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For decades, dental amalgam — the common “silver” fillings found in the mouths of millions — was the best option for restoring teeth after the removal of decay. This time-tested material is still going strong, but in recent years it's had serious competition from newer restoration techniques that use tooth-colored substances to make fillings. If you've heard of these new materials and want to know more, you can start with the following five facts.
1) Filling materials must match the properties of natural teeth.
When properly cared for, teeth are strong, resilient, and superbly functional. A good filling material should mimic the strength and durability of natural teeth under biting forces. It should also last a long time in the mouth, be relatively easy to place, and be economical in cost. In the past, amalgam fillings were the best choice to do the job. But that was thenā?¦
2) Tooth-colored filling materials offer similar benefits, plus aesthetic appeal.
Composite resins and dental porcelains are tough, durable materials that have been found to hold up well under years of use. Unlike traditional silver fillings, however, they match the appearance of natural teeth quite closely. This means that even a restoration in the front of the mouth may be virtually undetectable. And who wouldn't like that?
3) Tooth-colored resins may allow more conservative treatment in decay removal.
In order to keep them securely in place, amalgam (silver) fillings may require “undercutting,” which removes more of the tooth structure. The process involved in bonding tooth-colored restorations, however, generally requires removal of less tooth material. This means a stronger base for rebuilding the tooth's structure.
4) Different treatment methods are used for different degrees of tooth restoration.
Small cavities can be treated by direct “chairside” techniques, which are very similar to the methods used for traditional amalgam (silver) fillings: in one brief visit, it's all done. When a greater volume of tooth structure must be replaced, we may be able to create a larger tooth-colored filling in a longer visit. Or, we might need to have a special restoration made to match your teeth; then, you can come back to have it securely bonded for a natural and long-lasting result.
5) Both amalgam and tooth-colored fillings are safe and effective.
Each has advantages and disadvantages in particular cases. But as the technology of tooth-colored filling systems evolves, some dental researchers have heralded the beginning of the “post-amalgam era.” Are tooth-colored fillings right for your individual situation? We're the ones to ask.
If you would like more information about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”
Until recently anyone who needed to repair cavities in his or her teeth ended up with a mouth full of “silver” fillings. Dental amalgam, which has a silver appearance, was the tooth restoration material of choice. Amalgam, a combination of metals including silver, mercury, and other metals, is still used — but today there are other options that mimic the original teeth they are restoring.
You may have read about some people's concerns about the mercury used in dental amalgam. According to the American Dental Association (ADA), scientific studies have found no ill effects arising from using dental amalgam in fillings for adults or children: “While questions have arisen about the safety of dental amalgam relating to its mercury content, the major US and international scientific and health bodies, including the National Institutes of Health, the US Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.” Dental amalgam is still used for molars (back teeth) that must withstand heavy pressure from chewing.
For teeth that are more visible, materials that look and perform more like the original teeth — and are thus more pleasing in appearance — are now available. Dentistry is now taking a “biomimetic approach” (from words meaning “life mimicking”). The new materials — composite resins and porcelains — look like teeth because in many ways their structure imitates the biologic structure of teeth.
Composite resins are made of a plastic material (methacrylate) combined with fillers made of silica, a form of glass. They are able to bond to natural tooth structure and resemble the dentin, the inner layer of the tooth, which has a porous structure similar to bone.
Dental porcelains are a form of ceramic. They are non-metallic materials formed by the action of heat, like the ceramics used in porcelain cups and bowls. They come in a powder form that is mixed with water, shaped, and then placed in an oven until they reach the proper hardness. The end product is translucent and very hard, resembling the densely packed crystals of calcium that make up a tooth's normal outer layer, the enamel.
The old amalgam fillings required removal of tooth material to prepare a site in which they could be placed. Composite resins and porcelains can be used to treat teeth that have small or large amounts of damage to their natural substance because the materials bond directly to the remaining dentin and enamel. Thus they end up stabilizing and strengthening the restored tooth, as well as providing a natural-looking appearance.
Contact us today to schedule an appointment to discuss your questions about tooth colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”