The majority of teeth restored today in the United States due to cavities or fractures are restored using composite, or so called white filling material. Literally millions of teeth per year are filled or bonded using this material. This material has a wonderful track record, as long as the most proven procedures are followed to insure a long lasting restoration.
The placement of a bonded composite filling involves several steps. First, all decay, compromised tooth structure and old restorative material must be removed to allow for proper bonding. Next, a bonding agent, sort of like glue, is applied to the tooth to allow the filling to “stick” to the enamel and dentin of the tooth. Then, the correctly chosen composite filling is placed and shaped. The bite is then adjusted and the restoration is polished.
The tricky part is the “glue” step. If this is not done properly, the filling will either not last as long as it should, or even worse, fall out or fail very quickly. Dentistry uses a so –called generation system to describe the type of bonding agent being used to bond the filling to the tooth. In other words, The “first generation” described the first set of steps and materials used to bond a composite filling to a tooth, whereas now dental manufacturers have developed the “seventh generation” bonding agent.
The main issue is that from generations one through four, significant improvements were made to allow the bonding agent to perform better. Generations five through seven have mainly involved developments to combine chemicals and save time. While this has proven tempting for busy dental offices, time and research has proven that the fourth generation of bonding agents remains the most durable, longest lasting material.
The fourth generation agent involves using separate etching, priming and adhesive steps to allow the individual ingredients to work most effectively. When these ingredients are combined, like in later generations, the bonding is not as effective.
Many people ask me in my daily practice what is involved in filling teeth or “bonding.” I hope this article has shed some light on what I think is one of the most important aspects of how we fill teeth.
Dr. Smith is a Waxahachie dentist practicing at Main Street Dental Arts, 516 W Main St. He can be reached at 972-937-1841 or at email@example.com