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Tooth repair




A healthy trend has been gathering momentum: We're holding onto our teeth for longer than ever before -- thanks to fluoride, better dental care, and just good old fashioned oral hygiene.

It's good news for your overall health, because holding onto your teeth helps you look and feel years younger than you are. Not only does it help guarantee trouble-free, pain-free munching on healthy goodies like nuts and fresh apples, but a full set of choppers can also keep your cheeks from sinking, slow the natural thinning of your upper lip, discourage extra-deep wrinkles around your mouth, and help keep your jawline firm and your bite stable.

When Trouble Brews
But, hey, few people get very far in life with all of their teeth in perfect shape. So if a little bit of decay creeps into your smile, see your dentist for repair options as soon as you can. Science has engineered myriad ways to restore and stabilize tooth structures so that your smile remains strong -- and natural looking -- for many more years to come.

While you make your next appointment, brush up on some of the pros and cons of both the old and the new dental-restoration materials.

Plastic? Yes, Plastic
A plastic filling -- also called a "composite" or "white" filling -- is a relatively new class of dental-restoration material. In its early forms, it was prone to breaking. But the material has been greatly improved in the last couple of decades. It's made of acrylic resin and fine glass particles and can be mixed to look pretty close to tooth color. Thus, dentists today use composite material much more often than the old standard -- silver amalgam -- because people want their restored teeth to look more natural. Also, even though health and environmental concerns about mercury in amalgam fillings have not yet been proved, some people opt for composite to avoid mercury -- as do some dentists.

PROS

  • Is tooth-colored and natural looking
  • Is strong enough to fill small to midsize cavities
  • Won't corrode
  • Can adhesively bond to the tooth, adding strength
  • Requires less removal of healthy tooth structure during the drilling phase, in most cases

CONS

  • Isn't likely to be durable enough to fill large cavities
  • Is vulnerable to coffee and tea stains
  • Wears down faster than silvery amalgam fillings
  • Costs more and takes longer to place than amalgam fillings

Glass -- Well, Partly Glass
A combination of glass and acrylic -- known as glass ionomer fillings -- is most often used for delicate filling work, like in baby teeth or adult cavities located under the gumline, where the root joins the tooth. Or between teeth, if they're not load-bearing. Glass ionomer is very good for these purposes because it can be layered thinly. But glass ionomer fillings can't stand up to the wear and tear experienced by chewing and load-bearing surfaces. And although the material is white, it's not as natural looking as composite fillings.

PROS

  • Applies thinly enough to avoid removal of much healthy tooth structure
  • Bonds chemically with the tooth to prevent further decay
  • Releases tooth-strengthening fluoride for a long period of time because the raw materials of the filling contain the compound

CONS

  • Is white, but not translucent, which can make it a no-go for teeth that are front and center
  • Is not durable in teeth that bear the force of grinding and chewing
  • Is not good for large fillings

Amalgam: The Old Standby
You probably think of amalgam as a silver filling, but it's actually a mix of several metals that may include silver, copper, and tin and almost always includes mercury. Amalgam continues to fall out of favor among both dentists and patients for two reasons: For one, it's anything but natural looking. The silver color darkens over time and clearly stands out against natural teeth. For another, its mercury content has made it controversial. But it's still very strong and durable, outlasting newer materials.

PROS

  • Is inexpensive and durable
  • Is strong enough to withstand the forces of chewing
  • Doesn't wear down opposing teeth

CONS

  • Requires removal of some healthy tooth structure
  • Corrodes and darkens over time
  • Conducts heat and cold initially; some cold sensitivity may linger
  • Requires special handling precautions by dentists because of the mercury content

Porcelain -- Yep, Like Your Bathroom Sink
This glasslike material -- also called a ceramic filling -- isn't applied directly to your tooth or shaped by a dentist, like a traditional filling. Instead, the material is created in a lab, where it's custom formed into a toothlike or partial toothlike shape. It is later cemented into place by your dentist. A porcelain filling basically replaces or covers the tooth enamel that has worn off or been lost to decay. Because it's porcelain and shaped in a lab, it can be made to look very much like the natural tooth structure.

PROS

  • Is tooth-colored and natural looking
  • Tends to more accurately resemble a tooth's natural contours
  • Is long lasting -- porcelain is tough stuff
  • Is custom fitted and bonded to the tooth, so further decay is unlikely

CONS

  • Is strong enough to wear down opposing teeth
  • Is more expensive than composite
  • Is bulky, so often requires removal of healthy tooth structure
  • Takes two or three appointments, on average, to custom fit and cement into place

Gold -- Yes, It's Very Expensive
Though most people would rather have a gold watch than a gold tooth, this precious element can be mixed with other metals to create a high-quality, custom-made filling that is cemented into place -- much the same way that a porcelain filling is. A gold filling is sometimes also combined with porcelain crowns. Still, it's obviously not a natural-looking option. Gold does have one big thing going for it, though: It is extra durable.

PROS

  • Is extremely strong
  • Is gentle on opposing teeth
  • Is tarnish resistant and doesn't corrode
  • Doesn't let bacteria, food bits, or saliva seep through

CONS

  • Is very obvious and hardly natural looking
  • Is expensive; can cost up to 10 times more than amalgam
  • Will corrode amalgam fillings when placed next to them
  • Conducts heat and cold initially

A Filling Isn't Forever
As good as any filling material may be, eventually it will probably need replacing because of wear and tear, especially if you're a tooth grinder. But taking good care of your teeth could extend the life of your fillings.

Sometimes, though, decay will progress to the point where a filling just won't cut it. That's when your dentist may suggest a tooth-shaped cap called a crown. It's a great problem solver for broken, chipped, fragile, or badly decayed teeth. It's also a good option during tooth replacement or for teeth that have had root-canal therapy.

Whatever the case, when you lose a tooth or have a severely compromised tooth structure, it's best to fill that space properly with some kind of dental restoration to help keep your bite stable. Because losing just one or two teeth can add years to your RealAge and put the rest of your smile in danger.