Restorations/Fillings
Dental Amalgam
Dental Amalgam is a commonly used dental filling that has been used for over 150 years. It is a mixture of mercury with at least one other metal. Amalgam has many advantages over other restorative material, such as low cost, strength, durability, and bacteriostatic effects. Amalgam filling are strong and can withstand heavy biting pressure because of the metal content, therefore they are used for back molars.
Amalgam is used in dentistry for a number of reasons. It is relatively easy to use and manipulate during placement; it remains soft for a short time so it can be packed to fill any irregular volume, and then forms a hard compound. Amalgam possesses greater longevity than other direct restorative materials, such as composite. On average, most amalgam restorations serve for 10 to 12 years, whereas resin-based composites serve for about half that time. However, with recent improvements in composite material science and a better understanding of the technique-sensitivity of placement, it should be noted that this difference is decreasing. Amalgam filling material is relatively inexpensive compared to composite restorations.
There are circumstances in which composite (white fillings) serves better than amalgam; when amalgam is not indicated, or when a more conservative preparation would be beneficial, composite is the recommended restorative material. These situations would include small occlusal restorations, in which amalgam would require the removal of a more sound tooth structure, as well as in “enamel sites beyond the height of contour.”
The American Dental Association Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.
Tooth Colored Fillings
A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc. The decayed or affected portion of the tooth will be removed and then filled with a composite filling. As with most dental restorations, composite fillings are not permanent and may someday have to be replaced.
Tooth colored fillings create unnoticeable restorations for teeth, and because their bond to the tooth is dependent on surface area they tend to be more reliable on permanent teeth (which have more surface area due to their larger size) vs baby teeth when placing fillings on back molars. Composite materials are more expensive and take a little longer to place. Insurance companies will not always pay for composite fillings on back teeth.
How are composite fillings placed?
Composite fillings are usually placed in one appointment. While the tooth is numb, decay will be removed, as needed. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.
It is not unusual to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after the tooth acclimates to the new filling.