Restorative Dentistry (Fillings)
Your dentist will examine you for decay at your checkup appointments. Decay can be detected on dental x-rays and by examining your teeth. If you have a cavity, the tooth will not be able to “heal” itself. A filling will be recommended to restore the tooth. The filling material, amalgam, is made from a mixture of metals including Copper, Tin, Silver, and Mercury. Dental amalgam, in widespread use for over 150 years, is one of the oldest materials used in oral health care. Its use extends beyond that of most drugs, and is predated in dentistry only by the use of gold. Amalgam remains popular because it is strong, durable, and relatively inexpensive.
What are the advantages of metal fillings?
Durability – Silver fillings typically last ten to fifteen years and will usually outlast composite resin (tooth colored) fillings.
Strength – They can withstand chewing forces.
Expense – They are less expensive than composite fillings.
Efficiency - Amalgam can be placed in a wet environment, which is important when treating kids or individuals with special needs.
What are the disadvantages to metal fillings?
Esthetics – Sliver fillings don’t match the color of your natural teeth.
Discoloration – Amalgam fillings can create a grayish hue to the surrounding tooth structure.
Controversy - Amalgam fillings have been proven safe, but some individuals have some concern over the mercury in the material. When mixed as an alloy with other metals, the majority of the mercury is bonded and becomes stable; the miniscule remainder is released as mercury vapor. This small amount is well below safe limits and is absorbed by the body and excreted. If you swallow some particles of filling material, the mercury is very poorly absorbed, and the particle is excreted.
What information is available about mercury in dental fillings?
Please refer to the following websites if you have any concerns about mercury in dental fillings.
ADA statement on dental amalgam
FDA consumer update on dental amalgams
CDC fact sheet on dental amalgam uses and benefits
At Madison Family Dental, we continue to follow the research on dental amalgams. Studies of dental amalgam in tooth restorations have been conducted worldwide for more than 100 years. A recent study, The New England Children’s Amalgam Trial, looked at the long-term effects of dental amalgam on children. The study was one of the first randomized, controlled clinical trials ever done to investigate the safety of sliver amalgam used to fill tooth cavities. The study found no adverse health effects in children who received amalgam fillings. We encourage you to talk to your dentist at Madison Family Dental if you have questions about this issue or other oral health issues.
Resin
Resin, or composite, fillings are made of a glass filler particle held together with a plastic, or “resin.” Composite fillings are bonded into the tooth with a special light and can be used in front teeth or back teeth, in small to mid-sized cavities.
What are the advantages of composite fillings?
Esthetics – The shade of the composite fillings can be closely matched to the color of existing teeth. Composite fillings are particularly well-suited for use in front teeth or visible parts of teeth.
Bonding to tooth structure – Composite fillings mechanically and chemically bond to the tooth structure, providing further support to the tooth.
Versatility – In addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
What are the disadvantages of composite fillings?
Lack of durability – Composite fillings wear out sooner than amalgams. In addition, under the pressure of chewing they may not last as long as amalgams, particularly if used as filling material for large cavities.
Chipping – Depending on location, composite materials can chip off the tooth.
Sensitivity – There is a greater chance of sensitivity after the filling is placed. This usually goes away with time, but occasionally lingers and further treatment is required.
Leakage – The bond may break down on the filling, especially where chewing forces are high. This causes the filling to leak and replacement would be necessary.
Expense – Composite fillings can cost up to twice the cost of amalgams.
