Traditional dental restoratives (fillings) include amalgam, gold, porcelain, glass ionomer, and composite. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.
However, composites, porcelain and other tooth colored options are rapidly gaining in popularity, while the use of amalgam is dropping each year world-wide. In some countries, the use of amalgam has already been banned in women of child-bearing age and children, due to the presence of mercury in the filling material. While amalgam is still used in this country, Dr. Rich chose to eliminate its use in his practice over 10 years ago. In his words, "If I wouldn't put it in the teeth of my family members or my team, why would I offer it to my patients? It is interesting that, although it is still officially claimed to be safe, once I remove it from a patient's mouth, I must store and process the residual scrap as Federally regulated hazardous waste! It just doesn't make any sense for me to offer it in my practice, when so many other durable, beautiful options exist today.
What's Right for Me?
Several factors influence the performance, durability, longevity and expense of dental restorations:
- The components used in the filling material
- The amount of tooth structure remaining
- Where and how the filling is placed
- The chewing load that the tooth will have to bear
- The length and number of visits needed to prepare and adjust the restored tooth.
The ultimate decision about what to use is best determined in consultation with your doctor. Before your treatment begins, discuss the options with your doctor. To help you prepare for this discussion it is helpful to understand the two basic types of dental fillings: direct and indirect.
- Direct fillings are fillings placed immediately into a prepared cavity in a single visit. They include glass ionomers, resin ionomers, and composite (resin) fillings. The dentist prepares the tooth, places the filling, and adjusts it during one appointment.
- Indirect fillings generally require two or more visits. They include inlays, onlays, veneers, crowns, and bridges fabricated with either gold, alloys, ceramics, or ceramics fused over gold alloys. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The dentist then places a temporary covering over the prepared tooth. The impression is sent to a dental laboratory which creates the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed.