --> Prosthetic Dentistry --> Bonding & Fillings
What Is Bonding?

The application of tooth colored filling material (composite) to the teeth has been a dental technique for many years. Recent advances have increased the strength, durability, and longevity of these restorations. Bonding material can be molded and shaped to achieve outstanding results including tooth lightening, closing spaces between teeth, making teeth appear straighter, and repairing chips and cracks. When polished, it gives the appearance of natural tooth structure.

Spaces between teeth can now be changed and skillfully corrected. People have had spaces between their teeth for centuries. The cause for this situation is usually a discrepancy between the jaw size and tooth size or a heavy bite action that can eventually splay the teeth apart.

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Dental Cavities

Cavities occur as a result of tooth decay. Tooth decay is the destruction of tooth structure. Tooth decay can affect both the enamel (the outer coating of the tooth) and the dentin layer of the tooth.

Tooth decay occurs when foods containing carbohydrates (sugars and starches) such as breads, cereals, milk, soda, fruits, cakes, or candy are left on the teeth. Bacteria that live in the mouth digest these foods, turning them into acids. The bacteria, acid, food debris, and saliva combine to form plaque (Plaque is the sticky, colorless film of bacteria that forms on teeth), which clings to the teeth. The acids in plaque dissolve the enamel surface of the teeth, creating holes in the teeth called cavities, or caries.

To treat a cavity the dentist will remove the decayed portion of the tooth and then "fill" the area on the tooth where the decayed material once lived. Fillings are also used to repair cracked or broken teeth and teeth that have been worn down.

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 What Steps Are Involved in Filling a Tooth?

First, the dentist will numb the area around the tooth to be worked on with a local anesthetic. Next, a drill or laser will be used to remove the decayed area.

Once the decay has been removed, your dentist will prepare the space for the filling by cleaning the cavity of bacteria and debris. If the decay is near the root, your dentist may first put in a liner made of glass ionomer, composite resin, or other material to protect the nerve. Generally, after the filling is in, your dentist will finish and polish it.

Several additional steps are required for tooth-colored fillings and are as follows.

After your dentist has removed the decay and cleaned the area, the tooth-colored material is applied in layers. Next, a special light that "cures" or hardens each layer is applied.

When the multi-layering process is completed, your dentist will shape the composite material to the desired result, trim off any excess material and polish the final restoration.

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 What Types of Filling Materials Are Available?

A number of dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic and glass materials called composite resin fillings. The location and extent of the decay, cost of filling material, patients´ insurance coverage and your dentist´s recommendation assist in determining the type of filling that will best address your needs.

Cast gold

Advantages:

Durability - lasts at least 10 to 15 years, usually longer; doesn't corrode
Strength - can withstand chewing forces
Aesthetics - some patients find gold more pleasing to the eye than silver, amalgam fillings

Disadvantages:

Expense - more than other materials; up to 10 times higher than cost of amalgam filings
Additional office visits - requires at least two office visits to place
Galvanic shock - a gold filling placed immediately next to a silver, amalgam filling can cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur - it's a rare occurrence, however
Aesthetics - most patients don't find any "colored" fillings to be an "eye-pleasing" advantage


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Before Bonding

Before Bonding

After Bonding

After Bonding

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 Silver-Fillings (Amalgams)

Advantages:

Durability - lasts at least 10 to 15 years and usually outlasts composite fillings
Strength - can withstand chewing forces
Expense - is less expensive than composite fillings

Disadvantages:

Poor aesthetics - fillings don't match the color of your natural teeth
Destruction of more tooth structure - healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling
Discoloration - amalgam fillings can create a grayish hue to the surrounding tooth structure
Cracks and fractures - although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, amalgam material - in comparison with other filling materials - may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fractures
Allergic reactions - a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations

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Composite Resin Fillings (White Porcelain Fillings)

Resin fillings are the same natural color as your own teeth. They are often bonded to the tooth, which helps to strengthen it. Composite resin fillings also require the removal of less tooth structure than silver fillings, allowing you to keep more of your natural tooth.

They are more expensive than silver fillings but are considered to be a more conservative treatment due to the fact that they strengthen the tooth.

If you currently have silver fillings, they can be easily replaced with the composite fillings to match your own teeth. If you have a new cavity, your dentist will likely offer you the composite material over silver fillings. The same composite material can be used to improve the overall appearance of your teeth as well, with composite dental bonding.

Silver Filling
Silver Filling

Restored to White Porcelain
White Porcelain

White porcelain restorations, crowns and adhesive resin tooth coloured fillings will rejuvenate your smile, confidence and allow you to enjoy any culinary delight your heart desires.

Advantages:

The shade/color of the composites can be closely matched to the color of existing teeth; is particularly well suited for use in front teeth or visible parts of teeth (known as aesthetics).
Composite fillings actually chemically bond to tooth structure, providing further support to the tooth; composite filling integrates with the tooth, and it doesn't weaken the tooth as a silver filling does
In addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken or worn teeth
Sometimes less tooth structure needs to be removed compared with amalgams when removing decay and preparing for the filling
We now can make a smaller hole, since the white material can flow into small places
Due to the smaller hole, there is more of your own tooth left, leaving it stronger
Secondary decay is easier to spot beneath tooth colored fillings
If damaged, they can be easily fixed
They are temperature and electrical insulators-resistant to extremes of heat and cold. Composite insulate the tooth from excessive temperature changes
Allowing us to fix smaller cavities
You don't have to wait till a cavity gets "big enough to fill"
In some cases we can do an almost microscopic filling just when it starts by using air abrasion instead of the drill. These are often done without anesthetic if we catch them early enough
They are a more natural, attractive choice
Composites bond to the tooth to support the remaining tooth to help prevent breakage
Composites (white fillings) last about 8 years with a range of 7-10 years
Environmentally safe: no hazardous metal wastes to dispose of and no risk of mercury allergy

Disadvantages:

Lack of durability - composite fillings wear out sooner than amalgams (lasting at least 5 years compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgams under the pressure of chewing and particularly if used as the filling material for large cavities
AIncreased chair time - because of the process to apply the composite material, these fillings can take up to 20 minutes longer than amalgams to place
Additional visits - if composites are used for inlays or onlays, more than one office visit may be required
Chipping - depending on location, composite materials can chip off the tooth
Expense - composite fillings can cost up to twice the cost of amalgams


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