Smile Specialist

Replacement fillings, cosmetic materials, bonded fillings and restorations, Cosmetic Dentistry including all Dental Implants, MTI mini Implants, immediate Dental Implants, Crowns, Bridges, Veneers, Precision Dentures, Tooth Bleaching, Teeth Whitening, Cosmetic Bonding, Latest Ceramic Restorations, Second Opinions, Smile Profiling, Gum Diseases, Tooth wear and worn, uneven teeth, Periodontal Plastic Surgery, TMJ's, Difficult Occlusions, Excessive Wear Cases, Root canal treatment, Trauma and Emergencies; Anxious or Nervous Patients welcome too!

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The answer is simply the same filling type or different materials, or a different type of restoration that isn't a filling.

Filling types:

1. Amalgam - this contains Mercury, Silver, Copper, Nickel and Zinc usually, mixed (amalgamated) together to make an alloy.
Amalgam has been around for over 100 years, though it's formulation hasn't changed much Current scientific evidence (01/01/01) suggests that although it contains Mercury (a known poison), once mixed it does not harm health noticeably. Many people prefer not to have Amalgam fillings put back in their mouths, even if they do last an awful long time. Despite current evidence, more and more patients are requesting non-mercury-containing restorations.

2. Composites - these have been around 40 years or more and have progressed from being chemically set, to being set with a blue light. They are hard, strong (not as strong as amalgam), tooth-coloured and don't contain Mercury. They do, however, contain some plastic chemicals that may mimic female hormones (Bisphenol-A), but there is no evidence of this happening in Dentistry. In fact, softer plastics like carrier bags and cling-film contain more Bisphenol-A than hard Dental fillings.
There are different Composites for different purposes, including microfills and Hybrids. These can be chemically bonded to your teeth to both seal and retain your restorations. There are also many Cosmetic choices available too, with very natural effects possible using mamellon contours and layering techniques with transluencies.

3. Glass-Ionomers - These were a British discovery in the 1970's. They do not shrink, are tooth-coloured and naturally bond and seal to tooth substance. They do not contain plastics or mercury, but they do not wear as well as Composites or Amalgam. They can however be combined with these restorations in certain circumstances and leach out fluoride to prevent new decay.
Glass-Ionomers are a flexible versatile restorative that chemically is more biocompatible than many other alternatives.

4. Compomers - these are combinations of Glass-Ionomer and Composites. Unfortunately they are prone to expanding later so are not recommended for bonding porcelain work on with, as this can then cause cracking later.

5. Inert Glasses - these are pre-formed shaped restorations that can be used in areas of high stress and have the same wear characteristics as normal teeth. They can be bonded to tooth substance and Composite materials, without the disadvantages of other restoratives.
Materials like these (eg:Cerana) are the most biocompatible, strong and aesthetic restorative to give a tooth strength and beauty combined, on the same visit.

6. Indirect fillings - these are made in a laboratory or in a milling machine and are then cemented into your mouth. They take longer to do, often involve several visits and cost more than the previous alternatives. They look good, are strong and can be bonded too.
Indirect fillings such as inlays or onlays can be metal, gold or porcelain and are more suitable for larger holes or replacement fillings, where the extra strength of a Crown is not needed.

There are many ways to restore a filled tooth, depending upon your cosmetic and cost limitations, as well as the biting forces it will be subjected to. Sometimes, even the strongest fillings fail (usually because of the tooth being hollow and weak) and another alternative such as Crowns or Bridges need to be considered.

Your Dentist or Specialist can advise you about your personal needs.

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