Thanks to technological advances, dental patients today have several choices when it comes to selecting materials to fill cavities. They can choose between amalgam or composite fillings, which are often referred to as “silver” and white respectively, or tooth-colored porcelain fillings.
Below is the rundown on these materials.
Amalgam fillings, while reliable and time-tested, are being used less frequently due to the fact that composite materials have improved tremendously. These “silver” fillings are really silver amalgams containing a mixture of silver-tin alloy, copper, and mercury. They have been used for more than 100 years and are inexpensive and not technique-sensitive. They can last over 20 years.
The safety of the mercury in amalgam fillings is a question that has often been raised. Mercury is used in amalgam because it helps make the filling material pliable. When it is mixed with an alloy powder, it creates a compound that is soft enough to mix and press into the tooth. But it also hardens quickly and can withstand the forces of biting and chewing.
Many studies on the safety of amalgam fillings have been done. In 2009, the U.S. Food and Drug Administration (FDA) evaluated this research and found no reason to limit the use of amalgam. The FDA concluded that amalgam fillings are safe.
There are ongoing reviews evaluating the safety and effects of dental amalgams. The FDA does caution that if you are allergic or sensitive to mercury or any of the other components of amalgam, that you should choose another type of filling.
The World Health Organization has recommended that dental amalgam be phased out as part of an effort to reduce human exposure to mercury.
A composite filling is tooth-colored and therefore more esthetic. The advantages are more than just cosmetic. Composite fillings are more conservative meaning they can sometimes be placed with less tooth removal. They can also be used in smaller areas whereas an amalgam filling has a minimum size requirement.
Additionally, composite fillings do not cause tooth staining over time. Composite fillings, however, tend to have a shorter life span. They require a completely dry environment and can be difficult to use in some patients with above average saliva output or sensitive gums that bleed. When composites are placed correctly, they can last just as long as amalgams.
Composites can be more expensive than amalgams and sometimes insurance companies will cover them only up to the price of an amalgam and then require that the patient pay the difference.
Porcelain combines beauty and strength, reinforcing teeth when traditional fillings are not an option, according to Dr. Andrew Koenigsberg, a dentist at Gallery 57 Dental in New York City.
The all-porcelain solution requires less tooth removal than traditional porcelain fused to metal crowns and contains no metal, Dr. Koenigsberg added. New ceramic materials are durable and less prone to breakage than older ceramic materials.
Inlays are restorations that are smaller than crowns or onlays as they do not cover the biting surface of the tooth. Onlays partially cover the tooth, and crowns conceal the entire tooth surface above the gum line. Many offices can now make these restorations in a single visit which is more convenient for the patient.
If you are in the market for new fillings, speak with your dentist to see what option will fit your needs best.
This article was sponsored by Gallery 57 Dental.
Gallery 57 Dental
24 W. 57th St., Suite 701
(Between 6th & 5th Avenues)