Thanks to advances in modern dental materials and techniques, dentists have more ways to create pleasing, natural-looking smiles. Dental researchers continue to develop materials, such as ceramics and polymer compounds, that look more like natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials to repair missing, decayed, worn, or damaged teeth.
Several factors influence the performance, durability, longevity and cost of dental restorations. These factors include: the patient’s oral and general health, the components used in the tooth filling material, where and how the filling is placed, the chewing load that the tooth will have to bear, and the length and number of visits needed to prepare and adjust the restored tooth.
Resin-Composite “tooth-colored fillings”
Long ago, amalgams (or “silver”) fillings were the standard of care in dentistry. Although amalgam is still used today, newer reliable materials, such as composites, allow for a more esthetic smile-enhancing result. Thanks to years of dental research driven largely by patients’ desire for more beautiful smiles, composite resins now serve as an excellent option for replacement of missing tooth structure.
Composite fillings are a mixture of powdered glass or quartz filler in a resin medium that produces a tooth-colored filling. They provide good durability and resistance to fracture in small to mid-sized restorations that need to withstand moderate chewing pressure.
Amalgam “silver fillings”
Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and sometimes other metallic elements. Although dental amalgam continues to be a safe, commonly used restorative material, some concern has been raised because of its mercury content. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth.
While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have stressed that dental amalgam is still a safe, reliable and effective restorative material.
Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. Amalgam is also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line.
Disadvantages of amalgam include possible short-term sensitivity to hot or cold after the filling is placed. The silver-colored filling is not as natural looking as one that is tooth-colored, especially when the restoration is near the front of the mouth, and shows when the patient laughs or speaks.