Two decisions determine the outcome in restorative dentistry: how much tooth structure is removed, and what is put back in its place.
We work with materials that contain no metal, do not corrode, and create no galvanic action in the mouth.
Leaving sound tooth structure in place is the first criterion of our planning.
Restorative dentistry means replacing tooth structure lost to decay or fracture. That sounds simple, but two decisions determine the whole outcome: how much structure we remove and what we put back.
A holistic approach differs precisely in the answers to those two questions. The aim is to leave the tooth as intact as possible and to place materials in the mouth that are compatible with the body.
The mouth is a permanently moist environment subject to temperature changes, and saliva behaves as an electrolyte. When dissimilar metals are present together in such an environment, a weak electrical interaction can occur between them.
If, for example, there is an old amalgam filling on one side and a metal-supported crown on the other, a current can arise between those two metals through the saliva. Reported complaints vary from person to person:
It does not occur in everyone, and not everyone notices it. However, when a metal-free material is chosen, the possibility disappears entirely. That is our approach: where possible, select the material that removes the question from the table.
Metal-containing restorations may corrode over time. The visible consequence is a greyish discolouration at the filling margin or near the gum line. Ceramic and composite-based materials do not undergo this corrosion process.
No artificial material is as good as the tooth’s own enamel and dentine. For that reason the first criterion in restorative planning is the question “how little can I remove?”
In practice this means:
In the literature this approach is known as minimally invasive dentistry — the restorative expression of a holistic outlook.
| Material | Where it is used | Key characteristic |
|---|---|---|
| Composite | Small to medium fillings, anterior reshaping | Placed in a single visit, very little tissue loss, metal-free |
| Hybrid ceramic | Posterior inlays / onlays | Flexibility close to natural tooth, low risk of wearing the opposing tooth |
| Glass ceramic (e.max) | Anterior and posterior aesthetic restorations | High translucency, natural appearance |
| Full ceramic / zirconia | Larger restorations requiring strength | High strength without a metal substructure |
What they have in common: none contains a metal substructure, none corrodes in the mouth, and all can approach the light transmission of a natural tooth. Which is appropriate depends on the chewing load of the area, the remaining tissue and the aesthetic expectation.
In short: if the loss is small, composite is usually sufficient and more conservative. If the loss is large, a laboratory-produced ceramic restoration is both stronger and more stable in the long run. For intermediate sizes the decision depends on the position of the tooth and on any clenching habit.
When a tooth has lost a lot of structure, the reflex is often “let’s crown it”. Yet there are several steps in between, and those steps remove far less tissue.
| Restoration | What it covers | Tissue removed |
|---|---|---|
| Filling (composite) | The carious area | Only the decayed part |
| Inlay | The inner area between the cusps | Very little; cusps preserved |
| Onlay | Inner area + one or more cusps | Little; outer walls largely retained |
| Overlay | The entire occlusal surface | Moderate; side walls can be preserved |
| Full crown | The whole tooth | The most; the tooth is reduced on all sides |
Inlays, onlays and overlays are produced in the laboratory and bonded to the tooth. They offer better marginal adaptation than large fillings and far less tissue loss than a crown. Where sufficient structure remains, our preference is for these intermediate steps.
A frequent question that deserves a careful answer. To be clear:
The decision is therefore made on the current condition of the tooth and the patient’s preference — not on a slogan. We review your existing restorations together during examination.
What determines the lifespan of a well-made restoration is usually not the material but what happens afterwards.
A restoration goes unnoticed not simply by choosing the right shade number. A natural tooth is not a single colour: the incisal edge is translucent, the cervical region more saturated, and the surface carries fine lines and texture.
For anterior restorations we therefore work in layers, applying materials of differing translucency to reproduce how a natural tooth handles light. Most of our ceramic restorations are characterised by hand in our own practice — the work described on the Ceramic Workarts page.
This page is for general information. Which restoration suits you can only be determined after examination and any necessary imaging.
Today’s composite and ceramic materials, applied with the correct indication and technique, have the strength to withstand chewing forces. The determining factors are the remaining tooth structure, the size of the restoration and the quality of the application — not whether the material contains metal.
It does not cause complaints in everyone. However, if there are findings such as a metallic taste, unexplained sensitivity or local irritation of the mucosa, the presence of dissimilar metals together is worth assessing. We review it with you during examination.
It depends on size, location and oral hygiene. Small and medium composites can function for many years with appropriate care. In patients who clench, the lifespan may be shorter; a night guard then becomes relevant.
Not always. Depending on the remaining structure, partial ceramic restorations such as onlays or overlays can strengthen the tooth without full coverage. The decision follows radiographs and clinical examination.
Composite materials may discolour somewhat over the years; polishing restores much of it. Ceramic restorations are more advantageous in terms of colour stability. Coffee, tea and smoking accelerate staining in both groups.
We can assess together the condition of your existing fillings, whether moving to metal-free restorations is right for you, and which material would suit. You can request an appointment through our contact page.
For the whole of our holistic approach, see the Holistic Dentistry page.