When it comes to dental fillings, patients’ expectations have increased in recent times. Nowadays, aesthetics rank highly among these expectations and are for some patients the main reason for visiting a dentist in the first place.
In order to mask or hide fillings on teeth, it is imperative that our filling material should mimic the characteristics of the tooth structure it is replacing – in terms of colour, texture, translucency, strength, flexibility and wear, among many other considerations.
White fillings can be separated into very two distinct categories. Firstly there is the porcelain filling, which is also called an inlay/onlay, ceramic or Cerec filling. Secondly there is the composite filling, also referred to as a resin filling or plastic filling.
We dentists often say the difference between porcelain fillings and composite fillings is like the difference between crystal Champagne flutes and plastic camping cups.
Porcelain or Cerec fillings are pressed or milled outside the mouth and then cemented into the prepared cavity. As new technology and materials science has evolved, computers are increasingly becoming a part of the design and fabrication process, such as in CAD/CAM dentistry. These inlays/onlays are designed digitally, cut by a specialised milling machine and then cemented in place by the dentist.
Composite or resin fillings are placed directly into a cavity where they are set/cured and change from a soft putty into harder material and bond to the tooth structure.
In order to make an informed decision about which option suits your needs best, it’s important to understand the limitations and advantages of each type.
Porcelain fillings are most suited to restorations of:
- back molars, amalgam replacements and larger fillings that require more than one surface replacement
- both front and back teeth where there is a heavy wear factor, as we find with patients who bruxate (clench and grind)
- front teeth where cosmetic smile designs require shape, colour and size modifications.
Composites are great for very small cavities that do not comprise more than two surfaces of the tooth and these surfaces should ideally not be on the occlusal (or chewing) surface where there is less resistance to wear. They are also better suited for cavities above the gum and on teeth that do not carry a heavy load, such as most front teeth.
There is no denying that, in most cases, porcelain fillings are vastly superior to composite fillings. However, many patients are reluctant to commit to this treatment option due to the higher cost involved, especially when more than one tooth is affected.
That said, in the long term the porcelain option may in fact be more cost-effective. That’s because composite fillings tend, on average, to need replacing three times more regularly than porcelain fillings.