Dental fillings are very common and used in many kinds of procedures. The process of repairing a tooth or filling a cavity comes with a number of choices of filling materials, each of which has their own specific pros and cons. It is important to gain familiarity with all the types and their benefits/detriments in order to decide which one suits you the best. Make sure to always consult your dentist or oral surgeon as well, because they often have an office standard practice for fillings or a preference for material to work with based on experience. Here is a list of the different types of tooth filling, what their perks are, and the drawbacks they carry with themselves.
Amalgam
This is the oldest type and most commonly used filling of the last 150 years, and easily recognizable by its unique silvery color. Usually, people have the misconception that this filling is made of silver but it is actually a combination of half liquid mercury, and the other half is a powdered alloy of silver, tin, and copper. The mercury binds the alloyed metal dust into a material that is strong and durable.
Pros
- It is inexpensive, saving a considerable amount of money as compared to other fillings.
- It is durable and lasts for a long period of time, especially in teeth that experience more wear and force from chewing, like molars.
Cons
- It has been losing its presence to other types of fillings because of the presence of mercury in the mix, which is known to be toxic when present in high doses. In 2009, the U.S. Food and Drug Administration (FDA) evaluated amalgam fillings. They found only minuscule amounts of mercury released into the body from fillings over a long period of wear and concluded that amalgam fillings are completely safe for adults and children ages 6 and above.
- The metal tends to darken over a period of time.
- Removal of amalgam fillings in the case of wear or other causes can be difficult and may require the removal of healthy tooth material to extract the filling.
- Because it is metal composite, some patients may see some cold or heat sensitivity, though that is not common.
Composite Resin
It is the second most widely used filling and is becoming a common choice because of the variety of improvements which are being brought in. It is a mixture of plastic and glass, and because it is tooth-colored, it can also be used to reshape disfigured teeth in addition to its use as a dental filling.
Pros
- It is durable and more natural in appearance as compared to other fillings because the dentist or oral surgeon is able to mix composite that matches your tooth color.
- It bonds to the tooth, which can help support the structure left behind after drilling a cavity or root canal, helping to prevent breakage later on.
- The plastic in the filling can help to insulate and protect the tooth from extreme temperature changes.
Cons
- It does not prove to be a good choice for larger cavities, as in large cavities the composite usually wears much faster than amalgam. It tends to perform equally in wear to amalgam in smaller cavities.
- They take a longer time to fit in and are prone to tea and coffee stains.
- The composite can cost up to two times more than amalgam fillings, and as technology improves the results of composite resin, the cost may continue to rise.
Ceramic
Also known as porcelain fillings, these are manufactured in a dental lab in a shape which will fit the cavity perfectly. They are not attached to your tooth unlike amalgam and composite fillings. Ceramic can also be used for veneers.
Pros
- They perfectly blend with your tooth and are very natural looking.
- The material is durable and can last up to 15 years.
Cons
- These fillings are quite expensive.
- Porcelain can be brittle, and may crack or break.
- They may require removing a larger part of your healthy tooth.
Gold
This filling is manufactured in the same way as the porcelain ones and as the name suggests are quite expensive.
Pros
- They are extremely durable tooth filling which is resistant to tarnish and corrosion. They are the longest lasting fillings available.
- They do not shrink or wear like amalgam or composite, which prevents saliva, bacteria, and food bits from entering into the tooth cavity after the filling has been placed.
Cons
- They are not natural looking.
- The price may be prohibitive.
- If placed near an amalgam filling in your mouth, can actually react with your saliva to cause discomfort.
Glass Ionomer
This type of filling is made of acrylic and a type of glass called fluoroaluminosilicate. Glass ionomer is used most commonly as cement for inlay fillings. It can also be used in front teeth, at the “necks” of your teeth, or in the roots. As a filling material, it is often used in patients that have significant decay in the tooth extending below the gumline. It is also used for filling baby teeth.
Pros
- Glass ionomer is close to the color of most teeth, but is not matchable like composite, so may not be a total match. Resin-modified glass ionomer is usually a better match than traditional glass ionomer.
- These fillings are designed to slowly release fluoride, which can help protect the tooth from further decay.
Cons
- Traditional glass ionomer is significantly more likely to fracture or wear when compared to most other fillings.
- A resin-modified glass ionomer filling needs to be applied in thin layers. Each layer must be fully cured, or hardened, with a special bright blue light before adding the next layer. This makes the filling stronger, but can lengthen the time of the dental appointment.
- The lifespan of a glass filling is about five years or less, with a cost similar to composite resin.
Which of these options is the best for you will depend on many factors, including the extent of the damage to your tooth, the location of the filling within your mouth, your age, your price range, and your dentist or oral surgeon’s professional advice. Fillings are the only real solution for cavities and decaying teeth, and are necessary to save your teeth from further damage which could result in more serious dental or physical health problems down the road.
