Dental Fillings

Restoring Your Smile: Dental Filling Choices

Almost everyone experiences some tooth decay at some point in their life. The good news is that advances in modern dental materials and techniques now offer patients and their dentist more choices then ever on how restore and repair your teeth.

Amalgam Fillings:

Dental amalgam is a compound of mercury and other metals and is often called a silver filling because of its appearance. While dental amalgam continues to be a commonly used restorative material, some have raised concern because of its mercury content, but their concern is unfounded. Although mercury by itself is classified as a toxic material, the mercury in amalgam chemically combines with other metals to render it stable and safe for use in filling and restoring teeth.

Advantages:

Compared to other restorative materials, amalgam is highly resistant to wear and is relatively inexpensive. For those reasons, it remains a valued treatment option for dentists and their patients.

Disadvantages:

Amalgam fillings do not bond to the tooth. When amalgam fillings are used more of the healthy tooth must be removed to create a chamber that is small at the tooth surface and wider inside. The amalgam is then packed into the tooth and held in place by the undercut . In some situations this weakens the tooth and can predispose it to fracture when biting down on hard items.

Composite Fillings:

Composite fillings are a mixture of acrylic resin and finely ground glasslike particles that produce a tooth-colored restoration. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure.

For small restorations this is Dr. Aschacher's restoration of choice. Before the composite material is bonded to the tooth surface Dr. Aschacher will place a fluoride base called Fuji IX on and inside the prepared tooth. This product releases fluoride into the dentin and promotes remineralization of tooth structure to reduce the propensity for secondary cavities.

Advantages:

Because the composite material bonds to the tooth surface, less of the tooth structure needs to be removed. This allows your dentist to make a more conservative repair to the tooth.

Composites are also colored to match your tooth. This makes them perfect for reconstruction in places where your teeth show.

Disadvantages:

In teeth where chewing loads are high, composite fillings are moderately resistant to wear, but less so than amalgam fillings. The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. The time required to place a composite filling is usually longer than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling and they are subject to stain and discoloration over time.

Gold Onlays and Crowns:

Sometimes the best dental treatment for a tooth is to use a restoration that is made in a laboratory from a mold. These custom-made restorations, which require two or more visits, can be crowns, inlays or onlays. A crown covers the entire chewing surface and sides of the tooth. An inlay is smaller and fits within the contours of the tooth. An onlay is similar to an inlay, but it is larger and covers some or all chewing surfaces of the tooth. Materials used to fabricate these restorations are porcelain (ceramic), porcelain fused to metal, gold alloys and base metal alloys.

Gold alloys contain gold, copper and other metals that result in a strong, effective filling, crown or a bridge. They are primarily used for inlays, onlays, crowns and fixed bridges. They are highly resistant to corrosion and tarnishing.

Advantages:

Gold alloys exhibit high strength and toughness that resists fracture and wear. This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration.

Gold alloys are also gentle to opposing teeth and are well tolerated by patients.

Disadvantages:

Their metal colors do not mimic natural teeth. The cost of indirect restorations is generally higher due to the number and length of visits required, and the additional cost of having the restoration made in a dental laboratory.