Dentalnews (en)

Composite (Plastic) fillings – are they worth the cost?

White fillings are in ever greater demand – but they are not always a good idea!

People are sick of silvery amalgamate, people want to look good, and this includes having a perfect set of teeth. Many people are now getting their amalgamate fillings replaced by white fillings. In the picture you see diffrent white Fillings: Composite (1); Glasionomercement = GIZ (2); Ceramicinlays (3); Goldceramicinlays (4).

–

Be aware: Composite fillings do not work that well in side teeth, a fact which many people do not know!

–Even manufacturers warn that these fillings should only be used to correct surface defects, since teeth do not react well to them. The tooth nerve often dies when this type of filling is used, leading to a root canal.

–

Patients who get their amalgamate fillings replaced by plastic are in for a bumpy ride. The fillings consist of tiny building blocks called monomers. As soon as a dentist shines a lamp on the filling, these little monomers start to connect – like Lego blocks, a process called polymerisation, which results in polymers – larger building blocks.

–

But these plastic structures are not stable enough to hold up under chewing, so little „Lego blocks“ – monomers – start to separate (green area means Composite Fillings are ok, red area means Composite Fillings are not ok). These free-floating monomers are very toxic, they invade the tooth nerve, and the nerve dies.You do not feel the pain right away, it may take years for the   „dead“ tooth to start making trouble, so patients do not always attribute this problem to the plastic filling. Some patients experience problems immediately after the plastic is inserted, such as problems when chewing, pressure, excessive sensitivity to heat or cold.

–

While some dentists specialize in this type of filling and use a coffer dam, special covers and layering methods to prevent complications, but plastic fillings still end up costing about as much as a ceramic inlay. But ceramic inlays are much better for your teeth than composite fillings – assuming the inlay is inserted correctly.

–
White teeth may be more trouble than they are worth! Think about what you’re doing. If you invest in your teeth, then be sure to use goods materials – gold, titanium or ceramics!

And/or develop a better brushing technique, because if you have poor brushing habits then you will need fillings someday.

Toothache 4/5

Teeth gone, toothache and desperation still around!
–

–

–

–

Nothing but clouds on the horizon and a lot more mileage on the car.
Now you have no more teeth left, except maybe in the front – if you’re lucky. And still, nobody knows where the pain is coming from. It would have made your life a lot easier if this „vicious circle“ had been stopped much earlier, e.g. with a properly performed root canal or root tip resection.

–

Hopefully only a few of you have gotten to this point, because for most of you this ordeal should have ended sooner – with some competent professional treatment.
–

So why is the toothache still around?
Well, there are many reasons, and it usually takes an experienced team working together closely to solve the problem. For example, your body may be so used to feeling pain that some vestige of it remains even after the cause is gone. Also, your jaw may just be stressed out from the operations and tooth loss it has to undergo. There may be inflammations somewhere in the bone, or maxillary sinus. Or maybe monomers have seeped in to the bones (although no studies are as yet available on this topic). Or maybe there are still some teeth left that are causing problems.

–

Lots of ands, ifs or buts to clear up, and hopefully you haven’t already had a nervous breakdown in the process.

–

Stay tuned for: Once upon a time there was the tooth V

Root pivots are one way to get crowns attached to the roots of teeth!

Yesterday you read all about pivot teeth and how they are made, today we’ll show you some examples of pivot operations gone wrong – except of course the first picture, which shows how it should be done!

Root pivot x-ray Pic 1
This is what a pivot tooth should look like, the roots are thick, evenly filled to the tips. The root pivot is located in the back root (black arrow) and fills more than 1/3 of the root!
–

–

–

–

–

–

–

–

–

–

Pic 2
The pivot is too short and the rest of the root has not been filled up with enough of the root-filling compound
–

–

–

–

–

–

–

–

–

Pic 3
The pivot is too short and the rest of the root has not been filled up with enough of the root-filling compound, moreover the canal was drilled crooked, so the pivot is not actually in the canal
–

–

–

–

–

–

–

–

–

Pic 4
The pivots are too short and the rest of the roots have not been filled up with enough of the root-filling compound

—

–
Videos on the topics of root treatment, root pivots and dentistry can be found here!

The terms pivot tooth, pivot crown, stump reconstruction or pivot reconstruction all refer to a tooth reinforced by a pivot.

–

If a tooth has suffered extreme cavity damage (1)

–

–

–

that practically only the root is left (2),

–

–

–

a pivot (3) can be inserted into the root to

–

–

–

–

provide retention for affixing a dental crown (4).

–

–

–

To succeed, this procedure requires

• proper treatment of whatever is left of the root (the pink area in picture 2)
• the root itself to be in good condition

Nowadays, it is common to use fiber-glass pivots, earlier they were made of metal. More on the topic of pivot teeth here!

The cost of a pivot tooth ranges from 100€- 350€ in Europe, depending on the materials and manufacturing methods used. Monday we will show you some examples of badly performed pivot tooth insertions. An x-ray  will show you the status of your pivot teeth – more on the topic of x-rays here.

Permanent or removable dentures?

Cost of dentures, free dentures, Chinese dentures, cheap dentures – common queries, but the most important question is: permanent or removable?

Patients are often faced with a choice among different types of dentures, either removable ones or ones that stay in the mouth. Here the pros and cons at a glance:

—
Permanent
Pros: comfortable, looks better, good for your self-esteem

Cons: usually very expensive

–

Removable
Pros: usually cheaper
Cons: a reminder that you’re getting “older”, does not look as good, you run around the hospital toothless

–

Removable dentures are often touted as being easier to clean, but this is not exactly true: both kinds can be cleaned if you do it right. Of course, the kind your dentist uses more often will be the kind they are better at and recommend.

–

It’s fair to say that if you already have removable dentures and are happy with them, then you can go ahead and save your money. Get a new set from a dentist who recommends them. If you prefer permanent dentures, then look for a dentist who prefers them too!

–

More on the topic of dentures here!