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Facts About Fillings

If you need a filling, you have more choices than ever—so here’s how the options shape up. 

If you need a cavity filled, you can choose from several options. What’s right for you? A filling made from amalgam, which dentists have used for more than 150 years?2 Or would a composite or ionomer material work best?

The location and size of your cavity often dictates which material to pick. Durability, aesthetics, and cost are also factors.1,2

To help you make an informed decision, here is a breakdown of the most commonly used materials:

Amalgam

Dental amalgam, according to the American Dental Association (ADA), is a stable alloy made by combining elemental mercury, silver, tin, copper, and sometimes other metallic elements.1,2

Advantages: Dental amalgam is durable, easy to use, resistant to wear, and inexpensive compared with other materials, according to the ADA . Because the material can withstand very high chewing loads,1,2 amalgam fillings are particularly good for the molars in the back of your mouth, where the chewing loads are greatest.1

Amalgam can also be used in areas where it’s hard to keep the cavity and filling material dry or free of saliva.1,2 This includes deep fillings below the gum line.1

Disadvantages: You may have short-term sensitivity to heat or cold.1 If the cavity is visible near the front of your mouth, the filling won’t look natural.1,2 Also, your dentist usually must remove more of the tooth around the cavity than would be necessary with other types of fillings in order to secure the filling in place.1,2

Composite Fillings

Composite fillings are a mixture of tiny particles of glass or quartz in a resin medium.1,2

Advantages: Composites offer good durability and resistance to fracture in small to midsized restorations under moderate chewing pressure, according to the ADA.1,2

Composite materials are also tooth-colored, so they can be used in places where an amalgam wouldn’t look natural.1,2 Also, because the composite material bonds to your tooth, more of your healthy tooth can be retained.1

Disadvantages: Composites cost more than amalgam fillings because it takes more time for your dentist to place a composite filling.1,2 However, the cost is still moderate and depends on the size of the filling. In addition, composites can only be used in areas that can be kept clean and dry during the filling procedure. Finally, over time, composite fillings can stain, discolor, or wear.1

Ionomers

Glass ionomers are tooth-colored materials made of a mixture of acrylic acids and fine glass powders. Resin ionomers are made from glass powders with acrylic acids and acrylic resin.  Both glass ionomers and resin ionomers chemically bond to the tooth. 3 These less common ionomers are mainly used in small non-load-bearing fillings (between the teeth) or on teeth roots.1,2

Advantages: Ionomers mimic natural tooth color, can be used in wet areas, and, like composites, require smaller fillings than amalgams.1,2 they release flouride into the surrounding tooth structure to make it more resistant to new decay. 1,2

Disadvantages: Like composites, ionomers cost more than amalgams.2 Ionomers also suffer high wear when placed on chewing surfaces. They lack the natural translucency of tooth enamel.1

Other Materials

All-porcelain (ceramic) fillings and gold alloys, which contain gold, copper, and other metals, are less common filling choices. Ceramic fillings may require more than one visit to the dentist. While the color and translucency of all-porcelain fillings mimic natural tooth enamel, they can fracture under tension or on impact and can wear down opposing teeth. Gold alloys are strong, highly resistant to corrosion and tarnishing, and gentle to opposing teeth—but, of course, they do not look like natural teeth.1,2

1 “Dental Filling Options.” American Dental Association. www.ada.org/3094.aspx Accessed 2010.

2 “Dental Fillings: Facts.”American Dental Association. www.ada.org/sections/publicResources/pdfs/dental_fillings_facts_full.pdf Accessed 2010.

3 “Bond Strength of Resin-modified Glass Ionomer to Dentin: The Effect of Dentin Surface Treatment.” SJ Mauro, et al. Journal of Minimal Intervention in Dentistry 2000 2(1), p.45-53. http://www.midentistry.com/JMID-3-5.pdf Accessed 2010.

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