Amalgams Vs Composites: Which is The Better Choice?

When people think of fillings, they think of the silver, 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 Dental Fillings Are Important

Before diving into the pros and cons of the types of materials used for dental fillings, let’s discuss what a filling is, and why it is needed to maintain your oral health. Dental fillings are designed to replace decay in your tooth and restore a tooth’s appearance, strength, and structural integrity.

Although dental enamel is the strongest tissue in your body, it is still susceptible to bacteria. Bacteria feed on sugars and starches and releases 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 nerve of the tooth, which results in pain, infection, and the need for a root canal or tooth extraction.

Amalgam and Composite Fillers

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 back to its original shape and function.

Pros and Cons of Amalgam Fillings

Commonly known as silver fillings, amalgam fillings are made from a variety of metals, such as silver, mercury, zinc, and copper. Compared to composite resin, this type of filling is more affordable and when properly cared for, 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. Lastly, large amalgam fillings can create stresses and fracture lines that can lead to large cracks in teeth.

Pros and Cons of Composite Resin Fillings

Composite Dental Fillings

Composite fillings, also known as tooth-coloured fillings, are made from a combination of plastic and ceramic compounds. It comes in a range of tooth shades, which allows the dentist to blend the filling much better with your tooth, giving it a more natural appearance. It also requires less enamel removal and tooth preparation, allowing you to maintain as much of your natural tooth structure as possible.

The cons to composite fillings are its technique sensitivity and longevity. Composite resin fillings are more difficult to place than amalgam fillings as they are more moisture sensitive. Older versions of composite have been though to be not as resistant to wear as amalgam. However, as newer bonding techniques and stronger versions have been produced, 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.

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 forces, we may recommend other treatment options such as an inlay or a dental crown.

This article was written by Dr Jo Ann Wong.

References:

  1. Is It the End Of the Road For Dental Amalgam? A Critical Review
    Arvind Shenoy - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2813106/)
  2. A Controlled Clinical Study Of Amalgam Restorations: Survival, Failures, and Causes Of Failure
    Letzel H;van 't Hof MA;Vrijhoef MM;Marshall GW;Marshall SJ; - (https://pubmed.ncbi.nlm.nih.gov/2606273/)
  1. Longevity Of Restorations in Posterior Teeth and Reasons For Failure
  2. Hickel J; - (https://pubmed.ncbi.nlm.nih.gov/11317384/)
  3. Direct Resin Composite Inlays/onlays: An 11 Year Follow-up
    van JW; - (https://pubmed.ncbi.nlm.nih.gov/10785294/)
  4. Development of gingivitis around different types of composite resin
    (https://europepmc.org/article/med/3301912)
  5. Microleakage Of Composite Fillings in Er,cr:ysgg Laser‐prepared Class Ii Cavities
    Norbert Gutknecht-Christian Apel-Christine Schäfer-Friedrich Lampert - (https://onlinelibrary.wiley.com/doi/abs/10.1002/lsm.1064)

Dental Fillings - Why choose Ceramic Fillings over Regular Ones?

When we talk about restoring badly worn down or chipped teeth, the first thing that comes to mind is dental fillings. Most of us are aware of the tooth coloured composite fillings which are perhaps being most commonly used by dentists throughout the world for restoring damaged teeth. However, did you also know that there is another type of dental fillings available which are even stronger, naturally appearing and more durable than the conventional composite fillings? Yes, these are the indirect fillings, the inlays, and onlays.

What are Direct and Indirect Fillings?

direct dental fillings

However, before we discuss why inlays and Onlays are better than conventional filings, we must first understand the difference between the direct and indirect fillings.

Indirect restorations include inlays, onlays, crowns, bridges, and veneers. Among them, inlays and onlays can also be used as fillings, and the advantage is that they are stronger and last longer than direct fillings.

What are Inlays?

Inlays are indirect restorations that are used for the restoration of grossly damaged or fractured teeth that cannot be restored with direct filling materials, but at the same time, they are not extensive enough to require a crown. Inlays are used in cases where the damage has not progressed into the cusps, which are the protuberances that are present on the biting surfaces of teeth.

Although numerous types of materials can be used for preparing ceramic inlays, at Dental Designs Clinic, we use high-quality materials that have been approved by European and American standards. Instead of leaving it to an external laboratory, we prepare inlays in our clinic by using the state of the art CEREC system. As such, we ensure that you will not only get a naturally beautiful and attractive smile, but they will also be functional, restoring your ability to chew and speak properly.

How are Ceramic Fillings Prepared with the CEREC System?

CEREC System

Here’s how we will give a beautiful smile with ceramic and hybrid ceramic inlays with the CEREC system:

Why we use the CEREC system for Preparing Ceramic Inlays?

cerec milling dental designs singapore

You might now be wondering why we prefer digital inlays over conventional ones. So, here are a few reasons why CEREC inlays are better than direct fillings and conventional inlays.

While ceramic fillings are an excellent choice for restoring damaged teeth, but they can never be as strong and durable as your teeth. Therefore, the best filling is undoubtedly no filling at all! However, if you still need to get one of your teeth replaced, then ceramic inlays prepared with the CEREC system should be your first choice.

So, are you ready for enjoying a naturally pleasant and beautiful smile? Then book an appointment with our dentists today and let us take care of the rest.

References

  1. Clinical Performance Of Cerec Ceramic Inlays: a Systematic Review
    N. Martin-N.M. Jedynakiewicz - (https://www.sciencedirect.com/science/article/abs/pii/S0109564199000147)
  2. The Clinical Performance Of Ceramic Inlays: A Review
    Mark Bergman - (https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1834-7819.1999.tb00217.x)
  3. Three-dimensional finite element analysis of strength and adhesion of composite resin versus ceramic inlays in molars
    (https://doi.org/10.1016/S0022-3913(08)60029-3)
  4. Considerations For Ceramic Inlays in Posterior Teeth: a Review
    Christa Hopp-Martin Land - (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666490/)
  5. The Clinical Performance Of Cad-cam–generated Ceramic Inlays: A Four-year Study
    Harald Heymann-Stephen Bayne-John Sturdevant-Aldridge Wilder-Theodore Roberson - (https://www.sciencedirect.com/science/article/abs/pii/S0002817715609953)
  6. Molar fracture resistance after adhesive restoration with ceramic inlays or resin-based composites
    (https://europepmc.org/article/med/11699740)