Melbourne Smile Clinic
Covid-19 precautions in place: Routine Dental treatment is available for patients who present no Covid-19 risk factors. Patients who have tested positive to Covid-19 and/or display Covid-19 symptons are advised to delay dental treatment until clear of all risks.  Patients will need to hand-sanitise and use a disinfecting mouthrinse prior to treatment being provided. All our staff is currently vaccinated as per mandated by the Victorian Government.
 
Fillings
To repair decayed teeth conservatively

White filling materials are used to obtain a long-lasting, natural and cosmetic result.

Fillings | Dentist

Fillings

 

When are fillings needed?

Dental decay or caries is caused by bacteria penetrating through the outer enamel of a tooth into the subsurface called the dentine. Once decay has started in a tooth, it will keep progressing until measures are taken. If the decay is detected very early one and is only in the outer enamel layer, preventive measures can be taken to arrest the progress. These include improved home care, reduction of dietary sugar, and topical application of fluoride treatments. In the early stages of decay development, there is usually no pain from the affected tooth. When symptoms are experienced, it usually indicates that the decay is very advanced and therefore, the filling will be bigger and more complex.

At the Melbourne Smile Clinic, we believe in the preventive approach and early detection. This is why taking x-rays is necessary, so as to detect decay early. 

How are fillings done?

The decay is cleaned from the tooth under local anaesthetic, leaving a cavity in the tooth. This cavity has to be filled and sealed to prevent further entry of bacterial into the tooth and protect the exposed dentine subsurface, which otherwise would be sensitive.

A filling material is therefore used to fill the cleaned cavity.

The material most commonly used nowadays is RESIN COMPOSITE.

Resin composite consists of silica or zirconia particles held together by a resin matrix.

The resin composite filling material comes in various shades to match the natural tooth colour to achieve a natural result where the filling does not stand out from the rest of the tooth.

These decayed front teeth have been filled with resin composites

What are the Advantages of resin composites:

  • Tooth coloured material that can be made to blend in with the natural tooth surface, allowing an aesthetically pleasing result.
  • The resin composite has chemical properties that allows it to be bonded to the tooth surface, allowing a good long-term retention of the filling into the tooth
  • Resin composite fillings can easily be repaired or replaced if they wear down or chip.
  • Resin composite has good fracture and wear resistance under normal chewing forces.

What are the Disadvantages of resin composites:

  • Placement of a resin composite in a tooth is technique- sensitive. The operator must ensure the tooth is dry and uncontaminated with saliva during placement of the filling as otherwise, the material will fail to bond properly to the tooth surface and will fail more quickly.
  • For larger cavities, resin composite is not as long-lasting and can wear down or fracture more easily. In such cases, ceramic materials are preferable.
  • Resin composite fillings can stain over time and lose their surface sheen. Polishing the filling can restore the filling but can lead to surface wear over time until replacement is necessary

How long do fillings last?

Several factors affect how long a filling can last. These are:

  • Size of the filling- the larger a filling is, the higher the likelihood of failure or other complications as a large filling means that there was a large amount of decay in the tooth to start with. With extensive decay, a tooth is more likely to develop further issues such as nerve inflammation.
  • The location of the tooth in the mouth affects the likelihood of the filling failing. A filling in a back tooth that does most of the chewing can wear down or chip more easily than a filling in a front tooth.
  • Oral hygiene level will affect the lifetime of a filling. With poor oral hygiene, there is a higher likelihood of decay developing again under or around an existing filling, causing failure.
  • A diet high in sugary and acidic foods can also lead to increased rates of decay under and around existing fillings.

The higher the number of fillings a person has, the more important it is to have good oral hygiene, avoid frequent sugary foods, have regular checks and cleans at the dentist in order to maximise the lifetime of the fillings.

Fillings Technology

Digital Radiography

The use of digital radiography not only reduces the dosage of x-ray radiation that the patient is exposed to when radiographs are taken, they also eliminate the use of x-ray films and a layer of lead that eventually ends up as waste. Additionally, the use of x-ray developer solutions is eliminated, hence also reducing the production of potentially toxic waste.

Frequently Asked Questions

Several factors affect how long a filling can last.

These are:

  • The Material used- Resin composites are not as durable as amalgam (silver) fillings.  However, the strength of resin composites have improved over time and some studies have shown that the durability of resin composites is similar to amalgam fillings when the right technique is used for placement.
  • Size of the filling- the larger a filling is, the higher the likelihood of failure or other complications as a large filling means that there was a large amount of decay in the tooth to start with. With extensive decay, a tooth is more likely to develop further issues such as nerve inflammation. A larger filling is also more likely to chip or fracture. 
  • The location of the tooth in the mouth affects the likelihood of the filling failing. A filling in a back tooth that does most of the chewing can wear down or chip more easily than a filling in a front tooth.
  • Oral hygiene level will affect the lifetime of a filling. With poor oral hygiene, there is a higher likelihood of decay developing again under or around an existing filling, causing failure.
  • A diet high in sugary and acidic foods can also lead to increased rates of decay under and around existing fillings.

The higher the number of fillings a person has, the more important it is to have good oral hygiene, avoid frequent sugary foods, have regular checks and cleans at the dentist in order to maximise the lifetime of the fillings.

Biocompatibility
All materials used in the dental setting have been approved by the Australian TGA (therapeutic goods administration)

Resin composites
Resin composites are commonly used routinely as a tooth-coloured filling material. There is concern from members of the public that they contain bisphenol A (BPA) which is thought to have oestrogenic effects on cells. The evidence comes from studies showing that BPA binds to oestrogen receptors in vitro. However, the oestrogenic effect of BPA is 1000-fold less potent than the native oestrogen hormone.

All current resin composites consist of methacrylate monomers (such as Bis-GMA) and DO NOT contain BPA. However, BPA is a synthetic chemical starting point from which all methacrylates are derived – in dentistry as well as many other plastics.

No evidence exists that dental composites have estrogenic effects in vitro or invivo.

Dental ceramics
Dental ceramics are very chemically inert materials and remain stable over very long periods of time. They therefore have excellent biocompatibility.

They furthermore exhibit excellent flexure strength, fracture toughness, wear resistance and colour stability. The ceramics can also be formed into precise shape to replace missing parts of a tooth.

They are an excellent material where a substantial part of a tooth is missing or for crowns.

However, in order to be held onto the tooth, the ceramic restoration has to be bonded to the tooth surface with a cement.  The cement in some cases has to be a resin cement in order to provide the best adhesion.  Resin cements have chemical similarities to resin composites which have been described above.

Reference: Phillips’ Science of Dental Materials, Kenneth J. Anusavice 2007.

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  • Dr. Christine Yew BDS (U. of Melbourne), BSc (McGill U.)

    School/Training

    Dr Yew has over 20 years of experience in dentistry, graduating with Honours from the University of Melbourne in 2001. 

    Dr Yew is registered with AHPRA (the Australian Health Professional Regulation Agency: registration no. DEN0001023296)  and is a member of the ADA (Australian Dental Association).

    Dr Yew has been involved in the ADA mentoring programme  where she volunteers her time to offer advice and guidance to recently graduated dentists. Currently, she is a clinical supervisor for 3rd year dental students at the University of Melbourne and is also a member of the ...

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