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Restorative Dental Treatments

dental procedure

At Thorough Dental Care, we customise treatments for each of you and will recommend the types of fillings you require. There are a number of techniques to restore teeth to optimum health and function:

  1. White fillings placed directly in your mouth (composites)
  2. Indirect white fillings (porcelain inlays/onlays)
  3. 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:

  • More attractive than amalgam fillings.
  • Teeth may be strengthened as it bonds to the surrounding tooth, while an amalgam may sometimes weaken a tooth.
  • As composite fillings do not need mechanical locking for retention, so the cavity preparations are more conservative, hence preserve more tooth structure

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.
  • Food can get jammed between the teeth if the filling does not touch the adjacent tooth tightly. Composite fillings cannot 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 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 require 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 filling will be placed over the tooth until the next visit.
At the second visit, the temporary filling is removed and the inlay/onlay is fitted and bonded into place then polished.

Advantages of Inlays/Onlays:

  • 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. 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 alone, porcelain fused to Zirconia, porcelain fused to gold or entirely of gold.

The crown procedure involves:

  1. Preparing (drilling) the tooth into a shape acceptable for the device.
  2. Taking moulds of the prepared tooth and the teeth that bite into the prepared tooth.
  3. Selecting a shade for tooth-coloured crowns.
  4. Fabricating a temporary crown that will remain in place while the crown is being constructed.
  5. Cementing or bonding the completed crown into position.
    This procedure can take two appointments, but in more complicated cases we may require more than two 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, 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.