A client came to see us having broken his tooth eating crunchy food. He had a bad experience 4 years ago and had been reluctant to see a dentist. The tooth was not causing him any pain but he knew he had to get it attended to.
On assessing the tooth it had a very large composite white filling with a large chip to the side of the tooth. White composite fillings are excellent for small to medium sized cavities as they bond to the tooth and can bring the strength of the tooth back. When they get to a larger size the tooth can become quite weak and very large white fillings may only last you a few years and will then start to fail due to the high forces being placed on the tooth.
An alternative stronger option would be a porcelain onlay. These are lab made restorations which are very strong when bonded to the tooth. They can be designed to protect the biting surface of the tooth and therefore help to protect the cusps and prevent them from breaking. The edges of the porcelain onlays are normally kept above the gum line and can therefore be easily kept clean. Onlays are tooth conservative which means that as much of the natural tooth is preserved which helps to provide strength.
Unfortunately for this gentleman, the cavity in his tooth had been left for far too long and the decay was too extensive in the tooth to be able to save. Had he come much early we could have saved his tooth.