Odds are that somewhere along the way most adults have had a tooth filled, probably more than one. Fillings are how dentists repair teeth that have been damaged in some way, usually due to tooth decay. The purpose of the filling is to restore the area of tooth that has been damaged so that it can function properly again.
There are several types of fillings available. One of the oldest filling materials available is gold. Gold is available as both a filling material and a crown material. The advantages of a gold filling is that they are very long lasting. The disadvantages of a gold filling are that they are expensive, and they are highly visible. Another very old filling material is silver amalgam. The advantages of silver amalgam are that it is inexpensive, and it also is long lasting. There are 3 distinct disadvantages to silver amalgam, however:
1- It is not bonded to the tooth, and so it does not protect the tooth from cracking. It is basically cement in a post hole.
2- It is highly visible, often turning almost black due to tarnishing.
3- Silver amalgam contains mercury. This is a controversy in dentistry right now. Some research says there is no danger, other research says that there is.
The next filling material that is available is composite resin, usually referred to as “white fillings”. The advantages of composite is that it looks just like tooth, and it bonds to the tooth. This bonding allows the filling to resist cracking of the tooth, and allows the filling to be smaller because it doesn’t have to mechanically lock into the tooth. The disadvantages of composites are that it is more expensive, takes longer to place (because of all the bonding steps), and is very technique sensitive. All the proper steps must be taken (no shortcuts) or the filling will not last very long.
So, which material does the best job overall? What would I pick for my own teeth? Here at Dayspring Laser Dentistry we do strictly composite resin (white fillings). Why is that? Let’s answer that by looking back at all the materials. Gold is a wonderful material that has stood the test of time. Direct filling of teeth with gold (not crowns) poses some special challenges. The material used is a gold foil (like aluminum foil), and it is compressed into the tooth with a small impact hammer that compresses the foil into a single block of gold (like compressing aluminum foil into a ball). These impact hammers sometimes cause inflammation to the nerve of the tooth, which can result in a root canal. Also, gold can be quite expensive, and of course, highly visible.
Let’s look at silver amalgam next. From a purely dental standpoint, I want a material that bonds the tooth and restores strength, rather than acting like a wedge between the cusps. I also want to remove as little tooth as possible to restore your cavity. Of course, I want something that looks like a real tooth. But, the mercury is an important issue as well. The ADA and WHO are on record that amalgam is perfectly safe, and research has shown this. However, there are environmental factors at work as well. All dental offices are required to have an “amalgam separator on their suction systems so that amalgam scrap doesn’t go into our water supply. Also, it has been shown that mercury vapor levels are high in dental offices that use amalgam, posing a risk to those of us who work here. For these reasons, we decided 18 years ago to no longer use silver amalgam. I still have amalgams in my own mouth, and I only recommend replacing the ones that have new decay, but we don’t place any new ones. I feel that the newer materials allow us a way to restore teeth just as well without the use of mercury.
So, that brings us to composite resin “white fillings”. The most important aspect of using this material is attention to detail. Composite resin must be placed with no contamination by saliva. For this reason, we normally use a rubber dam or a special suction device that holds the mouth open, holds the tongue back, and suctions at the same time. It is also necessary to follow the bonding manufacturer’s instructions exactly. This is why composites take longer to place than other fillings, and cost more than amalgams. But, if you take these important steps, the composites will last for many years. One final step we take is a special light curing technique to reduce the shrinkage of the composite to prevent sensitivity.
At Dayspring Laser Dentistry we study constantly to be on the cutting edge of dentistry, and provide our patients with excellent care.
Call 856-875-8400 to make an appointment. You can also email us at firstname.lastname@example.org with any questions you may have.