Traditional dental restoratives, or fillings, include amalgam, composite, porcelain and gold. The strength and durability of traditional dental materials make them useful for situations where restored teeth must withstand extreme forces that result from chewing, often in the back of the mouth.
What’s right for me?
Several factors influence the performance, durability, longevity, and expense of dental restorations, including:
- The components used in the filling material
- The amount of remaining tooth structure
- Where and how the filling is placed
- The chewing load that the tooth will have to bear
- The length and number of visits needed to prepare and adjust the restored tooth
Before your treatment begins, your doctor will discuss all of your options with you and help you choose the best filling for your particular case. In preparation for this discussion it may be helpful to understand the two basic types of dental fillings: direct and indirect.
Direct fillings are placed immediately into a prepared cavity during a single visit. They include amalgam or silver and composite (resin) fillings. The dentist prepares the tooth, places the filling, and adjusts it in one appointment.
Indirect fillings generally require two or more visits. They include inlays, onlays, veneers, crowns, and bridges fabricated with gold, base metal alloys, ceramics, or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The dentist then places a temporary covering over the prepared tooth. The impression is sent to a dental laboratory, which creates the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed.
At Whitemud Dental, we offer all available filling materials and explain the pros and cons of each so you can make an educated decision which material is best for your situation.
Amalgam filling (metal)
Amalgam fillings are still used regularly because they are economic, safe, easy to place, and relatively long lasting. They are placed on back teeth and have a 150-year track record. We have patients who have had the same amalgam fillings for 20 years! Functionally, they are strong and do not leak as much as composites.
Composite filling (tooth colored)
Composites are a DIRECT FILLING and are wonderful for front teeth but they are not the ideal material for larger fillings, especially on back teeth. Because composite is a plastic-like material, they are not as strong as metal fillings, and more suscepible to leaking over time. This results in more frequent replacement of these fillings, and therefore greater insult to the nerve of the tooth.
Porcelain filling (tooth colored)
An alternative tooth-colored filling to composites is porcelain, which is an indirect filling. These are fabricated in the laboratory and cemented into the tooth. These fillings, or inlays, are stronger, less leaky, and longer lasting than composite fillings. They are a good alternative for patients who want a long-lasting filling but would prefer not to have metal in their teeth.
Gold fillings are in many ways the “gold standard” in dentistry. Although they do not sound modern, many dentists have them in their own mouths because no other material lasts as long. They are strong, can strengthen a weakened tooth, are bio inert, and wear down at the same rate as natural teeth.
They too are built in the laboratory, and once cemented into the tooth can last many, many years. Like the lab-fabricated porcelain fillings, they can be fit to the tooth so precisely that keeping the tooth clean and healthy is easier than when other materials are used. In their own way, they are beautiful too!