What is the best material for dental fillings? What material is used for tooth filling? What is the safest tooth filling material?
Today, several dental filling materials are available. Teeth can be filled with gold; porcelain; silver amalgam (which consists of mercury mixed with silver, tin, zinc, and copper); or tooth-colored, plastic, and materials called composite resin fillings. There is also a material that contains glass particles and is known as glass ionomer. This material is used in ways similar to the use of composite resin fillings.
The location and extent of the decay, cost of filling material, your insurance coverage, and your dentist’s recommendation assist in determining the type of filling best for you.
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Cast Gold Fillings
One of the differences between gold and other filling materials is that the gold filling is made in a laboratory. Your dental team will usually take an impression of the prepared cavity and send it to the laboratory for the technician to make the inlay or onlay. In the meantime, a temporary filling will be placed in the cavity. After the gold inlay or onlay (An inlay is small and placed within the biting surface of the tooth. An onlay can cover a larger area of the tooth) has been made, your dentist will fix it in place with dental cement. This type of filling is more expensive.
Advantages of cast gold fillings:
. Durability — lasts at least 10 to 15 years and usually longer; doesn’t corrode
. Strength — can withstand chewing forces
. Aesthetics — some patients find gold more pleasing to the eye than silver amalgam fillings.
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Disadvantages of cast gold fillings:
. Expense — gold cast fillings cost more than other materials; up to 10 times higher than cost of silver amalgam filings.
. Additional office visits — requires at least two office visits to place
. Galvanic shock — a gold filling placed immediately next to a silver amalgam filling may cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur. It’s a rare occurrence, however.
. Aesthetics — most patients dislike metal “colored” fillings and prefer fillings that match the rest of the tooth.
Silver Fillings (Amalgams)
Amalgam fillings are silver coloured. They are made by combining mercury and a silver alloy (50% mercury, 35% silver, and 15% tin, copper and other metals). This kind of filling is usually used on the back ‘chewing’ teeth. Before the filling can be placed, the dentist must prepare the area by removing all the decay and shaping the cavity to hold the filling in place. If the tooth is badly broken, your dentist may need to place a small stainless-steel pin to help secure the filling.
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Advantages of silver fillings:
. Durability — silver fillings last at least 10 to 15 years and usually outlasts composite (tooth-colored) fillings.
. Strength — can withstand chewing forces
. Expense — may be less expensive than composite fillings
Disadvantages of silver fillings:
. Poor aesthetics — silver fillings don’t match the color of natural teeth.
. Destruction of more tooth structure — healthy parts of the tooth must often be removed to make a space large enough to hold the amalgam filling.
. Discoloration — amalgam fillings can create a grayish hue to the surrounding tooth structure.
. Cracks and fractures — although all teeth expand and contract in the presence of hot and cold liquids, which ultimately can cause the tooth to crack or fracture, amalgam material — in comparison with other filling materials — may experience a wider degree of expansion and contraction and lead to a higher incidence of cracks and fractures.
. Allergic reactions — a small percentage of people, approximately 1%, are allergic to the mercury present in amalgam restorations. The mercury contained in the amalgam releases low levels of mercury in the form of a vapor that can be inhaled and absorbed by the lungs. High levels of mercury vapor exposure are associated with adverse effects in the brain and the kidneys. Studies have found no link between the amalgam fillings and health problems and the FDA considers them safe for adults and children ages 6 and above.
Composite fillings are strong, but may not be as hard wearing as amalgam fillings. Composite fillings are tooth colored and are made from powdered glass quartz, silica or other ceramic particles added to a resin base. After the tooth is prepared, the filling is bonded onto the area and a light shone onto it to set it. The dentist will choose a shade to match your own teeth, although over time staining can happen.
Advantages of composites:
. Aesthetics — the shade/color of the composite fillings can be closely matched to the color of existing teeth. Composites are particularly well suited for use in front teeth or visible parts of teeth.
. Bonding to tooth structure — composite fillings micro-mechanically bond to tooth structure, providing further support.
. Versatility — in addition to use as a filling material for decay, composite fillings can also be used to repair chipped, broken, or worn teeth.
. Tooth-sparing preparation — sometimes less tooth structure needs to be removed compared with amalgam fillings when removing decay and preparing for the filling.
Disadvantages of composites:
. Lack of durability — composite fillings wear out sooner than amalgam fillings (lasting at least five years compared with at least 10 to 15 for amalgams); in addition, they may not last as long as amalgam fillings under the pressure of chewing and particularly if used for large cavities.
. Increased chair time — because of the process to apply the composite material, these fillings can take up to 20 minutes longer than amalgam fillings to place.
. Additional visits — if composites are used for inlays or onlays, more than one office visit may be required.
. Chipping — depending on location, composite materials can chip off the tooth.
. Expense — composite fillings can cost up to twice the cost of amalgam fillings.
. In addition to tooth-colored, composite resin fillings, two other tooth-colored fillings exist — ceramics and glass ionomer.
Other Filling Types
. Ceramics. These fillings are made most often of porcelain and are more resistant to staining than composite resin material. This material generally lasts more than 15 years and can cost as much as gold.
. Glass ionomer is made of acrylic and a specific type of glass material. This material is most commonly used for fillings below the gum line and for fillings in young children (drilling is still required). Glass ionomers release fluoride, which can help protect the tooth from further decay. However, this material is weaker than composite resin and is more susceptible to wear and prone to fracture. Glass ionomer generally lasts five years or less with costs comparable to composite resin. The newest ones have an even better lifespan and, when placed in appropriate areas. are equal to composites.
Are There Such Thing as Permanent Dental Fillings?
Unfortunately, the bad news is that your filling won’t last forever. How long your fillings last depends on a number of factors, including the size of your cavity and the material your dentist used to fill the cavity.
So How Long Do Dental Fillings Last?
While fillings last a long time, none of the materials used in fillings last forever. Assuming that your surrounding tooth remains healthy and the filling itself is not large, you can expect your filling to last for years, even decades:
. Gold fillings last the longest, anywhere from 15 to 30 years.
. Silver amalgam fillings can last from 10 to 15 years before they need to be replaced.
. Composite resin fillings don’t last as long. You may need to replace them every five to seven years.
Remember that these are average life expectancies. You can extend the life of your fillings by practicing healthy oral hygiene and taking good care of your teeth.