Composite Fillings

Composite fillings are a popular choice for many dental patients as the shade of the material used can be closely matched to the teeth - this creates a pleasant natural appearance when a patient smiles or laughs. They are made by mixing a resin base with quartz, powdered glass or other ceramic material and are individually mixed for each patient. Composite fillings are not as long lasting as silver amalgam ones and how long they last will depend on where in the mouth they are fitted and how hard your bite is. Your dentist will be able to advise you on this. In addition, there are two other forms of white filling; glass ionomer fillings which are suited to non-biting surfaces as they are fairly weak, and the hard wearing but more expensive porcelain inlays.


Who Should Get A Composite Filling?

Composite fillings are designed for anyone who wants to cover up a small to medium area of tooth decay in an aesthetically appealing manner. They can also be used to cover up stained areas of teeth and for correcting the appearance of disfigured teeth. They are not, however, suitable for large areas of tooth decay and in those instances your dentist is more likely to suggest you opt for a porcelain inlay.

How Is A Composite Filling Fitted?

Firstly your dentist will give you an injection into your gum line to numb the area that is being treated. They will then dry the tooth, surround it with a rubber dam, and remove any tooth decay. Once the tooth has been cleaned up, a slightly acidic gel is applied to the tooth to create an rough base for the resin to adhere to. The composite is then applied a layer at a time. After each layer has been placed, it will be hardened using a blue light lamp. Finally, when all composite has been applied, an abrasive will be used to remove any rough edges.


Advantages

There are a number of advantages associated with teeth composites, the most obvious being the aesthetic difference.

composite fillings can be made to look natural

Direct dental composites are available in a wide range of shades to allow for near-perfect colour matching to natural teeth, all of which bond well to the tooth structure. Composite fillings can micro-mechanically bond to a tooth’s structure, both strengthening it and restoring it to it’s original look. Another benefit is the natural look that can be achieved, but not at the expense of the healthy tooth. As composite fillings are glued to the tooth as opposed to amalgam fillings, the dentist does not need to damage or destroy a healthy tooth to create retentive features that assist with adhesion. When compared to dental crowns, composites are a less expensive alternative, and yet are still effective. Installation of a crown normally calls for a significant amount of healthy tooth to be removed, which is not necessary with composite restoration.

Restoration is also an excellent alternative to total tooth removal. As the physical integrity of a tooth can be restored with the use of the composite, there is no need to remove a tooth as you may have to if you wanted to use an amalgam filling. Composites are versatile too; with an amalgam filling, a hole is drilled into the tooth around the decay to create an even space to fill, but composite fillings can repair a number of imperfections such as worn enamel, chipped teeth and broken teeth. Should the composite become damaged or chipped itself, it can easily be repaired with a visit to the dentist, whereas an amalgam filling would likely need to be replaced completely. Amalgam fillings can also be subject to slight corrosion, although not to the levels they one were, but one distinct advantage of resin composites is the fact that they do not corrode at all.


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Disadvantages

There are a few disadvantages to composites that you should be aware of when choosing this over other reparative dental work.

For example, composite resins have in the past been subject to substantial shrinkage during the curing process, which led to an inferior bonding interface. Along with inferior adhesive properties, shrinking creates the possibility for microleakage to occur, which can cause subsequent further decay if not detected early. This subsequent decay is thought to be one of the most distinct disadvantages of composite restoration; a survey of 1,748 restorations revealed that the risk of secondary caries in the composite group was 3.5 times that of the risk of secondary caries in the amalgam fillings group. The durability of composite fillings can in some cases be less than that of amalgam fillings, which many can deem a disadvantage. If you play contact sports or engage in physical activity in which you are at risk of chipping your tooth, an amalgam filing may be better, as composite materials can chip off the tooth.

When the composite is being fitted, the mouth area needs to be kept completely dry. The tooth must be kept dry as the resin is applied and cured, and while may seem straightforward for teeth at the front, it can be complicated when treating Posterior teeth (molars). Because the application process can be more complicated and therefore take longer than with other types of filling, it can mean that the fittings are more expensive. Composite can take up to 20 minutes longer than amalgam fittings, and so many people opt for the latter for the convenience factor.

Practicing good dental hygiene and attending regular check-ups with your dentist can prevent many of these issues occurring, particularly the risk of secondary caries occurring.


Costs Of Composite Fillings

Composite fillings are only available on the NHS when there is a clinical need for them and your dentist will be able to advise you if this is the case. If you are eligible, then they fall under Band 2 treatment costs, which at the time of writing is £49. Some people are entitled to free NHS dental care and they include; people under the age of 18, expectant mothers, women with a child under 12 months, anyone claiming income support and those in receipt of pension credits.

If you have a low income, it is possible for you to apply for help with NHS dental costs. You will need to complete an NHS Low Income application form which can be found at any dentists, job centre or hospital. Your eligibility will be assessed after a review of your income and outgoings.

If you only have a cosmetic need for a composite filling, then you will have to visit a private dentist for your treatment. Prices vary widely but typically an anterior composite filling costs in the region of £60 - £100, whereas a posterior filling costs upwards of £160. Your dentist will be able to give you an accurate quote once they have carried out an examination of your teeth.

Aftercare

You can eat and drink almost straight away after having your composite filling, however many people prefer to wait for the numbness from the anaesthetic to subside. One of the main issues regarding composite fillings is that they are prone to staining, therefore it is advisable to avoid tea, coffee, red wine and smoking if you want to maintain their initial appearance.

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