Dental Fillings: Materials, Options, and Expert Advice

Dental fillings, cavities, and filling materials?

I have been searching for a long time and spent half a day trying to find information about dental filling materials.
How can I find relevant information or contact organizations that specialize in this area? (It is difficult to ask for medical knowledge at the outpatient desk, and the Ministry of Health and Welfare requires a license number and name, which is quite confusing for someone like me who is not familiar with it.) Currently, I have found the following filling materials: 3M from the USA, 3M Z250XT, 3M Z350XT, 3M P60, 3M P90, Germany's KaVo, SonicFill ultrasonic bubble-free composite resin filling system, and Italy's Micerium resin filling with 3M nano resin Z350XT, which has a strength of around 300 MPa, while Micerium resin has a strength of 700 MPa.
Question 1: How can I use the Ministry of Health and Welfare's resources to find relevant information and professional organizations for consultation (e.g., differences in materials and what materials are available in Taiwan)? (So far, I have found that 3M Z350XT (nano resin) and SonicFill (flowable resin) are available, but it seems that only a few clinics provide them.
The commonly used materials in clinics should be 3M Z250 and Z350.) I find it difficult to search through the Ministry of Health and Welfare, and the Dental Association only provides information on self-paid treatments.
I have seen related terms in the self-paid association, but I still cannot find the information.
I know that fillings are categorized into specialties and general practice.
At 21 years old, I know resin is used for fillings, and dental floss should be used around 24-25 years old.
When using it, I feel there are gaps between my teeth and the resin, and the filling disappears when I use dental floss (I am afraid of cavities, so I brush twice a day).
Now at 35, my teeth have turned black but do not hurt.
I want to fill them and avoid cavities for the third time.
Which filling materials will not create gaps with my teeth? (Currently, I see options like resin, inlays, porcelain veneers, and crowns.) How can I eliminate exaggerated effects caused by commercial advertisements due to information asymmetry? (I have read many articles discussing medical ethics, and it seems unlikely for anyone to be 100% ethical.) What I can do is understand some product information to eliminate issues of information asymmetry and overload.
Question 2: It is certain that repeated fillings can harm teeth.
What resin materials are available in Taiwan that can reduce my chances of getting cavities for the third time? I only consider this when necessary, and I am afraid of the cost of porcelain veneers, which exceed 15,000 TWD (and crowns and other types require more destruction of healthy tooth structure).
Question 3: Does the process of adding pulp preservation techniques (biomedical materials) before filling protect my dental nerves, and when is it necessary to perform microscopic root canal treatment versus standard root canal treatment? (The internet suggests that the former can handle the tooth structure better.
Is it necessary to perform microscopic root canal treatment and pulp preservation techniques, especially since this is the second cavity in the same location?) I believe the second cavity occurs because there are fine gaps between the filling and the tooth that I cannot clean, and I also cannot brush the areas where the filling has fallen out.
Question 4: Is preventive resin suitable for children, and can adults use it as well?

Mr. Zheng, 30~39 year old female. Ask Date: 2023/02/20

Dr. Zeng Guanghui reply Dentistry

1.
If the extent of the cavity is small, composite resin can be used for filling.
If the cavity is larger, options to consider in sequence include inlays, porcelain veneers, and crowns.
If the cavity is too extensive to be filled, a dental crown should be placed for protection.

2.
The composite resin used for filling has sufficient hardness, and if the edge sealing procedure is properly executed during the filling process, the restoration can last for a longer time.
If it is truly assessed that filling is not feasible, then veneers should be considered.

3.
For deep cavities, it is important to consider protecting the dental pulp before proceeding with the filling.

4.
Preventive resin is applied to the grooves of newly erupted molars in children and is not applicable to adults.

Director Cheng Guanghui, Department of Dentistry, Nantou Hospital.

Reply Date: 2023/02/20

More Info

When it comes to dental fillings, understanding the materials available, their properties, and how they can affect your dental health is crucial. Here’s a comprehensive overview based on your inquiries.

Understanding Dental Filling Materials
1. Types of Materials: The most common materials used for dental fillings include composite resins (often referred to as dental plastics), amalgam, glass ionomer, and porcelain. Each material has its own strengths and weaknesses:
- Composite Resins: These are tooth-colored materials that blend well with natural teeth. They are suitable for visible areas but may not be as durable as amalgam for larger fillings.

- Amalgam: This is a durable material made from a mixture of metals, including silver, mercury, tin, and copper. It is often used for back teeth due to its strength but is less aesthetic.

- Glass Ionomer: This material releases fluoride, which can help protect the tooth from further decay. It is often used in areas not subject to heavy chewing pressure.

- Porcelain: Often used for inlays, onlays, or crowns, porcelain can be matched to the color of your teeth and is highly aesthetic.

2. Strength and Longevity: The strength of filling materials can vary significantly. For example, 3M Z350XT composite resin has a strength of around 300 MPa, while some advanced materials like the Italian "美塑樹脂" can reach up to 700 MPa. When considering longevity, amalgam fillings can last 10-15 years, while composite fillings may last 5-10 years depending on the location and size of the filling.

Finding Reliable Information
To find reliable information about dental materials and options in Taiwan, consider the following steps:
- Consult Professional Organizations: The Taiwan Dental Association or similar organizations may have resources or contacts for inquiries about dental materials.

- Health Department Resources: While you mentioned difficulties navigating the health department's website, it may be beneficial to visit in person or call for assistance in accessing information about dental materials.

- Ask Your Dentist: Your dentist can provide detailed information about the materials they use, their properties, and why they choose specific types for your fillings.

Addressing Concerns About Fillings
1. Preventing Cavities: To minimize the risk of further cavities, ensure that your fillings are properly sealed. If you notice gaps between the filling and your tooth, it may be necessary to have the filling replaced. Regular dental check-ups can help catch these issues early.

2. Material Selection: If you are concerned about repeated fillings damaging your teeth, consider discussing with your dentist the possibility of using more durable materials or techniques, such as inlays or onlays, which can provide better coverage and protection.

3. Pulp Preservation Techniques: If you have deep cavities, techniques like pulp capping or pulp preservation can be beneficial. These methods aim to protect the dental pulp (nerve) and may reduce the need for more invasive treatments like root canals. Micro-endodontics can be necessary if the decay is extensive, but your dentist will evaluate the best approach based on your specific situation.

4. Preventive Resin Restorations: While preventive resin restorations are typically used for children, adults can also benefit from similar preventive measures. Discuss with your dentist the possibility of applying sealants or preventive materials to help protect your teeth from decay.

Conclusion
In summary, understanding the various dental filling materials and their properties is essential for making informed decisions about your dental health. Regular communication with your dentist, seeking reliable information from professional organizations, and being proactive about your dental care can significantly enhance your oral health and help prevent further issues. If you have specific concerns about your fillings or dental procedures, don’t hesitate to discuss them with your dental care provider for tailored advice.

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