Frequently Asked Questions
Am I a candidate for a Porcelain Filling?
In order to determine if you are a candidate for porcelain fillings, you must schedule a new patient consultation. At this appointment, Dr. Michael and his team will take a full mouth set of x-rays, intra-oral photographs and extra-oral photographs for you and the doctor to review. All images are displayed on a wide screen monitor mounted to the dental-chair. Here you will be able to visualize broken and cracked teeth, decay, silver and black fillings, and any other existing dental restorations you may have had done in the past. It is usually obvious when you see cracks, decay and broken or cracked teeth, that there is something wrong. It can clearly indicate the need for porcelain fillings or porcelain crowns. Dr. Michael will make a recommendation and present a treatment plan which is in your best interest to prevent pain, infection, an unsightly broken tooth, or a dental emergency at an inconvenient time.
Once a plan has been presented, you are encouraged to ask any questions you may have during the treatment consultation. If you have questions afterwards, Dr Michael encourages you to call or email to answer any of your questions. Communication is the key to successful dental care.
Broken, cracked and silver filled teeth can prove to be unsightly and potentially painful if not addressed in a timely manner. Porcelain fillings are a viable option to address these issues in the smile. Dr. Michael can complete these restorations in as little as one short visit utilizing the CEREC porcelain crown and filling technology.
How does the porcelain filling procedure work?
Porcelain fillings are very similar to any other dental procedure in that the procedure begins with the application of topical anesthesia. Once the gums are comfortably numb, a local dental anesthetic is administered which completely numbs the tooth.
The upper and lower teeth are then imaged with the CEREC tooth scanner. These images are transferred to the chair-side design center where the doctor designs the porcelain fillings after the tooth is prepared. A final scan will be completed after the tooth is prepared.
The tooth or teeth are then prepared for for the porcelain dental fillings by removing decay, cracks, old fillings, or any other substance that must be removed to make room for the porcelain filling restoration. Once the surfaces are cleaned and shaped, a final CEREC scan is taken of the final tooth preparation.
Dr. Michael then designs the new porcelain fillings chair side with the CEREC design software. At this point, the patient either has about a 30 minute break to read, watch TV or work on their computer or Dr. Michael continues to perform necessary dental work while the porcelain fillings are being fabricated in our dental lab. Some patients choose to have all of this work done utilizing dental sedation. Sarasota Dentistry offers oral, IV and Nitrous Oxide sedation to make all of these procedures extremely comfortable.
Once the porcelain filling is milled, stained, glazed and fired, it is ready to be placed in the prepared tooth. It is tried in to verify the fit. 99% of the time these restorations fit without adjustment due to the precise technology being utilized. Once the fit is verified, the porcelain is etched and primed prior to bonding it in the mouth. The tooth is also etched, primed and then the porcelain filling is gently placed in the tooth with a layer of adhesive resin between the porcelain filling and tooth. Excess adhesive resin is removed and the restoration is light-cured to harden the remaining resin between the tooth and the porcelain filling. Again, excess resin is removed, the bite is checked and the porcelain filling is now completed.
Can my tooth still break after a porcelain filling?
Porcelain fillings are much stronger than amalgam or silver fillings but teeth can still break with porcelain fillings. Porcelain fillings are place inside of a cavity preparation surrounded by natural tooth structure. The remaining natural tooth could still fracture. When choosing a porcelain filling, it's a decision between a more conservative porcelain filling or a more secure full coverage porcelain crown.
How long do porcelain fillings last?
Porcelain fillings, like most other dental restorations, can last a lifetime if cared for properly. However, some people are very hard on their teeth due to heavy grinding or bad habits; such as chewing ice or peanut brittle.
What are porcelain fillings made of?
Three of the popular porcelain fillings are IPS empress, IPS emax, and feldspathic porcelain. There are currently a number of hybrid porcelains coming on the market too. IPS empress is a leucite glass-ceramic that has been in use since the 80's. It is mainly being replaced by IPS emax, a lithium disilicate ceramic, due to it's superior strength. The oldest of these is feldspathic porcelain. All of these porcelain materials are acceptable choices for porcelain fillings. Hybrid porcelains are also becoming popular with CAD/CAM porcelain fillings. Again, there are advantages and disadvantages to the hybrid porcelains. Hybrid porcelains have tooth wear factors more closely related to natural tooth wear - which is an advantage. However, the bond strength of hybrid porcelain to tooth is greatly reduced. Depending on the type of cavity prep, bond strength may not be a factor.
How much do dental fillings cost?
There are many types of dental fillings: amalgam (mercury), composite (bonding), gold, porcelain, hybrid porcelain. The price of dental fillings ranges from one area to another and from one dentist to another. The value is not just in the material, but in the reputation and service the dentist provides. Many dentists have chosen not to offer amalgam fillings due to their risk but a good range of costs is as follows: amalgam fillings are the most affordable type of filling ($50-$200), followed by a composite or bonded filling ($100-$500), next are porcelain fillings ($1000-$1600), and last is gold which is slightly higher than porcelain due to the cost of gold which could fluctuate. Keep in mind that additional work may be necessary in addition to the porcelain filling, such as, root canal therapy or periodontal therapy.
Are amalgam or mercury fillings safe?
Amalgam is legal and considered safe by the American Dental Association. However, there are many who still believe that mercury fillings are toxic and cause systemic disease. Many dentists choose not to offer mercury or amalgam fillings due to the risk... not only to the patient but the dentist that is exposed to the mercury on a daily basis. Mercury fillings are legal and usually a long-lasting restoration, however, most teeth that have a mercury filling placed in them ultimately result in a fractured tooth This is due to the fact that the mercury filling swells over time due to corrosion of the filling material. Tooth is not flexible and when a filling swells and you bite on it repeatedly, it generally results in a fractured tooth. These fractures may be easily repaired with a crown or, worst case scenario, the tooth may require a root canal therapy or extraction. Mercury fillings have their place in society, but they also present a risk and an alternate filling material should be considered.