A dental restoration or dental filling is a dental restorative material used artificially to restore the function, integrity and morphology of missing tooth structure. The structural loss typically results from caries or external trauma. The American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.
Dental restorations may be fabricated out of a variety of materials:
Dental Amalgam
Dental Amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of many types of metals that form a very stable filling material. Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects.
Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 15 years, whereas resin-based composites serve for 5-6 years. We generally do not place amalgam fillings on any area of the mouth that needs an aesthetic restoration.
Dental Composites
Dental composites are also called white fillings. We have also heard it called “porcelain fillings” but this is a misnomer because it is made of a resin based material not porcelain. Crowns and inlays can also be made in our laboratory from dental composites. These materials are similar to those used in direct fillings (those made at the time of decay removal) and are tooth colored. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration.
The majority of fillings we place now are composite restorations. Our patients realize that they are getting a highly cosmetic filling material that has more maintenance than most other materials we use in Dentistry but desire to have a highly aesthetic restoration. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this material is getting much better.
There are circumstances in which composite (white fillings) is the recommended restorative material. These situations would include small grooves in the biting surface of teeth, in which amalgam would require the removal of a greater amount of sound tooth structure.
Disadvantages of Silver Fillings
Silver fillings have some drawbacks. Most of the problems relate to aesthetic problems. These fillings are not tooth colored and can make the tooth look gray or dark when smiling. It is important to remember that many people have these fillings in their mouth for 25-30 years before any additional treatment is needed. There is a controversy that has been occurring over the last 30 years about the safety of silver fillings and the question about Mercury leaking out. As of this time, there has been no research article that has been duplicated that proves this is a problem.
