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When people think of fillings, they think of the silver and metal fillings that have been around for the last 150 years. However, with the new advancements made in dentistry, traditional amalgam fillings are no longer the only choice available and today, many dental offices also provide composite resin. We discuss both to help give you a better understanding.
Why are dental fillings important?
Before diving into the pros and cons of the materials used for dental fillings, let’s discuss what a filling is and why it is needed to maintain oral health. Well, dental fillings are designed to replace decay in your tooth and restore a tooth’s appearance, strength, structural integrity and function of decayed or damaged teeth.
Although dental enamel is the strongest tissue in your body, it is still susceptible to bacteria. Bacteria feed on sugars and starches and release an acid byproduct, which softens enamel, allowing even more bacteria to invade and break down your tooth and cause cavities. If left untreated, the bacteria can continue invading deeper into the tooth and reach the tooth's nerve, resulting in pain, infection, and the need for a root canal or tooth extraction.
When the cavity is small, your tooth can still be restored with a filling. Your dentist will remove bacteria and decay and thoroughly clean the tooth, before placing a dental filling into the prepared hole. This helps restore your tooth to its original shape and function.
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Pros and Cons of Amalgam Fillings
Commonly known as silver fillings, Amalgam fillings are made from a mixture of metals, including silver, mercury, tin and copper. Compared to composite resin or tooth coloured filling, this type of filling is more affordable when properly cared for and can last up to 15 years! Because of the metal alloy used, amalgam fillings offer stronger resistance to wear, making them a superior choice for back teeth or larger areas of decay.
However, amalgam fillings have developed a bad reputation due to the mercury used, as some patients are particularly sensitive or allergic to it. Another downside is its appearance. Silver fillings are more noticeable, especially when you are laughing or smiling widely. Over time, amalgam filling can also stain the appearance of the entire tooth, making it appear greyish and less aesthetic.
Pros and Cons of Composite Resin Fillings
Composite fillings are made from a blend of plastic and ceramic compounds. They come in a range of tooth shades, which allows the dentist to match the filling more closely with your natural tooth, giving it a more natural appearance. Additionally, composite fillings require less removal of tooth structure, helping you preserve more of your natural tooth.
However, composite fillings have some drawbacks, including technique sensitivity and longevity issues. They are more challenging to place than amalgam fillings due to sensitivity to moisture. Older versions of composite were thought to be less resistant to wear compared to amalgam. Nonetheless, with advancements in bonding techniques and stronger materials, modern composite resin fillings have proven to be very durable.
What is the right choice for me?
In the last 30 years, there has been a shift away from amalgam towards composite resin fillings. This shift has been brought about due to concerns about mercury toxicity as well as the general trend towards more aesthetic, tooth coloured fillings. In practice, most patients prefer tooth coloured fillings and are reluctant to accept amalgams.
Choosing between amalgam and composite dental fillings depends on your specific needs and preferences. Amalgam fillings are durable and cost-effective but less aesthetic. Composite fillings, on the other hand, offer a natural look and are free from mercury.
At Dental Designs we make every effort to fill cavities with tooth coloured composite resin, as we believe that this filling option is the best because it is safer, less noticeable, keeps your teeth stronger and also has good longevity. In cases when a cavity is too large or located on a back tooth that encounters a lot of force, we may recommend other treatment options such as an inlay or a dental crown.
This article was written by Dr Jo Ann Wong.
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References:
- Shenoy A. Is it the end of the road for dental amalgam? A critical review. J Conserv Dent. 2008 Jul;11(3):99-107. doi: 10.4103/0972-0707.45247. PMID: 20142895; PMCID: PMC2813106.
- Letzel H, van 't Hof MA, Vrijhoef MM, Marshall GW Jr, Marshall SJ. A controlled clinical study of amalgam restorations: survival, failures, and causes of failure. Dent Mater. 1989 Mar;5(2):115-21. doi: 10.1016/0109-5641(89)90141-3. PMID: 2606273.