When the decay has destroyed less than about 50% of the chewing or biting surface of the tooth, we can usually place a "filling".
For many years, mercury/silver amalgam filling materials have been the standard filling material for back teeth.
Tooth colored plastic filling materials are as good as or better than amalgam by all measures. Tooth colored fillings look better, are bonded to the tooth structure so they provide a measure of support and strength for the restored tooth and last about as long.
Tooth colored fillings are often smaller and more conservative than silver fillings. This help preserve good tooth structure. The downsides to tooth colored fillings are greater skill level and slightly longer time needed for placement and a higher cost due to materials and time factors.
You can expect tooth colored filling to cost 25-50% more than a comparable mercury/silver filling.
If patients wish a longer lasting restoration, or if the size of the filling is greater than 40-50% of the biting surface of the tooth, then an inlay may be chosen.
Inlays are fillings that are processed in a dental lab. They are usually gold or porcelain.
The life expectancy of inlays far exceeds that of fillings, especially with gold inlays. I have patients with gold inlays that are over 40 years in the mouth.
By definition, an inlay lies inside the cusp tips of the tooth.
If an inlay covers one or more cusps of a tooth, it is considered an onlay.
Onlays have the same advantages as inlays, but are used when tooth damage is more extensive.
Also known as a "cap", a crown is used to restore badly broken teeth, or teeth with very large fillings that would prone to fracture. The crown acts like a "thimble" to prevent the fracture of the tooth.
Crowns may be gold, porcelain or when strength and appearance are required porcelain fused to metal frameworks. (See our Cosmetic Dentistry section).
