Teeth with damaged structures can be restored through various techniques, which include fillings, crowns, and veneers.
The structural integrity of a tooth is determined by a person’s genetics, their medical history, and their hygiene habits. Cavities or dental caries are a common form of structural tooth damage due to bacterial decay. When the structure of a tooth is damaged, it must be repaired to prevent further weakening of the tooth structure leading to the eventual destruction of the tooth.
Teeth with minimal amounts of structural damage can be repaired by several methods, which include amalgam fillings, composite fillings, and porcelain inlays. These various filling types differ in their durability, their cost, and their aesthetic appearance, as discussed below. In comparing the durability of filling types, patients should realize that genetics and personal hygiene also have an effect on the durability of tooth restorations.
Amalgam or silver is the most commonly used filling material used by dentists. Amalgam is durable and generally outlasts other types of filling materials. Amalgam fillings are relatively inexpensive and are frequently covered under most insurance plans. Patients should be aware that amalgam fillings are less aesthetically pleasing than other filling types, as they are a dark grey color. Numerous published studies have examined the safety of amalgam fillings. While amalgam fillings do contain mercury, the mercury is trapped inside the metal. According to the American Dental Association, amalgam fillings are safe and will continue to be a preferred filling material for years to come.
Composite or plastic fillings are aesthetically pleasing, tooth colored fillings, which are nearly indistinguishable from natural tooth structure. However, they are less durable than amalgam fillings. The bonding agents that anchor the composite to the tooth may also make the tooth itself more sensitive to hot and cold for a period of time after the tooth is filled. The composite filling process is also somewhat more time-consuming and costly than the amalgam filling process. However, a patient who desires a pleasing aesthetic appearance will find the increased cost of the composite filling negligible.
Porcelain inlays and onlays are tooth-colored pieces of glass, which are bonded onto the tooth surface to replace the missing tooth structure. Porcelain fillings are the most durable filling type. They are also the most natural, aesthetically pleasing fillings available. They are more natural in appearance than any other available type of fillings. The porcelain filing procedure takes place in two visits.
When the structural damage to a tooth is great enough that the tooth cannot support a filling, the tooth is repaired with a crown. Crowns are restorations that replace the enamel on the tooth and hold the tooth structure together. Beneath the crown, the tooth’s internal dentin structure is replaced by a stabilizing core or post.
There are many different varieties of crowns. Standard crowns are porcelain crowns, which are fused to metal restorations. They are somewhat aesthetic, as they match tooth shade and color. However, they do not have the aesthetic vitality of esthetic crowns, which contain little or no metal and are thus more natural in their appearance.
Veneers are thin porcelain discs that replace the façade or front surface of a tooth. Veneers are the most reliable and aesthetic way to change the shape and color of a tooth. Porcelain is able to mimic natural looking tooth structure and is also stain-resistant. The procedure generally requires minimal tooth preparation prior to veneer placement.