White Composite Fillings
Composite Fillings are most commonly known as white fillings. One question that few patients ask is, ” Why don’t dentists just automatically place white fillings instead of the horrible looking silver ones?”
Certainly there is a cost difference and the NHS does not encourage dentists to use white fillings. Although white fillings are generally done under a private basis, the cost difference is actually not that much so there must be other reasons. Placing a white filling in a tooth is a lot more demanding, requires more skill, it is much more technique sensitive and a lot more can go wrong afterwards. If any moisture gets onto the tooth whatsoever, this will create gaps causing the filling to leak and in turn causing sensitivity or even worse, new decay can spread undetected which will progress into the root.
I once saw a new patient who had had 8 white fillings done only a year previously with another dentist but was experiencing pain with one of them. Although these fillings looked intact on visual examination, on the x-rays, it was a total horror story. All 8 fillings were leaking. Of these, 3 teeth needed extractions as the decay had gone so deep to make these teeth unsalvageable. A further four required root canal treatment with crowns and one filling had to be replaced.
As a patient, the moral of the story is that if you are going to have white fillings, make sure you get some kind of assurance from the treating dentist that they will be done properly and once done, make sure x-rays are taken to confirm that they are not leaking.
Having sent out the above warning, I have done many thousands of white fillings successfully. Overall, I would say that they do wear down quicker than amalgam fillings so will need to be replaced at more frequent intervals. Finally, if you are going to have one placed in your tooth, it is definitely better for the dentist to use rubber dam for which you can find a separate link to. There are also certain circumstances where white fillings are not the treatment of choice. Also at present, I do not routinely recommend patients have their old silver ones changed unless there is a good reason to apart from just cosmetic concerns. So all in all, I myself, prefer to place a white cosmetic filling wherever possible as long as the technique is meticulous and the patient understands their limitations.
Restorative Dentistry : An Integrated Approach
by WELBURY R.
Medical Problems in dentistry by Crispian Scully
Master Dentistry: Volume 1: Oral and Maxillofacial Surgery, Radiology, Pathology and Oral Medicine