A tooth filling is used to repair a tooth defect and thus protect the tooth from further damage. In a sense, it takes over the function of the missing tooth substance and ensures that normal chewing is possible. If you need a filling, you can usually choose between different materials. Each of these materials is characterized by specific advantages and disadvantages.
- In principle, medical specialists differentiate between direct or plastic fillings and indirect fillings or inlay fillings.
- For a plastic tooth filling, the doctor uses malleable material (usually plastic or amalgam) that hardens in the tooth.
- An inlay filling always requires two treatment appointments, as the dentist first has to take an impression so that a laboratory can make the filling.
- The statutory health insurance companies only cover the costs of an amalgam filling in the posterior area, but also a plastic filling for anterior teeth.
What types of fillings are there?
In principle, dentists differentiate between plastic filling materials (direct filling) and inlay fillings (indirect filling). For a plastic tooth filling, a material is used that is malleable and only hardens in the tooth. Usually it is amalgam or plastic. Due to these material properties, the dentist can insert the filling directly during the treatment appointment.
In contrast, the manufacture of a precisely fitting inlay filling takes place in a dental laboratory, which means that patients have to appear at the dentist at least twice. Usually an inlay is made of either gold or ceramic. If the defect on the tooth is so extensive that the filling replaces almost the entire surface of the tooth, doctors refer to it as an onlay .
The advantages and disadvantages of the different types of fillings primarily depend on the material used. This also affects the durability of the tooth filling.
Amalgam filling: still a classic today
Amalgam has been in use as a reliable plastic filler for more than 100 years. The silver material is composed of various metals and mercury. Not only is it inexpensive but also easy to work with. In addition, the material scores with its long durability, which is 10 to 15 years. Due to the unattractive appearance of an amalgam filling, dentists usually only use it to treat molars.
However, more and more experts are now of the opinion that dental fillings made from amalgam are harmful to health. Because amalgam releases toxic mercury over time.
Plastic fillings: the modern alternative to amalgam
In the meantime, medical specialists are increasingly refraining from using amalgam and relying on plastic fillings instead. These also belong to the plastic tooth fillings and consist of a composite filling material. Since the plastic content is now mostly only around 20 percent, the term composite filling is more common among dentists. Unlike amalgam, composite can be produced in different shades, which allows adaptation to the natural tooth color. This enables a very aesthetic treatment result. For this reason, the material is particularly suitable for the area of the anterior and posterior teeth. However, with an average of 7 to 10 years, the durability of a plastic tooth filling is significantly lower than that of amalgam.
Ceramic fillings: inlays with a deceptively realistic look
Since ceramic inlays can hardly be distinguished from natural teeth, they are enjoying increasing popularity. The production of a ceramic tooth filling always takes place in a dental laboratory, which increases the effort and costs of the treatment. The patient must therefore inevitably appear at the dentist for a second appointment after the inlay has been made, at which the doctor inserts the filling into the tooth. However, the additional costs pay off in several ways: A ceramic filling is not only biocompatible, it is also pressure-resistant. In addition, the material scores with its attractive aesthetics and a long service life (sometimes more than 15 years)
Gold fillings: two different versions available
Although most people prefer an inconspicuous dental filling made of plastic or ceramic, many patients nowadays opt for a dental filling made of gold. However, a distinction must be made at this point between gold hammer fillings and gold inlays. With the first type of filling, the dentist taps thin gold foils into the tooth in layers. A gold inlay, on the other hand, is created like its ceramic counterpart in a dental laboratory. Dental gold is not only very well tolerated, but also very resistant and durable (10 to 30 years).
The advantages and disadvantages of the various filling materials
Of course, every material has different material properties. As a result, the different types of dental fillings are also characterized by specific advantages and disadvantages. The following table summarizes which these are:
Amalgam filling
| advantages | disadvantage |
| direct tooth filling, so only one appointment is necessary | contains toxic mercury |
| long life span | unsightly look |
| Health insurance pays all treatment costs | The dentist has to remove a comparatively large amount of tooth substance |
Plastic filling
| advantages | disadvantage |
| direct tooth filling, so only one appointment is necessary | Depending on the position of the tooth defect, additional payment is necessary |
| cheapest alternative to an amalgam filling | sometimes problems with the formation of gaps between tooth and filling |
| Adjustment to tooth color possible, which allows an aesthetic treatment result | comparatively low shelf life |
Ceramic filling
| advantages | disadvantage |
| high durability | two appointments at the dentist necessary |
| very good tolerance | very high financial outlay (up to around 450 euros) |
| natural appearance (white tooth filling) | is only used in the area of the posterior teeth |
Gold filling
| advantages | disadvantage |
| very high longevity | high costs (up to around 350 euros) |
| very good tolerance | Several treatment appointments are necessary for inlays |
| is only used in the area of the posterior teeth |
Tooth filling: the procedure of treatment at the dentist
How the treatment works in each individual case depends on whether the patient receives a plastic filling or an insert filling. If the tooth is affected by caries , the doctor first removes the affected area on the tooth enamel (and, in the case of severe infection, also from the dentin).
In the case of a direct filling, the dentist repairs the tooth in the same session. The doctor usually works a plastic filling in several layers, which he then cures with a special UV light. In the case of an amalgam filling, he lines the hole with an insulating layer before he lets in the filling material.
If, on the other hand, an inlay is placed, the attending physician first takes an impression during the first appointment. This enables the dental technician to produce the filling with a perfect fit. Usually the patient is given a temporary that he wears until the actual inlay is inserted. During the subsequent visit to the dentist, the specialist first checks the accuracy of fit of the tooth filling before finally inserting the inlay into the tooth.
What costs does the health insurance cover?
In the posterior region, the statutory health insurance only bears the full cost of a tooth filling made of amalgam. Anyone who opts for a different filler substance receives a subsidy of the same amount. If the damaged tooth is an anterior tooth, the insurance also covers all of the composite filling. Inlays, on the other hand, have to pay for inlays out of pocket – they only receive the subsidy that they would have received for an amalgam filling. Depending on the material, you should expect the following contribution:
- Composite: up to 120 euros
- Gold: up to 350 euros
- Ceramic: up to 450 euros
For those with statutory health insurance, taking out additional dental insurance can be worthwhile. Depending on the tariff, this will partially or completely take over the co-payment.
