Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

[Packergirl]

Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Hi everyone,

I am new here but have been crawling round this site for a while.
I just turned 23. I had never been to the dentist for the first 21 years of my life. During that time, I ate my fair share of sweets, starchy foods, sweet drinks and didn't really keep up with my oral hygiene. During my second year at uni. I passed by my uni's dental practice and thought I should probably get a checkup.
My 1st checkup went okay, until the dentist said that I had a cavity in one of my premolars and should get it filled in 2 months, he also said that I could have a white or silver filling. I went away, did my research and decided to choose a white filling, afterall I could replace it in 5+ years. Went back 2 months later, after the dentist finished drilling, he stopped and told me: 'the decay is a lot deeper that I thought, if you go ahead and get the white filling you'll have to replace it in 2 years'. I told him to go ahead anyway. I felt some sensitivity on the tooth, especially when biting down, but that went away after a short while.
I changed to an electric toothbrush immediately after, started using corsodyl. But then my gums started bleeding. Went back to see another dentist a while later (at the same practice), she checked my teeth, xrays etc but found nothing. Although she said I should see their hygienist. But I didn't go back.
Fast forward 2 years later, my gums were still bleeding regularly but I always put it in the back of my mind. Then mum bough these floss picks that you can use if you have teeth wth very little spaces between them (which I have). I started trying to floss, but sometimes it felt like I was trying to yank my teeth out. I started oil pulling shortly after that. Days later, my bleeding tooth started hurting, so I stopped flossing. By this time, I was very panicked and booked an appointment to see a dentist at the same practice. I had a full blown melt down twice where I cried like a baby in front of my mum thinking I was going to lose some of my teeth and get dentures or implants. I could have sworn that some of my teeth were loose when I moved my tongue against them, but when I pushed them with my fingers, they were fine. Also, I could have sworn that part of my filling fell out.
Last tuesday - went to see the dentist. She was surprisingly patient with me, even though I kept asking some questions over and over again. She blew air into my gums and probed them with some sort of needle looking thing.Took xrays on the problem areas, moved some of my teeth and said they were fine. She wasn't particularly worried about the filling, but was quite upset/energetic when she could pass a bit of floss through the filled tooth and my 1st molar, and after I told her food sometimes get stuck in there. Apparently, these weren't supposed to happen. When I mentioned the 2 year deadline, she shook her head and said that there was glass ionomer in my mouth, and 'glass ionomer are only meant to be temporary, there are meant to be there for a few months to a year max'. She put a little cotton ball in some white bottle, then put against my filling and asked if I could feel anything (because of the whole 'decay is very deep' issue dentist no 1 told me about). I could feel a slight tingle shoot up the tooth, and she said that was fine. She then told mum and I that she could fill it with silver or white filling. Silver would cost me £51 on the NHS, white would cost £130 as she was doing it privately. I asked her which one lasts longer and she says 'white lasts just as long' (eye raise). Mum went ahead and said I will get the white filling because she knows how vain I am. We had to pay a deposit and also book for a NHS scale and polish (that the dentist will do). She asked me to book everything for an hour. I asked her if I can chew with my teeth (because I had been swallowing my food before the appointment), and she said 'of course, you don't want to upset your stomach'.
After we left, I was relieved for a while, thinking I won't have to get a root canal/extraction anytime soon. I really want to save my natural teeth as possible!!

I have booked the appointment for next thursday as its the only day my mum is free and I don't want to go alone. But now I am very worried. There are loads of opinions, research, experiences on google etc. Some said their teeth hurt for months or years after having the white filling, some said they had to replace it 4 times before submitting to a root canal (which I am trying to avoid). Some say it fell out the day after the procedure. Some say they had intense pain immediately after and had to get a root canal because the nerve was compromised/the dentist's work was shoddy. I don't know what to do or if I made the right choice. This new dentist has been practising for 13 years, graduated and qualified in Greece, and has worked in many practices in the UK and a hospital or two. She has a post grad in implantology, and her experience is more towards orthodontics, so I'm sure she is an okay dentist. Most of the practices she has been at had at least generally good reviews (at least 4 star average) online, including my current practice. She even approved when I told her I was doing the oil pulling technique and advised me to chew sugar free gum to prevent decay, so she sounds more qualified and open minded than the crap dentist who did my filling without really telling me what materials were in it. I get the feeling she is very patient but also businesslike and to the point.

I am just so worried about things going wrong. Heaven knows 2015 was a bad year for me (lost my job and was unemployed and living with the parents for most of last year). I had plans for this year and I feel my teeth is just shooting all those to hell. What I want to know is:

- For those who had white fillings done in the UK, how long did the sensitivity/pain last?
-How intense was the sensitivity? When or how did it hit?
- How did you solve it? Or did it go away on its own?
- How long did you keep your white filling till you had to replace it?
- How often have you had to replace the white filling?
- Which tooth did you have the white filling on?
- If you could go back, will you get the silver filling?

I know its a very long post and I'm sorry about that. I just really need help because I am getting very scared and I think my filling is falling apart more everyday, I have been avoiding chewing on that side of my mouth and I can't wait for the 14th of January to get here so I can get it fixed. Please any advice will be very helpful. I need help.
Thanks.

 

[littlething]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Hi and welcome! I'm not in the UK (I'm in the US), and I haven't had a silver filling since I was in elementary school (and all on baby teeth). I did just get a bunch of white composite fillings (2 of them are on premolars, but it's all a mix of front teeth and molars as well), and I've only had them for 2-3 months, so I can't answer your questions about how they have held up long-term. It is my understanding though that if done right, composite fillings last at least 7-10 years. Silver amalgam fillings last longer, but require the removal of more healthy tooth structure (I think). Most dentists here only do composite fillings.

Composite fillings are prone to more sensitivity, but I have been told that this shouldn't last more than a few weeks. I did have a few deep fillings done, and my dentist told me that some sensitivity is normal since they are closer to the nerve, but should go away (but lingering sensitivity was generally not a good sign). Generally speaking, the deeper the filling, the more of a chance that it ends up irritating the nerve and causing complications. I only had a tiny bit of sensitivity in one of them the first day or two (just slight cold sensitivity, although part of it was because I was testing the tooth out, haha), but they have been completely comfortable since. Sometimes, sensitivity can be caused by a high bite, and this can easily Be adjusted. have also read that brushing with toothpaste for sensitive teeth (I.e. Sensodyne) have helped others.

hope this helps

 

[Packergirl]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Thanks for your answer littlething. Lucky you for not having any problems. I hope the fillings last you a very long time!
I just spoke with another dentist from another practice about feeling very little sensitivity/pain on the gum/tooth. She said something along the line of 'your gums could either be sensitive. Or your nerve may be dying so you may need a root canal'. I am really praying that its the gums being sensitive. She also agreed with the glass fillings being temporary so maybe my dentist knows what she is doing. And she said white fillings are meant to last as long as the silver ones...so here's hoping! I just don't want a root canal because I fear that will be the beginning of a long line of problems that will lead to extraction
Good luck with the fillings
​

 

[Spike 1969]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Hi there and welcome.

I am from the UK and have a mixture of Amalgalm and Composite fillings so I do have some experience of both types. I believe The general consensus is that the Amalgalm fillings have a higher compressive strength and are longer lasting (so are often used in molars) than composites but are aesthetically not as nice to look at. With regard to length of life, most of my composites are 4+ years old and so far so good, as with most things dental it depends on the materials and dentists skill in prepping the tooth, bonding and placing the filling but with my current dentist who is excellent I have no doubt that they will last a very long time. Glass ioniser fillings are a relatively short lived material I believe.

With respect to sensitivity, it is accepted that composites can take longer to settle than amalgams, longer than a couple of weeks it's worth getting it checked out by a dentist, I have only ever had one tooth give issues and that was done badly by a shoddy dentist in a chain practice (they took over my old practice when my old dentist retired) and I had sensitivity to heat/cold and pain biting down which was due to a compromised nerve. I have ended up with a root canal, post and crown by my current dentist and that has been trouble free and cosmetically looks better than the original tooth so I shouldn't worry about an RCT, just make sure the tooth is crowned rather than permanently filled as they can become brittle and break.

Hope the above proves to be of help to you. Please feel free to ask any questions and I will do my best to assist you.

Kind Regards

 

[Packergirl]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Thanks Spike1969! I am sorry to hear about your shoddy dental experience. And I usually do an eyebrow raise when dentists tell me composite lasts as long as amalgam. If only they could be completely honest with us! I have a couple of questions; how long has the RCT lasted? Did you have the option of having it done with an endodontist? If yes, why did you not go with that option? And how long did the RCT procedure take overall?

I'm asking because my filling-ed tooth has started feeling strange. I swear it hurts very slightly at times, and then goes away or the feeling moves to another part of my teeth. I don't want to be someone who always imagines the worst especially when I had the all-clear at the dentist last tuesday, but I have the idea that I may need a RCT and all because of a dentist who didn't tell me that my filling could fail earlier than 2 years! Thanks for answering by the way.

 

[Spike 1969]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Hi there

No problem; I have had my current RCT tooth since September last year; prior to that I had an RCT treated molar on my lower left that lasted 12 years and only failed because my old dentist did not crown it so it broke and I had to have the pieces removed but the RCT treated tooth never gave me an ounce of trouble.

The process on my premolar was done over 3 appointments as follows:

Appointment 1 - Clean out canals and sterilise them then temp filling (35 mins)
2 week break
Appointment 2 - check and re clean canals and sterilise again then put in gotta percha (root filling material) cure and put in a Composite filling (40 mins)

We then left it for approx. 3 months, made sure it was settled and did the crown as follows:
Appointment 1 - crown prep, fit Titanium post and take impression, make and fit temp crown (1 hour)

2 week waiting time for the crown to be made
Appointment 2 - remove temp crown and fit permanent crown/ adjust bite (20 mins)

The crown looks, feels and functions just like a normal tooth, my dentist called me at home the day after to make sure it was OK, he's excellent.

I will also say that all the appointments were 100% painless and very easy, there's actually less drilling for an RCT than a conventional filling.

Reasons for my dentist rather than an endo is that it was a premolar so relatively straightforward, having discussed with my dentist (I trust his skills and judgement totally), he said the root has a slight curvature but he was confident in being able to do a good job. For molars he generally refers his patients to a trusted endo as they are more complex to carry out.

Hope this is helpful to you, if you need more information please let me know

 

[Packergirl]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Thanks a lot. I have a few questions (sorry for searching your brain like this) - are there foods that you can't chew with the root canal-ed tooth? What food are those? And why can't you chew with them? Didn't you have the option of choosing the amalgam filling for appointment 2?

I guess I am very scared because now that I know more about the cycle of treatments a tooth can go through, I'm trying to push back having any of my teeth extracted to as later as possible. From what I have learned it goes like this : filling/filling with crown - root canal - extraction - gap/dentures/bridges/implants. I'm trying to avoid these because dentistry isn't cheap at all. If I had a root canal now I wouldn't be able to afford the best treatment out there (which is what I would go for). Plus success rates with an endo is much higher than with a dentist, apparently

 

[Spike 1969]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Hi there

There are no foods I cannot eat with the RCT tooth; I didn't get the option of Amalgalm on my 2nd appointment because to do that would have involved completely removing the rest of the existing Composite one and thus further weakening the tooth rather than drilling a small hole through the existing filling and then patching the existing composite filling.

Regarding success rates of endo vs dentist, it very much depends on the skill of the dentist and how well equipped they are, I trust my dentist so was happy for him to do the work and he's made a great job, for large molars he would generally refer to an endo but premolars he is confident (30+ years experience) so I had no qualms about letting him do it.

Hope this is helpful.

Kind Regards

 

[Packergirl]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

Thanks for the support guys. Just wanted to give you all a recap of what happened:

The dentist comes out and shows me into the room. Then she asks me if everything is alright, I say yes, but my tooth-with-a-filling has been feeling kinda strange these past few days. I then burst it out that I'm hoping that I don't get a root canal. She says everything is going to be okay.
Then she gives me the glasses, injects some anesthetic the part of my mouth she will be filling, and we start with the cleaning. She uses the ultraviolet light (at lease I think that's what she called it) to clean between my teeth and gums. It sometimes felt like there was a zing going through some of my teeth, especially my lower incisors, but I get I have more nerves there.
Good thing is she gave me breaks now and then to rest my jaw, sit up and rinse out my mouth, she sometimes cracks jokes too.
Then I have another 10 second break before I lay back down to start with the filling. This is what happened:
First she tried to remove the old filling, but that took her some time because apparently the filling was well stuck in there. She uses the drill, some sharp instruments, murmurs something about 'sub gingivival', 'bone' and sprayed some liquid on it, then was able to get it out.
She put some cotton balls on my gums, and then added the 'saliva ejector' to the bottom of my mouth.
She put something that smelt like adhesive :/
Then she starts putting in the filling (or at least I think it was the filling) - this part was tough because I felt she was literally trying to push the filling into my gums. A small metal clamp was involved here as well. She kept on saying 'you need to hold really still for me darling, I'm working with the smallest gap in the world' , sometimes followed by 'okay, I'm very happy with this now'.
I think a curing light was involved, because she kept asking the assistant for 'light, please'
Then it felt like she was prodding the filling, the way you would lightly prod puff pastry so it doesn't puff up in the oven.
Then she gave me a light sheet of paper to bite on, then some filing. Then, gave me the paper to bite on the opposite side of my teeth as well to make sure it wasn't disrupting my overall bite.
Then came the polishing. Because she wanted it to look like part of the tooth.
Then she was done, she warned me that there would be pain in my gum (because she had to 'pull my gum down'? - don't think I heard that part well) for a couple of days but that would go away. Apparently, the filling should last me 10 years if I look after it right.

Its been 3 hours since the whole thing, my mouth is still numb but the anesthetic is slowly wearing off. Do I feel anything? Well I can feel a slight pain and itching in that tooth/part of the gum. Plus, there is a certain taste that comes off when I rub my tongue against the tooth. I hope it goes away in a couple of days with the help of ibuprofen, sensodyne and orajel.I haven't eaten yet, will do so when the numb feeling wears off. Lets hope it goes well.

 

[Packergirl]

Re: Please help. Glass ionomer vs composite vs amalgam for premolar? I'm very scared

If anyone has any more tips on how to maintain the hurt/sensitivity, that would be great