Direct white fillings

These are a popular alternative to the silver amalgam filling and are preferred for their superior function and appearance. Plus there are people who have concerns about the safety of amalgam fillings in regard to the inclusion of mercury.

For these people, the direct white filling is an option.

What are direct white fillings?

To start with, let us explain the use of the word ‘direct’ in connection with fillings.

Basically, there are direct and indirect fillings.

Indirect filling

The indirect filling is the name given to an inlay/onlay which differs from your standard amalgam filling: the difference is that they are produced in a dental laboratory before being inserted into your tooth.

This means two visits to your dentist. The first visit involves the preparation for the inlay/onlay and the second visit is the actual fitting of the inlay/onlay.

Inlays and onlays are discussed further in a separate section.

Direct filling

The direct filling is just that: it is inserted into your tooth (e.g. cavity) during a single visit to your dentist. This immediate or direct form of treatment is ideal for people with busy lives who have teeth with a small amount of decay.

There is a choice of materials for fillings which include ceramic, silver amalgam and composite resin. Ceramic and composite fillings have a white appearance which means that they will closely match the rest of your teeth.

This is why they are preferred for cosmetic reasons.

The advantages of direct white fillings

They are ideally suited to people with small or medium tooth cavities. Plus they have a natural colour which fits in well with your tooth.

Disadvantages of direct white fillings

The only disadvantage is that the filling becomes cracked or loose and then falls out of the tooth. However, the likelihood of this happening is small.

This is a risk with any type of filling and inlay/onlay.

How are direct white fillings fitted?

This is a skilful procedure which requires a high level of expertise.

The dentist has several options in regard to the technique he/she uses which will affect the price. So, the more complex and time consuming the process the more expensive the treatment will be.

Three considerations

The procedure has three issues to deal with:

• Shrinking of the filling
• Wear and tear of the filling
• Coverage of the filling

There is the risk of a filling starting to shrink around the edges which then leaves a gap between the material and the tooth. The problem with this is that it enables bacteria to access that space which can lead to an infection.

So the filling has to be applied in stages to ensure that it covers the cavity and is both strong and durable. Polishing and/or glazing the filling will reduce the risk of wear and tear, e.g. cracking or splitting.

The filling is bulked out with different layers so that it protects the internal structure of the tooth and prevents further decay. The aim is to strengthen the tooth and maintain its function.

The procedure for a filling involves you being given a local anaesthetic beforehand. This will help to numb the area to be treated. This may be accompanied by sedation and if it does then ensure that someone will drive you home afterwards.

The affected tooth will be restored (e.g. built up) and/or decay will be removed before the filling is placed. It is then cleaned and the cavity plugged with the filling material which then bonds with the tooth.