I Need A Filling - What Are My Options?

If you have a cavity in a tooth or a filling that is leaking you need to have a new filling but what are the different materials available and what’s the difference between them.

 

Amalgam- this is the traditional ‘silver’ fillings that were the mainstay of dentistry in the past but is used less and less today as other materials improve and begin to surpass amalgam. It is generally the most inexpensive material for restoring teeth and requires the least time to place however it does have downsides. The primary issue patients have with amalgam is its appearance as it is much darker than natural tooth as thus can be quite unsightly and as such it is not used for fillings on front teeth but is suitable for back teeth. From a clinical point of view the main issue with dental amalgam is the higher rate at which teeth with amalgam filling chip and break. This is because amalgam expands slightly as it fills and does not ‘stick’ to the tooth around it and thus often acts like a wedge which eventually causes the tooth around it to break. Some patients also express concern about the material as it does contain a small quantity of mercury however it has been in use and has been studied for 150 years and there is no evidence of any harm coming from its usage- the only cases where its use is prohibited is for pregnant patients and this is merely as a precaution.

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Composite- Composite is the technical term for ‘white fillings’ and is increasingly becoming the standard filling material used by dentists to restore teeth. In the past this material was not as strong as silver fillings and had a tendency to become worn and discoloured over time however due to advances in technology these problems have largely been resolved to the point that there is increasing evidence that a well-placed composite filling lasts longer than an amalgam restoration. The big advantage of white fillings is that they look natural and can give a far more attractive finish than silver fillings however they also help to hold teeth together and prevent teeth fracturing by bonding to the tooth around the filling. This means that if there is a tooth that is vulnerable to shattering or a tooth which is beginning to crumble around an old filling it is often prudent to place a composite filling rather than a silver filling. This bonding does have one drawback which is that white fillings can only be placed where the tooth can be kept dry as it is impossible to bond to wet surfaces predictably. As a result any fillings that are under the gum line or in areas which are hard to get to such as wisdom teeth may be off limits to white fillings.

 

Inlays/ Onlays- This class of restorations are custom made in a laboratory by a technician to fit over or in a cavity in a tooth and are the strongest restorative material. This makes them well suited to patients who have a tendency to wear down or break teeth and fillings or excellent for restoring large cavities that are too big to repair with conventional fillings. They are generally made from high impact porcelain and are made to look like your natural tooth. They are still occasionally made from gold if the restoration extends slightly under the gum line but generally due to advances in the strength of porcelains and in the quality of our cements onlays and inlays will be made in porcelain to look like a natural tooth.

 

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If you ever require any treatment your dentist will always go through with you what your options are and give you any information about what materials are suitable for your case and what the specific advantages and disadvantages might but generally due to advances in the strength of porcelains and in the quality of our cements onlays and inlays will be made in porcelain to look like a natural tooth.