Composite Tooth Colored Fillings

What is composite tooth colored filings?

Composite tooth colored filings are a dental filling used to restore a chipped tooth or is used to fill cavities if an individual prefers a natural look.  A tooth-colored filling mimics the look of natural tooth color.  In addition the filling may help to restore the tooth’s natural look.  It may be used for cosmetic changes such as the size or shape of a tooth.


When would you want composite tooth colored fillings?

Composite tooth colored fillings provides a natural look as the material matches the color of the surrounding teeth.  Generally, if an individual has a chipped tooth in the front then a dentist will use a natural tooth colored-filling to build up the area of the tooth that is chipped or broken.  Although less common, a natural tooth-colored filing may be used to fill a cavity in the back of the mouth.


What are some of the advantages of composite tooth colored fillings?

One of the biggest advantages to tooth-colored fillings are the color closely matches that of your natural teeth.  Should you have a weakened or chipped front tooth then the dentist will recommend the tooth-colored filing.  The filling is a chemical so it bonds easily to the tooth versus having to use permanent slots.  The filling will restore a large percentage, as much as 85% – 95%, of the tooth’s original strength.  Having tooth-colored fillings is a quick process as the resin dries in seconds versus other materials that may take days to harden.

White, natural-looking tooth-colored filings are made from a resin.  Because the filling is chemically bonded there is no need for numbing the tooth if the dentist is just fixing a chipped tooth.  Numbing the area would only be necessary if there is tooth decay that has gone below the enamel layer and into the dentin layer which surrounds the nerve.

How are composite resin fillings placed?

Tooth colored composite fillings are chemically bonded to teeth. For this reason, the placement of white fillings does not always require numbing the area being restored. Numbing (anesthetizing) the area is often required if tooth decay has progressed beneath the enamel layer and into the underlying dentin layer which surrounds the nerve of the tooth. Once decay is removed, the tooth is cleaned and a primer (weak acid) is applied to the area being restored. The primer opens pores in the enamel and dentin. A bonding agent is then flowed into the open pores and cured. Curing prepares the bonding agent to adhere to the tooth colored filling material. The filling material is then placed inside the tooth. After shaping the tooth colored filling material to resemble the natural anatomy of your tooth it is hardened by curing with a strong curing light. Once the white filling hardens, your bite will be checked to make sure your teeth fit together properly. If the tooth filling extends into the space between your teeth your dentist will also make sure you can floss between your teeth properly. Adjustments will be made if necessary followed by smoothing and polishing of your new filling.

What are the alternatives to composite resin (tooth colored) fillings?

Alternatives to composite resin fillings vary depending upon the:

(a) Size of the area to be restored
(b) Strength required of the filling material
(c) Esthetics desired
(d) Desire for a longer lasting restoration.

The most esthetic and long lasting alternatives to composite tooth colored fillings are laboratory fabricated composite inlays and porcelain inlays. On the positive side, inlays are longer lasting than composite resin and also more stain resistant. Porcelain inlays do not degrade in the presence of alcohol and are even esthetic. Drawbacks when considering inlays instead of tooth colored fillings include a much higher cost and the need for at least two visits in order to place them because they are made in a dental laboratory.

Compomers (modified composite resins) are also alternatives to composite resin tooth colored fillings. The matrix of this composite filling is composed of a polymer resin and the filler is an aluminum-fluoride-silica powder. Compomers are not as wear resistant as composite resin but they release fluoride and thus are very good in non-load bearing areas more prone to decay. Although esthetically pleasing they do not offer as many options in terms of color and translucency.

Silicate ionomer and glass ionomer tooth fillings are other alternatives to composite resin (white) fillings. Both of these materials are weaker and more brittle than the other alternatives to composite fillings. Silicate and glass ionomers are also not suited for use in back teeth where greater strength is required. Silicate and Glass Ionomer restorations are also less wear resistant than composite resin fillings and do not last as long. In addition, neither silicate or glass ionomer filling materials can match the natural appearance of composite resin. On the positive side, these restorations are capable of releasing fluoride into the tooth structure they are bonded to and in doing so strengthen the tooth and make it more resistant to decay.

Non-tooth colored alternatives

Non-tooth colored alternatives to composite resin are gold inlays and dental amalgam.

Gold inlays are very long lasting and more biocompatible. The cost is high however, and placement of gold inlays requires at least two visits because gold inlays are made in a dental laboratory.

Dental amalgam is also very strong, second only to gold among alternatives to tooth colored fillings. Dental amalgam fillings are also the least expensive alternative to white fillings and they require only one visit in order to place them. Drawbacks to dental amalgam use include the use of 43% to 54% of elemental mercury in dental amalgam filling material. For more on dental amalgam, including concerns about the safety of mercury vapor release from dental amalgam, please refer to this dental amalgam page. As the metal in dental amalgam oxidizes with age the filling material often changes color from silver to black. In addition, placement of dental amalgam fillings at the gum line often causes a dark discoloration of the gum tissue around the filling.

Both metals, gold and dental amalgam, are stronger and longer lasting than composite resin (tooth colored) fillings. Both are also good conductors of heat and cold, and as a result, are more prone to producing tooth sensitivity, especially when the restorations are large or deep.

The best choice for tooth fillings?

When it comes to selecting the best material for you and your particular teeth, consultation with your dentist is key. Strength, esthetics, cost and longevity of dental filling materials may vary greatly in different situations and for different patients. Some of the considerations your dentist takes into account when recommending a particular filling material for your teeth are the current condition of the teeth, the size of the area to be restored, the location of the teeth involved and the forces (chewing, shearing, grinding, etc.) being placed on the teeth during chewing and other normal movements of your jaw.

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