Fillings and Core Buildups

Dental procedure
Overview

Fillings are among the most frequently prescribed and versatile of all dental restorations. In a procedure known as cavity preparation, the dentist uses any of a variety of dental drills (also called burs), microabrasion devices, or laser tips to remove damaged tooth structure, and any tooth material that has been weakened or undermined by decay. Applying their knowledge of ideal tooth shape (morphology), dentists replace the missing tooth structure with filling material of various types.

Fillings are placed into teeth following the removal of tooth decay (caries), and filling material can also be used to restore chipped or partially broken teeth to their normal contour and function.

When performed traditionally, a mixture of silver, zinc, copper and mercury known as amalgam is used to fill the back teeth, and sometimes even the front ones if the decay is on a surface that is not visible when the patient smiles. Although they can be bonded into the tooth with modern dental adhesives, silver fillings are held into the tooth primarily by mechanical interlocking features cut into the tooth by the dentist.

If replacement of multiple silver fillings is recommended, it’s a good idea to understand what’s involved and why it’s important. Diagnostic photographs of failing (for example, cracked) fillings can help you to understand why replacement may be needed. If you are having it done for cosmetic reasons, it’s important to understand the risks.

Large four-surface silver filling that is still in excellent shape.

Figure 1: A large silver filling in a lower molar tooth. (Image courtesy Byron J. Greany, DDS)

Figure 1 shows a large silver filling in a lower molar tooth. These fillings have been the workhorse of dentistry for many years, and when properly placed and cared for, can provide decades of service. Placing silver fillings in the presence of significant moisture (for example, saliva) can cause them to outgas, resulting in pitting and voids that reduce their service life. That’s why it’s important to isolate the teeth with a rubber dam or cotton rolls when placing silver fillings in them.

The debate surrounding the use of mercury in silver fillings continues. Because of silver amalgam’s durability, track record for long term success, ease of use, similar wear properties to natural tooth enamel, and relative inexpense, it continues to be widely used and endorsed as safe for most patients. If you have questions about the safe use of silver for you or your child, talk it over with your dentist. There are generally other options available.

Beginning in the 1960’s a process known as dental bonding was developed. Since its inception, dental bonding has continued to improve in strength and durability, allowing teeth to be more conservatively restored. Modern bonding materials may allow teeth that have been structurally compromised to be repaired with long-lasting and cosmetically pleasing fillings. A tooth-colored material known as composite resin is currently used to restore many cavities—even those found in the back teeth (Figures 2, 3, and 4).

Dental caries (tooth decay, or cavities) has infected this lower molar tooth.

Figure 2: Tooth decay (caries) has created a cavity in this partially prepared lower molar tooth.

Figure 2 shows where tooth decay (caries) has created a cavity in this partially prepared lower molar tooth. Blue caries detection dye has been used to identify less obvious areas of decay. Use of caries detection dye helps the dentist remove all of the decay without removing too much tooth structure.

Tooth cavity preparation for a composite resin filling dental restoration.

Figure 3: The decay has been removed.

Figure 3 shows the cavity prepared for a filling. The decay has been removed, and the preparation stained with dye to verify complete caries removal. No dye is visible, because the decay has all been removed. If the decay is very deep into the tooth, the dentist may place a layer of base material (an insulation layer) over the yellow dentin floor. Some cavities require very thin base layers called liners.

Bases and liners can reduce post-operative sensitivity in the tooth, and promote formation of reparative dentin (a calcified substance cells in the tooth produce to protect the pulp from damage). Some dentists apply desensitizing agents to the exposed dentin before filling the cavity. All of these techniques are considered to be part of the filling process.

A 1-surface composite resin filling in a lower permanent molar (note rubber dam).

Figure 4: A tooth-colored composite resin filling has been placed in the prepared cavity.

In Figure 4, a tooth-colored composite resin filling has been placed in the prepared cavity. Well placed and well taken care of, it should provide many years of service.

The process

Before teeth are filled

When you have fillings done, the dentist will review your health history. If you have replacement joints (for example, total knee replacement, hip replacement, etc.), you may be pre-medicated with antibiotics for the procedure. If you have certain types of heart murmurs or replacement heart valves, you may also need to take an antibiotic pre-medication prior to the procedure.

If you are anxious about dental procedures, your dentist may recommend sedating you for the procedure. There are several methods of relaxing patients for dental treatment, including oral anti-anxiety pills like Valium®; inhaled anti-anxiety medication like nitrous oxide; and intravenous anti-anxiety medication, such as Versed®. Your dental plan may not pay benefits toward sedation.

The following description of the filling procedure may vary from patient to patient, and dentist to dentist, depending on unique individual circumstances and preferences. However, the steps will generally resemble the following:

On the day of, or prior to treatment, your dentist will generally review the procedure, its risks and anticipated benefits with you. Ask any questions you may have ahead of time. Understanding the procedure, and any options you may have will lead to the best possible treatment outcome.

Anesthetic

A dental team member will frequently apply a topical numbing gel to the anesthetic injection site, to help reduce injection discomfort. Sometimes cavity preparations can be accomplished without any anesthetic. You should discuss that with your dentist. If local anesthetic is administered, you will generally feel just a slight pinch, if anything. After that, the area will begin to tingle, and then “go to sleep”, normally for a couple of hours. Injections for lower molar teeth can produce a bit more discomfort, because the nerves to be numbed are deeper under the skin.

If the patient is a child, don’t tell them in advance that they’re “going to get a shot.” Most of the time, children who are not pre-conditioned to fear a procedure by an adult will be unaware of the injection. Most dentists who treat kids are pretty good at talking a young patient through what to expect without making them fearful.

Isolation of the teeth

Once the tooth or teeth are numb, the dentist or dental assistant may isolate the area with a rubber dental dam or other barrier. Although these are sometimes awkward to place, they can enhance the procedure and the treatment outcome greatly. Rubber dams prevent contamination of the filling with saliva and warm, moist, exhaled air, which can impair the bond between the filling and the tooth. Rubber dams also prevent the patient from having to swallow bacteria-rich decay and old filling material. They protect the tongue and cheeks from injury by dental instrumentation. You can think of rubber dams as a surgical drape. Patients often express concerns that they won’t be able to breathe or swallow if a rubber dam is used; however, neither is the case. If you anticipate difficulty breathing through your nose, an external nasal dilator (for example, BreatheRight Strips®) may help.

Decay removal/Cavity preparation

When good isolation is achieved, the dentist will remove the tooth decay with a dental handpiece, a laser handpiece, or an abrasion handpiece. The type of device to be used reflects the dentist’s philosophy and training to a large extent; however the goal is always to remove bacterially infected and weakened tooth structure. When all of the obvious decay has been removed, and the preparation shape has been idealized to retain a filling, the dentist may use a caries detection dye, which will stain areas of less obvious decay. It helps the dentist remove all of the decay without removing excess tooth structure. Some dentists may use a cavity disinfecting solution like chlorhexidine, which can kill tooth bacteria and help remove tooth cuttings known as smear layer for a better bond.

If the cavity is deep, the dentist may apply a base layer or liner to insulate or medicate the tooth pulp. Some dentists use desensitizing varnishes. If the filling is to be bonded into the tooth, the cavity will be etched for a short time with a phosphoric acid solution. Any of a variety of adhesives and adhesive primers will be applied. The filling will be placed, and, in the case of composite resin fillings, will be cured (polymerized) with a blue light. It will then be polished, and following removal of the isolation barrier, the bite will be checked and adjusted if necessary.

Dental acid etch solution is used to prepare enamel and dentin as the first step in the bonding process.

Figure 1: Dental acid etch solution is applied to the prepared enamel and dentin as the first step in the bonding process. Often, a de-sensitizing agent will be applied to the prepared dentin prior to acid etching.

Dental bonding

Dental bonding is a technique used by dentists to firmly attach fillings, crowns, inlays, onlays and veneers to the teeth (Figures 1 and 2). Virtually all bonding systems combine the following steps: An acid solution is applied to the tooth to produce a microscopically roughened surface. Under a microscope, acid-etched tooth structure resembles Velcro®, with linear filaments projecting from the tooth surface.

A liquid adhesive solution is applied, which contains long strands of resin polymers that entangle themselves among the linear filaments of enamel. When the polymer strands of the dental adhesives are exposed to light of a certain wavelength, they begin to form molecular bonds (cross-links) with one another, effectively locking themselves in among the enamel filaments. Tails of the polymer strands are left protruding from the tooth’s surface on every wall of the prepared tooth.

A dental curing light produces blue wavelength light to cure the photopolymer composite resin filling.

Figure 2: A blue light source (approximately 460 nanometer wavelength) is used to harden tooth-colored, composite resin filling material in these lower molar teeth.

The dental restoration (fillings, crowns, etc.) is also treated to produce a similar surface. When the restoration is placed in the tooth and exposed to the curing (polymerizing light), the polymer strands from the tooth and restoration cross-link, producing an ultra strong chemical bond. Different materials have been developed to enhance the process, but they all work in essentially this way.

Bonding has ushered in a new era of minimally invasive dentistry, in which teeth can now be fixed without the need to cut away healthy tooth structure, just to hold a filling or crown onto the tooth.

Advantages and benefits

The following are advantages and intended benefits of fillings in teeth:

  • They restore the affected tooth to its normal contour and function.
  • Bonded fillings are minimally invasive and can strengthen the teeth to help prevent them from breaking—in some cases delaying the need for crowns or onlays indefinitely.
  • Removing decay and filling the cavities reduces the number of active bacteria in the mouth.
  • Early intervention by filling cavities before they get bigger preserves tooth structure and extends the tooth’s life.
  • Preserving the teeth preserves the jaw bones, and the contours of the face.
  • Preserving the teeth prevents unwanted tooth movement and changes in the bite.
  • Fillings are the most economical way to restore teeth. They can also be among the most cosmetically pleasing, and in certain applications, can last decades.
Disadvantages and risks

Preparing teeth for fillings involves the removal of both diseased and healthy tooth structure. Ideally, the amount of healthy tooth that is removed is kept to a minimum, especially when caries detection dye is used. However, teeth are living tissues, and working on them is considered a surgical procedure. Surgical procedures of any kind have the following risks:

  • Discomfort, either during or after the procedure. Generally, this is minor and easily controlled.
  • Risks associated with local anesthetic (if used). These are also generally minor.
  • Sensitivity to biting, cold, or heat, following the procedure. Normally this is temporary. The risk of post-operative sensitivity is greater if a tooth is not isolated from mouth moisture for fillings which are bonded into place.
  • Inflammation of the tooth pulp (pulpitis), which may be temporary (reversible), or irreversible. If your tooth sensitivity does not resolve, the tooth may require root canal (endodontic) therapy. The risk of developing irreversible pulpitis and/or infection (abscess) is also greater if bonded restorations are placed in a tooth without isolating the tooth from mouth moisture.
  • Infection of the tooth pulp or the surrounding gum tissues following the procedure. Unless the decay extends deep inside the tooth, the risk of pulp infection is relatively low for routine fillings. Whether or not a tooth gets better on its own afterward depends on many factors, including age of the patient, immune status of the patient, restorative history of the tooth (i.e. whether it has been worked on before). In general, young, healthy patients will have more healing cells and immune cells per litre of blood volume, and are less likely to develop complications post-operatively (with a wide degree of variation).
  • Deep decay may extend into the tooth pulp (nerve and blood vessel tissue inside the tooth). If so, the tooth may require root canal (endodontic) therapy, and a crown or onlay may be recommended after the root canal treatment is completed.
  • Some teeth have small offshoots of nerve tissue called ectopic pulp horns, which may be encountered even in a routine cavity preparation. These are rare, but when encountered can result in the need for root canal (endodontic) therapy.
  • Fillings can break and require replacement.
  • Large fillings involving surfaces that touch the adjacent teeth may result in an open contact with the neighboring teeth. This can lead to a food compaction injury. There are usually options to placing large fillings, however the cost may be greater. Your dentist is the most qualified person to tell you whether your tooth could get by with a large filling, or whether some other type of restoration would be more appropriate.
  • New fillings may have overextended areas called overhangs or flash, which can shred dental floss and collect food. Left uncorrected, flash can lead to inflammation of the periodontal tissues and a re-occurence of decay in the tooth. Generally, flash is easy to remove/re-contour, so be sure to let your dentist know if you’re experiencing this problem.
Other care that may be needed

Additional procedures that are commonly required in patients needing fillings:

  • Enamel microabrasion: for minimally invasive tooth preparation. This is generally not billed separately from the filling procedure.
  • Sealants: to help prevent cavities on other teeth from developing.
  • Prophylactic odontotomy: another option that may be available to help prevent cavities on other teeth from developing.
  • Topical fluoride treatment: a third method of preventing cavities
  • Crown lengthening surgery: if decay extends onto the roots of your tooth.
  • Root canal treatment (endodontics): if the decay extends into, or close to the pulp.
Other treatment options

Depending on the size of the decay or chip in your tooth, any of the dental procedures listed below may be an option to fillings. Fillings will generally be the most economical option, and can have equal longevity and superior esthetics (keeping their limitations in mind).

Crowns may be needed if a significant portion of the tooth is damaged and decayed. Onlays are like crowns, but they are usually more conservative of natural tooth structure, covering only the damaged areas of the tooth when a crown may not be needed. Onlays (by definition) cover at least one of the tooth’s pointed cusps.

Inlays are like fillings, but they’re made outside the mouth and bonded or cemented into the tooth (depending on what they’re made of). Building them outside the mouth makes it easier to produce normal tooth contours, and close contacts with adjacent teeth more predictably when the damaged or decayed area is a little bit to large for a filling.

Veneers are most often done on the visible surfaces of teeth to repair minor cracks; chips; decayed areas; or simply to provide an improvement in the cosmetic appearance of the affected tooth (or teeth).

Your dentist is the most qualified individual to tell you which type of restoration is most appropriate for your tooth.

What if I do nothing?

Allowing tooth decay (caries) to go untreated will result in destruction of additional tooth structure, and the need for more extensive dentistry, which may include root canal (endodontic) therapy, tooth removal (extraction), and tooth replacement (for example, with fixed bridgework, removable dentures, or dental implants).

Eventually, the bacteria that are present in a tooth cavity will reach the hollow inside of the tooth (pulp), and will have an open pathway into your jawbone. This can cause pain, swelling, numbness or altered sensation; and can lead to tooth loss. Premature loss of teeth causes the other teeth to shift, altering the bite, and affecting the jaw joints. Rarely, infections resulting from advanced tooth decay have led to death.

Author: Thomas J. Greany, D.D.S.
Editor: Ken Lambrecht
This page was reviewed by members of our review board.

This page was last updated on July 7, 2015.

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Acute Apical Abscess
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Caries
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Crowns
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Dental Implants
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Endodontics
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Failing Dental Restorations
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Fluoride Treatments
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Food Compaction Injuries
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Photographs
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Post-Operative Hyperocclusion
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Veneers
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Links to additional (more technical) dental information on the Web

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Background information

Effect of Addition of Citric Acid and Casein Phosphopeptide-Amorphous Calcium Phosphate to a Sugar-Free Chewing Gum on Enamel Remineralization in situ
Cai, F., et al.
Caries Research
2007 (41): 377-383

Update on the Adaptive Immune Responses of the Dental Pulp
Hahn, Chin-Lo, MS, PhD, DDS and Liewehr, Frederick R., DDS, MS
Journal of Endodontics
2007 33 (7): 773-781

Postoperative Sensitivity in Class I Composite Resin Restorations in vivo
Casselli, Maia, et al.
Journal of Adhesive Dentistry
2006 8 (1): 53-58

A clinical evaluation of packable and microhybrid resin composite restorations: One-year report
de Souza, Fabio Barbosa, DDS, et al.
Quintessence International
2005 36 (1)

Endodontic complications after plastic restorations in general practice
Whitworth, J. M., et al.
International Endodontic Journal
2005 38 (6): 409-416
Editor’s notes: In an e-mail received from Dr. Whitworth on February 20, 2008 he stated that the study was conducted by the British National Health Service Primary R&D Division, and that there was “hardly a rubber dam in sight” for the procedures, including the composite resin fillings.

The advantages of minimally invasive dentistry
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
2005 136: 1563-1565

The effect of adhesive and flowable composite on postoperative sensitivity: 2-week results
Perdigao, Jorge, DMD, MS, PhD, et al.
Quintessence International
2004 35 (10): 777-784

Minimally invasive dentistry
Murdoch-Kinch, Carol Anne, DDS, PhD, and McLean, Mary Ellen, DDS
The Journal of the American Dental Association
2003 134: 87-95

Total-etch vs. self-etch adhesive—effect on post-operative sensitivity
Perdigao, Jorge, DMD, MS, PhD, et al.
The Journal of the American Dental Association
2003 134 (12): 1621-1629

Cleaning and polishing efficacy of abrasive-bristle brushes and a prophylaxis paste on resin composite material in vitro
Schmidlin, Patrick R., Dr med dent, et al.
Quintessence International
2002 33 (9): 691-699

Cracked tooth syndrome—incidence, clinical findings and treatment (PDF, 123K)
Homewood, C.I. (Kip), BDSc DDS, LDs, FRACDS
Australian Dental Journal
1998 43 (3): 217-222

Tooth sensitivity related to Class I and II restorations
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
1996 127 (4): 497-498

Dental Adhesive With Composite Restorations: A Clinical and Microstructural Evaluation
Goracci, et al.
International Journal of Prosthodontics
1995 8 (6): 548-556

Does the cycle of rerestoration lead to larger restorations? (PDF, 2704K)
Brantley, C. F., et al.
The Journal of the American Dental Association
1995 126 (10): 1407-1413

Changes in the pulpal vasculature during inflammation
Takahashi, Kazuto, DDS, PhD
Journal of Endodontics
1990 16 (2): 92-97

Caries Vaccine
Various
HealthMantra web site
Last viewed: 9/23/2010
Editor’s notes: An untitled article summarizing various international research projects aimed at developing a caries vaccine. Summary discusses progress 1990–1999.

Comparison of Conventional Caries Detection and Caries Detector Dye
Zavareh, F. Arbabzadeh, et al.
International Association for Dental Research web site
Last viewed: 9/23/2010
Editor’s notes: Originally presented at the International Association for Dental Research/American Association for Dental Research/Canadian Association for Dental Research, 83rd General Session, March 9–12, 2005.

More U.S. Teeth Susceptible to Silent Enamel Eating Syndrome
Not specified
Medical News Today web site
Last viewed: 9/23/2010

Tooth Decay, Open Wide—Oral Health Training for Health Professionals
National Maternal and Child Oral Health Resource Center web site

Last viewed: 9/23/2010

Information you may wish to read before making a decision on treatment

An Evaluation of Buccal Infiltrations and Inferior Alveolar Nerve Blocks in Pulpal Anesthesia for Mandibular First Molars
Jung, Il-Young, DDS, MSc, PhD, et al.
Journal of Endodontics
2008 34 (1): 11-13
Editor’s notes: This article describes a potentially useful technique for getting lower molars numb, which may be more comfortable than traditional methods.

Clinical Performance of Class II Adhesive Restorations in Pulpectomized Primary Molars: 12-month Results
Zulfikaroglu, Burcu Togay, et al.
Journal of Dentistry for Children
2008 75 (1): 33-43

Effects of Natural Cross-Linkers on the Stability of Dentin Collagen and the Inhibition of Root Caries in vitro
Walter, R., et al.
Caries Research
2008 42 (4): 263-268

Preformed metal crowns for decayed primary molar teeth
Innes, NPT, et al.
Cochrane Database of Systematic Reviews
2008 1

Effect of LED Curing Modes on Postoperative Sensitivity After Class I Resin Composite Restorations
Qasem, Alomari, et al.
Journal of Adhesive Dentistry
2007 9 (5): 477-481

Evaluation of a new caries detecting dye for primary and permanent carious dentin
Hosoya, Y., et al.
Journal of Dentistry
2007 35 (2): 137-143

Noninvasive Control of Dental Caries in Children with Active Initial Lesions- A Randomized Clinical Trial
Hausen, H., et al.
Caries Research
2007 (41): 384-391

Treatment of localized anterior tooth wear with a glass-fiber-reinforced composite resin: A clinical report
Akar, Gulcan Coskun, DDS, PhD and Dundar, Mine, DDS, PhD
The Journal of Prosthetic Dentistry
2007 97 (3): 133-136

When and how to repair a failing restoration
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
2007 138: 1605-1607

When is a full crown restoration indicated?
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
2007 138: 101-103

A novel technique using preformed metal crowns for managing carious primary molars in general practice – A retrospective analysis
Innes, N.P.T., et al.
British Dental Journal
2006 200 (8): 451-454

Clinical Evaluation of Posterior Composite Restorations in Endodontically Treated Teeth
Can Say, Esra, DDS, PhD, et al.
The Journal of Contemporary Dental Practice
2006 7 (2)

Influence of remaining coronal tooth structure location on the fracture resistance of restored endodontically treated anterior teeth
Ng, Clarisse C.H., BDSc, et al.
The Journal of Prosthetic Dentistry
2006 95 (4): 290-296

Minimally invasive operative techniques using high tech dentistry (PDF, 148K)
Brostek, Andrew M. Dr., et al.
Dental Practice
2006: 106-106
Editor’s notes: Online publication date September/October 2006.

A review of the management of endodontically treated teeth- Post, core and the final restoration
Cheung, William, DMD
The Journal of the American Dental Association
2005 136 (5): 611-619

Do We Still Need Formocresol in Pediatric Dentistry? (PDF, 593K)
Casas, Michael J., DDS, DPaed, MSc, FRCD(C), et al.
Journal of the Canadian Dental Association
2005 71 (10): 749-751

Effect of bonding amalgam on the reinforcement of teeth
Rasheed, Ammar A., BDS, MSc
The Journal of Prosthetic Dentistry
2005 93 (1): 51-55

Long-term survival of endodontically treated molars without crown coverage: A retrospective cohort study
Nagasiri, Rapeephan, DDS, MS, and Chitmongkolsuk, Somsak, DDS, Dr Med Dent
The Journal of Prosthetic Dentistry
2005 93 (2): 164-170

Longevity of posterior tooth dental restorations
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
2005 136 (2): 201-203

What has happened to conservative tooth restorations?
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
2005 136: 1435-1437

Review of Pediatric Sedation
Cravero, Joseph P., MD, and Blike, George T., MD
Anesthesia & Analgesia
2004 99: 1355-1364

The effect of external nasal dilators on blood oxygen levels in dental patients
Moses, Alan J., DDS and Lieberman, Marcus, PhD
The Journal of the American Dental Association
2003 134 (1): 97-101

Amalgam—Resurrection and Redemption, Part 1: The Clinical and Legal Mythology of Anti-Amalgam
Wahl, Michael J., DDS
Quintessence Publishing Company
2001

Amalgam—Resurrection and Redemption, Part 1: The Medical Mythology of Anti-Amalgam
Wahl, Michael J., DDS
Quintessence Publishing Company
2001

Managing incomplete tooth fractures
Ailor, J. Edward Jr., DDS
The Journal of the American Dental Association
2000 131 (8): 1168-1174

Tooth wear treated with direct composite restorations at an increased vertical dimension: Results at 30 months
Hemmings, Kenneth W., BDS, MSc, et al.
The Journal of Prosthetic Dentistry
2000 83 (3): 287-293

Reduction of post-operative pain: A double-blind, randomized clinical trial
Browning, William D., DDS, MS, et al.
The Journal of the American Dental Association
1997 128 (12): 1661-1667

Reduction of postoperative pain: a double-blind, randomized clinical trial
Browning, William D., DDS, MS, et al.
The Journal of the American Dental Association
1997 128 (12): 1661-1667

The 5-year clinical performance of direct composite additions to correct tooth form and position: II. Marginal qualities
Peumans, M., et al.
Clinical Oral Investigations
1997 1 (1)

Addressing the caries dilemma: detection and intervention with a disclosing agent
Styner, D. et al.
General Dentistry
1996 44 (5): 446-449

The use of caries detector dye in diagnosis of occlusal carious lesions
al-Sahaibany, F., et al.
Journal of Clinical Pediatric Dentistry
1996 20 (4): 293-298

A New Technique for Restoration of Worn Anterior Teeth—1995 (PDF, 565K)
Christensen, Gordon J., DDS, MSD, PhD
The Journal of the American Dental Association
1995 126 (11): 1543-1546

ADA Seeks Clarification on FDA Dental Amalgam Statement
American Dental Association web site
Last viewed: 8/27/2008
Notes: ADA media release containing statements on FDA’s Settlement of Dental Amalgam Lawsuit filed by Moms Against Mercury

Cranberries contain possible anti-caries/anti-plaque agents
BrightSurf.com web site
Last viewed: 9/23/2010
Editor’s notes: Correspondence with the IADR showed that this research was presented at the annual meeting of the IADR in Brisbane, Australia, June 29, 2006 by Koo, H, et al. Dr. Koo’s group has published two articles on the subject.

Definitive Restoration of Endodontically Treated Teeth in a German Dental Office: a Retrospective Study
Tekyatan, H., et al.
International Association for Dental Research web site
Last viewed: 9/23/2010
Editor’s notes: From the Proceedings of the 81st General Session of the International Association for Dental Research; June 25–28, 2003.

Endocarditis Prophylaxis Information
American Heart Association web site
Last viewed: 9/23/2010

FDA says mercury-based fillings not harmful—Critics say agency playing politics, seek ban on their use in pregnant women
msnbc.com web site
Last viewed: 9/23/2010
Notes: Associated Press—September 1, 2006

In Battle Against Tooth Decay Simple Push Fillings Preferred Over Crowns
Charlotte Webber, BioMed Central
Medical News Today web site
Last viewed: 9/24/2010

Innovative New Treatments Take Fear Out of Dentist’s Chair
No author specified
Medical News Today web site
Last viewed: 8/27/2008

JAMA Publishes Dental Amalgam Studies (PDF, 96K)
Illinois State Dental Society web site
Last viewed: 9/23/2010
Notes: American Medical Association issues statement in support of the use of dental amalgam—April 19, 2006

Letter to U.S. Representative Ron Paul stating the USFDA’s position on use of dental amalgam (PDF, 416K)
U.S. Food and Drug Administration web site
Last viewed: 9/23/2010
Notes: A letter from an FDA spokesperson to US Representative Ron Paul (TX), describing the current position of the US Food and Drug Administration on Dental Amalgam Fillings, August 5, 2002.

Microdentistry Fundamentals
No author specified
National Center for Biotechnology Information web site
Last viewed: 9/23/2010

Questions and Answers on Dental Amalgam
U.S. Food and Drug Administration web site
Last viewed: 8/27/2008
Notes: U.S. Food and Drug Administration Web site