Tooth Fillings

If you need to have a tooth filled (restored), there are different kinds of materials that can be used. Your dentist will talk with you about the kind of filling material that is best for you and for the tooth that needs to be filled. Each kind of material has advantages and disadvantages. You should know what these factors are so that you can make an informed choice.

What you choose depends on your needs and the best way to repair the cavity in your tooth. There are other factors that may affect the choice of filling material. These include the location of the filling and biting forces in the area of the mouth where the filling is located.

For many years, the only choices for fillings were metal. These are a mixture or “amalgam” of mercury and silver alloys, or gold alloy. In the past 20 to 30 years, other materials have been developed for fillings. These are “tooth colored” rather than silver-colored and gold. They include composite resin, glass isonomer and porcelain.

The final choice is yours.

 Choices in Restorative Materials (fillings):

Amalgam

The word “amalgam” means a mix or blend. It can be a mixture of mercury with another metal or mix of metals.

Dental amalgams include mercury, silver, copper and tin. About 40% to 50% of the filling material is mercury. They have been called “silver fillings” because of their silver color when they are first placed. It is usually used on back teeth. It is one of the oldest filling materials and has been used for over 150 years.

Advantages:

– Amalgam is very strong and lasts a long time.

– Fillings are usually done in one visit.

– This is the least expensive type of filling material.

Disadvantages:

Amalgam fillings give off mercury vapor. The vapors can then be inhaled and enter your body.

– Current studies cannot confirm if this mercury causes health problems.

– Amalgam has a silver color that can get darker over time.

Composite (resin)

Composite is a mixture of plastic resin. These fillings are also called plastic or “white fillings.” This type of material may either be chemical cure or may be hardened by exposure to ultraviolet light. Composite is used for fillings, and veneers. Sometimes it is used for replacing parts of broken teeth.

Advantages:

– These fillings are the color of natural teeth.

– Composites may be used on either front or back teeth.

– Fillings are usually done in one visit.

– Composite is a relatively strong material.

Disadvantages:

– This type of filling can break and wear out more easily than metal fillings, especially in areas of heavy biting forces. As a result, composite fillings may need to be replaced more often than metal fillings.

– Compared to other fillings, composite fillings are sometimes difficult and time-consuming to place. They cannot be used in all situations.

– Composite has a moderate cost. It cost more than amalgam.

– A chemical called Bisphenol A can be released from composite fillings. This chemical has hormone-like activity. Current studies cannot tell if this is a health problem. No government has recommended limits on its use.

Glass Ionomer

Glass ionomer is a glass product. It is used for small or temporary fillings. It is also used as a cement for dental crowns. It is usually not used on the chewing surfaces of back teeth.

Advantages:

– These fillings are the color of natural teeth.

– Glass ionomer contains fluoride. This helps prevent further decay.

– Fillings are usually done in one visit.

Disadvantages:

These fillings will not last as long as other materials.

– Glass ionomer is not recommended for use on the chewing surfaces of back teeth.

– This material has a moderate cost, like a composite.

Gold or Gold Alloy

Gold or gold alloy fillings are a mix of gold and other metals such as silver and copper. This material is used for crowns, and bridges. Fillings made of gold alloy are made in a dental lab and sent back to the dentist to cement into place.

Advantages:

– Gold is extremely strong. Fillings made of gold alloy will last a long time.

– Gold alloy may have porcelain fused to the outside surface to make it tooth colored.

– No toxic or environmental effects have been indentified to date.

Disadvantages:

– Gold has a high cost, more than all other materials.

– More than one dental appointment is needed to complete these fillings.

– Fillings are gold colored if not covered with porcelain.

Porcelain

Porcelain is a mix of glass-like materials. Sometimes it is called ceramic. It is used for tooth colored crowns, and bridges. Fillings made of porcelain are made in a dental lab and sent back to the dentist to cement into place.

Advantages:

– These fillings are tooth-colored.

– They may be used alone or fused to gold alloy to make them tooth colored.

– Porcelain usually lasts a long time.

Disadvantages:

– Porcelain is somewhat brittle and may fracture.

– More than one dental appointment is needed to complete the filling.

– Porcelain has a high cost, similar to gold.

The result is a beautiful smile!