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All the below content has been written by Dr. Sandip Sachar. 

Dental Cavity Fillings.

Dental fillings are used to fill cavities that form in the teeth.  We will discuss the different types of dental fillings and when to use each of them.  At Sachar Dental NYC, we use only the latest and most advanced materials that are made of the least toxic components.  These materials enable us to fill cavities with the longest lasting, strongest and most durable results that are the most cosmetically appealing.  The use of composite tooth colored fillings and porcelain, allow us to make a filling virtually undetectable, and achieve long-lasting results, while restoring the function of the teeth.

What are cavities?

A cavity is a hole or deficit within a tooth.  It is caused by tooth decay.  Tooth decay occurs when bacteria break down plaque on, and between the teeth, and under the gums.  Plaque occurs when food particles are left to remain in the mouth after brushing.  Bacteria live off this plaque. A byproduct of bacteria is acid that is produced.  This acid eats away at the tooth enamel and results in tooth decay and eventually, cavities.

How to prevent tooth decay | dental cavities

Tooth decay can be prevented, or at least slowed down, by proper oral hygiene.  This involves brushing and flossing twice per day.  and plaque from the teeth.  However, flossing and brushing Brushing and flossing remove bacteria alone cannot remove all plaque.  It is also important to have a professional dental cleaning and checkup twice per year.

What are the different types of dental fillings?

Why do we use each type of dental filling?

Performing dental fillings is called restorative dentistry.  This is because the goal of fillings is to restore the original shape, size, and function of the original tooth.  Dental fillings are also performed in order to seal the tooth that has a cavity or deficit, in order to stop further decay from bacteria.  There are many different types of fillings. 

There are temporary fillings that are placed on the tooth for a short period of time to seal it and prevent bacteria from spreading inside.  

In previous years, dentist used silver metal in the mouth to fill cavities.  At Sachar Dental NYC, we believe in using the least toxic materials, and we never use silver fillings. 

We use a resin composite material that is BPA-Free and results in a functional and cosmetically appealing tooth colored filling. 

We also use porcelain to fill larger cavities.  There are two types of porcelain fillings, inlay and onlay.  When we fill the inside of the tooth, it is called an inlay filling, and when we fill the inside and replace one of the outside surfaces of the tooth, it is called an onlay.

When do we use each type of dental filling?

Sometimes we perform temporary fillings.  There are a few instances when temporary fillings are indicated.  When there is a dental emergency, and for one of various reasons, at that time, we are unable to perform an actual permanent filling, the temporary fillings is used to seal the tooth and prevent the spread of bacteria and further decay.  The temporary filling material that we use at Sachar Dental NYC is the top of the line that contains fluoride, which helps to prevent cavities from forming underneath the temporary filling, while waiting for the permanent filling.  Fluoride also helps the root of the tooth, and the nerve to heal.  The temporary filling goes on as a moldable putty that is placed on the damaged tooth, after the tooth is thoroughly cleaned.  The patient then comes back for another visit to complete the permanent filling. 

Another time that we use a temporary filling is when we are not sure if the patient will need a root canal or not.  When a cavity is deep enough to expose the nerve within the root of the tooth, and the nerve is noted to be inflamed, we are not sure if we will need to perform a root canal procedure or not at this stage.  When this is the case, we clean the inside of the tooth as much as possible and apply a temporary filling. We then wait to see if the nerve heals, or if it progresses to the point where a root canal procedure is necessary.  Either way, the temporary filling is eventually removed and replaced with either a permanent filling or a root canal procedure is performed.  Another instance where we use temporary fillings is when we do porcelain inlay and onlay fillings. These require us to wait time between the two visits while the porcelain is fabricated in our laboratory. The temporary filling is utilized to seal the tooth while the laboratory fabricates the inlay or onlay filling.

When patients present with small to medium sized cavities, we are able to fill them with tooth colored fillings called composite fillings.  The composite filling is able to seal the tooth and restore the shape, appearance and function of the tooth.  In order to achieve a more cosmetic results, we always match the color of the composite filling material to the color of the patient’s tooth.  This produces a filling that is durable, functional and cosmetically appealing.  

When deficits are larger, they will require an inlay filling.  In this case, we fabricate a porcelain filling that is made from an impression that we take of the tooth. The inlay is made in the laboratory out of porcelain and is installed at a subsequent office visit. 

When there is even larger deficit that involves one of the outside surfaces of the tooth, we perform an onlay filling. An onlay filling is similar to an inlay filling such that it is fabricated in the laboratory out of porcelain from a mold of the tooth. It is also installed at the second visit.  These porcelain fillings and crowns are also matched in color to the patient’s tooth color to achieve a more cosmetic result.

How are dental filling procedures performed?

The first step in a temporary filling is to clean the tooth in question.  All necrotic or decayed tooth is removed and the tooth is thoroughly cleaned to remove all plaque, bacteria and tartar.  The temporary filling starts off as a moldable putty. This putty is placed onto the tooth in question and shaped such that it restores the size, shape and biting surface of the tooth.  In a small amount of time this putty hardens forming the temporary filling.

The first step in performing a composite filling is to remove the decayed or necrotic parts of the tooth.  Additionally, the tooth surface is cleaned to remove all bacteria, plaque and tartar.  Once the tooth is cleaned sufficiently, the composite filling is bonded to the tooth. It is molded to the proper size shape and is light cured to permanently harden. 

When cavities and deficits within the tooth are larger, a porcelain filling is used in the form of an inlay or onlay.  The technique for both of these is very similar.  Any necrotic or decayed part of the tooth is removed.  The remaining surfaces are thoroughly cleansed to remove all plaque, bacteria and tartar.  At this stage, a mold is taken to identify the exact shape of the tooth.  This mold is sent to our laboratory in order to have an inlay or onlay custom fabricated from porcelain.  A temporary filling is then placed on the tooth to seal it.  The patient returns to have the inlay or onlay filling installed and permanently bonded to the tooth after the temporary filling is removed.

When the deficit is even larger, a filling by itself will not work.  We will then perform a dental crown procedure.  A crown covers the entire tooth.  Similar to the inlay or onlay, once all the necrotic or decayed tooth is removed, and the remaining surfaces are thoroughly cleaned, we take a mold of the tooth.  This mold is sent to our laboratory in order to fabricate a custom dental porcelain crown.  A temporary filling is then placed.  The patient then returns at a subsequent visit to have temporary filling removed, and the dental crown permanently bonded to the tooth.

Replacement of old fillings, removal of silver and mercury fillings.

At Sachar Dental NYC, our philosophy is always to use the least toxic materials possible.  Unfortunately, these new non-toxic materials were not always available in the past.  Fillings were often made out of silver amalgam.  These fillings were found to contain mercury which is toxic to the nervous system.  Mercury has been linked to many disease processes.  At Sachar Dental NYC, we are very careful and cautious in the removal of amalgam fillings.  It is crucial that the patient does not inhale any vapor that is formed while removing the amalgam filling.  It is also crucial to have high-speed and low-speed suction evacuation positioned precisely.  They are both positioned precisely over the tooth with the filling that is being removed, in order to remove all the vapor and particles that are formed while we are drilling.  Our highly training dental assistants hold this high-speed suction firmly in place during the entire procedure.  We are meticulous in ensuring there are no particles of the amalgam filling left in the mouth.  When necessary, additionally, we use a rubber dam that prevents any of the mercury materials to be left in the mouth.  The rubber dam exposes only the tooth being worked on, and protects the rest of the mouth. 

What are the costs to have dental fillings performed in New York City?

At Sachar Dental NYC the following are the costs associated with the different types of fillings that we perform:

  • Temporary filling: $200
  • Composite filling: $200 - $400
  • Porcelain filling: $1,500
  • Porcelain crown: $1,800

Does insurance cover the cost of dental fillings?

Most PPO dental insurances cover the cost of all the types of fillings mentioned above at 50-80%.  We will submit the claim to your insurance company and only collect the patient’s small portion at the time of the visit.  We always inform our patients what to expect their out-of-pocket costs will be, before performing any type of procedure.  Prior to your visit, we check with your insurance company to determine what are your level of benefits. 

Can I use flexible spending dollars or a medical savings account for these charges?

Yes, you may be able to use your medical savings accounts or flexible spending dollars to cover charges related to your treatment.  At the time of your service, we will provide you with all the necessary documentation and receipts.

Do you offer payment plans for treatment?

At Sachar Dental NYC, we offer interest free financing through Lending Club and Care Credit.  In 15 minutes, we will let you know if you are approved for interest-free financing.  These options will enable you to make payments over the next 12-18 months without any interest charged.

Why are we the best dentists in New York City for fillings?

At Sachar Dental NYC, our philosophy is to always perform the least invasive procedures possible to solve the problem.  We try to maintain as much of the natural tooth as possible, and do not rush into more invasive procedures such as extractions or crowns.  Additionally, we always use the least toxic materials possible.  Although it costs us more for a BPA-Free material, we think it is worth it. We do not pass this cost onto our patients.

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