Advances in modern dental materials and techniques increasingly offer new ways to create a healthy, pleasing, natural looking smile.  There are so many choices – different types of ceramics, plastics, gold, base metals and dental amalgam.  With so many options, how will a person know what is right for them?

Several factors influence the type of material that is utilized to restore a tooth.  Is the restoration in an esthetic area, how much force is being placed on the tooth, how much tooth structure remains for support of the restoration, how many visits will the restoration require, what will be the cost of the material and restoration, etc…  The list goes on and on.  All of these factors will influence the look, durability, expense and ultimate longevity of the restoration.

To help you better understand your options and what type of restorations are available, over the next few weeks I will discuss the advantages and disadvantages of some commonly used dental restorations.  The ultimate decision about what to use is best determined by the patient in consultation with the dentist.  Before treatment begins, always discuss options with your dentist.

Types of Dental Restorations

There are two types of dental restorations – direct and indirect.

•  Direct Restorations – Direct restorations are fillings that are immediately placed into a prepared cavity in a single visit.  This is what happens when a patient goes in for a routine filling.  The material can be dental amalgam, glass ionomer, resin ionomers and some composite (resin) fillings.  The dentist prepares the tooth, places the filling and adjusts it all in one appointment.  Any polishing and finishing is done right after the restoration has been placed.  Over the years, direct restorations typically begin to show signs of wear and deterioration before an indirect restoration will.   

•  Indirect Restorations - Indirect restorations generally take two or more visits although some newer technology allows some of them to be done in one.  These include inlays, onlays, veneers, crowns and bridges fabricated with gold, base metal alloys, ceramics or composite.  During the first visit the dentist will prepare the tooth and take an impression (mold) of the area to be restored.  The impression is then utilized to create a model of the tooth on which the dental restoration can be fabricated.  From start to finish there are over one hundred steps in creating an indirect restoration for a patient, all of which require extreme precision.  Indirect restorations generally last longer than indirect restorations.  At a second visit, the dentist will cement or bond the restoration into the prepared cavity of the tooth and adjust it as needed.   

 Next week I will begin to discuss the pros and cons of the different types of direct restoration materials.  Until then, be sure to put on a smile.  It’s contagious!