I wish we were talking about doughnut fillings — chocolate, jelly, custard? But, as your dentist, I am more qualified to talk about dental fillings, and sadly, none of the options involve chocolate.
The most common question I get regarding fillings is, “Will it be a white filling or a silver one?” The answer in my office is always “a white one.” At Anderson Dental Care, we exclusively use tooth-colored composite fillings. However, filling materials are more complex than just their color. So, if you were sitting in our cozy Cincinnati dental office, and had questions about fillings, this is a robust version of what we might tell you. There are two main types of fillings: Resin Composite fillings and Dental Amalgam fillings. These are the pros and cons of each type.
Resin Composite Filling (a.k.a.the white filling)
Composite fillings are made of a resin and plastic material that, while it is soft, is glued into the cavity (the opening created when we drill out decay), then hardened with bright blue “curing” light.
Advantages of Composite Fillings
They are aesthetically pleasing: It’s a popular choice among dentists and patients because it can be matched to the shade of the existing teeth, so it’s not as obvious as a silver amalgam filling.
You keep more of your own tooth: As your dentist, I can save more of your natural tooth’s material Amalgam fillings require me to take a larger portion of your tooth.
It doesn’t contain any potentially harmful metals.
Disadvantages of Composite Fillings
They don’t last as long as a metal filling: They typically need to be replaced every five years or so because the material breaks down a little faster (although amalgam fillings also have to be replaced, and not usually just with another filling…more on this in a minute).
They are more expensive: Composite fillings take longer to fit into a tooth, requiring more time in the office, resulting in a higher cost. Many insurances also only cover the cost of amalgam fillings, so your out-of-pocket cost may be higher for a composite filling.
The adhesive can wear away: The resin filling composition won’t corrode with age, but the glue can chip away over time, particularly if patients have bruxism. If you have cavities in your molars that are filled with composite fillings — you should be wearing a nightguard if you want them to last!
Dental Amalgam Filling(a.k.a.the silver filling)
Historically speaking, amalgam fillings have been around since the early 1800’s. They are made of a combination of metals including 50% elemental mercury and equal parts silver, tin, zinc, and copper. Mercury is used as the binding agent to hold the other particles together. (If the word mercury has set off alarm bells in your head, just keep reading).
Advantages of Amalgam Fillings
They last -The typical silver amalgam filling can last 15 years or more.
They are easy to use – Because of the liquid state of mercury, silver amalgam is simple for dentists to fit into a cavity with no concerns that it could become contaminated.
They are inexpensive – Dental amalgam is the least expensive type of filling material (often, insurance companies will make you pay extra for a tooth-colored filling).
Disadvantages of Dental Amalgam Fillings
When it’s time to replace an amalgam filling, you are likely to need a crown, not just another filling – This is one of the biggest problems when it comes to amalgam fillings. I describe it to my patients like this: Imagine your tooth as a piece of wood. Now, think of wedging a piece of metal into that piece of wood to fill a hole. Next, hammer that same piece of metal a hundred times a day for 15 years to simulate chewing. That metal will sink deeper and deeper into that piece of wood and eventually crack it at its base. This cracking is the same thing that happens to your tooth below the gum line. Either the tooth fractures at that point, which means you now need a crown or the crack goes deeper into the nerve itself and now you’ve earned a root canal, as well. You only get one amalgam filling per tooth, and when it’s time to replace it, a more extreme procedure is almost always necessary.
They are not aesthetically pleasing – Because of it’s silver color, it isn’t a good choice for filling a tooth that’s highly visible. Even on the back or top surfaces of teeth, amalgam fillings cause the entire tooth to appear grayish since teeth are not entirely opaque.
They can cause gaps between the filling and tooth and allow in more decay- The metal material can expand and contract over time, causing teeth to crack. These fluctuations can create spaces between the filling and the tooth that food and bacteria can become trapped in, allowing new cavities to form.
The mercury in silver amalgam is controversial – The FDA still approves them. They say that amalgam fillings with mercury are not hazardous to your health. In 1840, The American Society of Dental Surgeons denounced the use of amalgams due to concerns about mercury poisoning, but as I said, the FDA still approves it.
Keep in mind there are different types of mercury. Fillings contain elemental mercury which releases mercury vapor that is absorbed by the lungs. The form of mercury found in fish is methylmercury, a type of organic mercury mainly absorbed through the digestive tract.
Ultimately, you need to make that decision for yourself. There are a lot of studies about mercury and the potential hazards – a quick google search will bring up plenty of information. In my office, I’ve chosen to only use resin composite filling material.
Filling cavities is an important part of our practice. Identifying decay and filling cavities helps our patients keep their natural teeth longer, which is always our goal. If you have been avoiding getting your teeth checked or know you need cavities filled or replaced, call our Cincinnati dental office at 513-817-0834 or make an appointment online. To make fillings less stressful, we have a fantastic comfort menu that our patients rave about.
If you’ve been putting off seeing a dentist due to cost, you’ll be happy to know that we provide an affordable alternative to paying out of pocket or carrying pricey dental insurance.
At Anderson Dental Care, we offer a PREMIER DENTAL CARE MEMBERSHIP, and our members save 20% on dental procedures and get anywhere from 2-4 maintenance cleanings a year. Packages start at $31/month.