One of the advantages of a white filling is that it is a simple, single-visit procedure. However, the application of a white filling generally takes longer (up to 20% more time) than the application of a silver filling.
These are the steps involved in the procedure:
- A local anesthetic is given. Your dentist gives you a local anesthetic to numb the area in which he/she will be working. The anesthetic takes between three to five minutes to take effect.
- The dentist prepares an access to the decayed area of the tooth and removes the decayed portions. This preparation can be done with traditional drills, micro air abrasion (controlled sand blasting) or even with lasers. With a composite filling, he/she is able to preserve more of the natural tooth, because the composite resin can be bonded to the tooth and is strong even in thin layers unlike amalgam, which gets its strength in the bulk of the material.
- If the decayed area is close to a nerve, a special liner is inserted to protect the nerve.
- A material called "etchant" is applied, which is about 30% phosphoric acid. This is used to open up the pores of the dentin and roughens up the surface of the exposed enamel, so a better bond is achieved. This "etchant" material is left on for about 10 to 15 seconds. The etchant is rinsed off with water and is lightly dried. The bond resin (high tech glue) is applied to help stick the composite to the tooth. This flowable material is made of the same dental resin as the composite however it is much more flowable. This layer is hardened (polymerized) with a very bright blue light.
- The composite material is applied in thin layers, and slowly built up, layer by layer.
- As each subsequent layer is applied, a bright blue light is used to harden the resin.
- After the filling is completed, the dentist uses a special paper called "articulating paper" to make sure the new filling doesn't sit too high. By using articulating paper, he/she makes sure that your bite remains in proper position. If the filling needs adjustment, the dentist makes the needed shape change before you leave the office.
- After the proper tooth shape is achieved, then the tooth is polished. A number of polishers are used, each with different levels of abrasives, to make the composite as smooth and beautiful as a natural tooth.
Any filling involving the back teeth (molars) may require a bigger filling, since those teeth contain more surface area. In order to chew effectively, molars contain valleys and grooves on the chewing surface, which must be adequately covered by a filling substance.
Sometimes a filling will not be enough to protect a damaged tooth. If the tooth enamel is thin and will easily fracture, or if a tooth has previously had a root canal that weakens the tooth condition, then the tooth will probably require protection in the form of a cap or crown.
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