The fillings and crowns available in the NHS can be made of a number of different materials. Fillings are used to repair a cavity in the tooth caused by decay. Your dentist will offer you the type of filling they deem clinically necessary. The most common type of filling is dental amalgam, made from a mix of different metals.
Dental amalgam fillings are often used on the back teeth, as they are tough. There are several articles on the Internet about the supposed toxic properties of amalgam, but there is no evidence that exposure to mercury from amalgam fillings has harmful health effects. Crowns and bridges are available on the NHS (Band 3, £282.80). Tooth abscesses can also be treated in the NHS.
Orthodontics is a type of dental treatment that aims to improve the appearance, position and function of crooked or abnormally arranged teeth. You can't mix NHS and private orthodontic treatment. If a child younger than 15 years old needs a filling, your dentist may use other materials such as tooth-colored fillings or preformed (stainless steel) crowns. White fillings are now a popular alternative to amalgam fillings.
New dental materials make it much easier to find the perfect match for the color of a particular tooth. In most cases, it's absolutely impossible to see that the tooth has a filling. Sometimes, white filling material can be used to cover unsightly marks on teeth, similar to veneers. The placement of a preformed crown is intended to provide a more durable restoration than a filling.
The process of preparing a tooth for filling materials can weaken it structurally, since it is necessary to remove the decayed tissue from the cavity in order to place a restoration. In addition, healthy tissue may need to be removed to access decayed tissue. In addition, in the case of certain filling materials, such as amalgam, the cavity must be prepared in an “ideal” shape to allow the incorporation of a form of mechanical resistance and thus avoid the loss of the restoration. Restoring the original shape of the primary molars with a filling material can be difficult, especially with multi-surface cavities.
The increased occlusal load to which multi-surface fillings are subject often leads to premature restoration failure. Through Atraumatic Restorative Treatment (ART) and the selective extraction of carious tissue, the tooth can be prepared for a filling without the need for local anesthesia; however, ART restorations have a shorter lifespan in multi-surface restorations than in single-surface restorations (Frencken 2012).
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