Have you ever had a cavity? If you can answer no to that question, good for you! Keep doing what you’re doing, and consider yourself lucky. If you answered yes, then you fall into a very large percentage of the population, and you’ve most likely had a filling to fix it. We understand that some people fear any dental work, and others could care less about getting a filling done. Either way, we treat each person, and each filling with the highest level of care, and a gentle touch. We also use the most up to date materials to restore your teeth back to health.
Dentistry has come a long way since its early days, and one big way that has been evident is in tooth filling materials. There are hundreds of different filling materials on the market, but they can be broken down into a few different categories.
First there are two subsets of fillings, direct and indirect. Direct restorations are placed into your tooth, where they harden by a chemical reaction. Most fillings are done this way. With indirect restorations, the tooth is prepared, then scanned or impressed for a model to be made, and then the filling is made and hardened outside your mouth and then cemented or bonded in place. Indirect restorations are generally better, especially as the size of the filling gets bigger, but they are more costly.
Amalgam - this is the silver filling that was the workhorse of dentistry for over 50 years. While it is not highly utilized anymore, it has some properties that may still make it the best fit for certain circumstances.
It’s positives are that is able to be placed even in wet conditions, and it is antibacterial, which can help to prevent a recurrence of a cavity, especially in someone who has a very high rate of tooth decay. It is also very durable
It’s negatives include poor esthetics, it doesn’t bond to tooth structure, and it’s expansion and contraction is a lot different than your tooth, so it can cause micro fractures as it heats and cools over the years of use. Lastly, it contains mercury, and a very small amount of that will be ingested while it is in your mouth. It is much less than eating fish 3 days a week, and the overwhelming body of evidence shows that it is not enough to cause harm to those who have them, there is always a chance that certain individuals could be more sensitive to it. It’s downsides usually outweigh its positives due to newer better options.
Composite resin - This is a white filling that is made up of different particles in a resin matrix that is bonded to your tooth with a separate bonding agent, both of which are light cured in your mouth.
It’s positives are excellent esthetics (it can be matched very well to almost any tooth color), it bonds to tooth structure, which helps support it better.
It’s negatives include difficulty of placement (the tooth needs to be perfectly dry), and it has no inherent ability to protect the tooth from further decay.
Glass ionomer - This is a white filling material that is basically glass that is mixed with acid that then hardens in place on your tooth.
Its positives are that it bonds to tooth structure without a bonding agent, even in a slightly moist environment, it has better esthetics than amalgam because it is white, but doesn’t blend very well with tooth structure, and it releases Fluoride into the tooth over time to help prevent further tooth decay.
Its negatives include a rougher finish, and lower strength than composite resins and amalgam.
Bioactive resin - This is the newest restorative material, and probably the biggest advancement in recent years. It is basically a blend of Composite resin and glass ionomer that incorporates the best properties of each. It blends well esthetically, it bonds to tooth structure with or without bonding agent (better with) and it releases fluoride and calcium over time to help remineralize surrounding tooth structure and help prevent future decay. It is relatively new, and no long term studies have been done yet, but it appears to be an excellent overall filling material, and we have been very happy with its performance so far. This is quickly becoming my filling material of choice.
Gold - it has the longest track record, and is arguably the longest lasting restorative material. It is designed on a model, and then cast and polished, then cemented in or on the tooth.
Its positives include that it is extremely durable, and slightly more esthetic than amalgam, but still not white. Due to its malleability, it can be sealed up well at the edges even without the ability to be bonded.
Its negatives are that it doesn’t bond to tooth structure, it isn’t white, and it is the most expensive filling material, and takes the most total time of treatment and always requires two visits.
Porcelain - there are many different types of dental porcelain, and they can be fabricated in a number of different ways.
Its positives are many. It is the best blend of strength and beauty of all restorative materials when used properly. It can be bonded to tooth structure. It holds its color very well over time in comparison to composite resins.
Its negatives are that it is more technically difficult to make and insert, it has a longer fabrication time that can be done in one longer visit or two separate visits depending on how it is made. It is almost as expensive as gold.
At Reaves Dental, we always use the best restorative material for your specific situation, and are always happy to have a discussion with you about what to use for your teeth.