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Thirty to forty years ago, there were only a few materials in use and these went back in some cases to the previous century. Since then there has been an enormous development of different materials normally under the heading of white fillings or composite/compomers. Beyond this, materials are now in use that transform the way we work, from minimal or zero tooth removal through to major reconstructions of teeth.
At one time, the type of cavity or decay dictated the best type of filling and the type of filling dictated the overall shape of cavity we had to prepare.
This meant that in some case what seemed a tiny hole turned into a very obvious silver or black filling and this did nothing to encourage patients into early intervention.
Now our restorations reflect a far more ideal outcome. A small cavity is restored with a small almost invisible colour matched filling and because of the adhesive properties, some cavities require no drilling at all.
To date the technology is excellent but there are still slight flaws and we still have to adapt to specific circumstances. A couple of early intervention techniques pretreat teeth before a hole even exists but certainly in the case of one of them, the absolute effectiveness is unproven.
Beyond these materials that we can sculpt in the mouth, we now have cast and milled porcelain restorations that can rebuild teeth completely. These now have strengths that allow us to recommend them.
At one time, many of the white fillings had serious flaws, they could cause tooth fracture, they could kill the nerve in the tooth, they stained easily and their wear characteristics were poor. Basically each of these has been solved and these materials have moved from alternative to first choice in nearly all cases.
The most important aspect of white fillings is the placement by the dentist. If all the stages are carried out correctly they work very well, however they fail very badly if placed casually. They are therefore not quick restorations and they are not suitable in all cases.
Veneers are very thin aesthetic facings that transform the front surface of our teeth. As with the fillings above they can be done in "cast" laboratory made porcelains or they can be built up as layers of composite. Again what matters is correct case selection.
In most porcelain veneers about 0.5 mm is removed from the front tooth surface which allows the tooth to be rebuilt to its correct and original dimensions. Preparation free veneers can have problems.
Veneers can look poor if the balances of shade, lip line, size, shape and ratios are not fully considered in the context of facial size and shape.
Patients who grind their teeth may not be suitable for cast veneers. (See Bruxists)