I Need a Dental Filling, What Are My Choices?Published:June 20th, 2012
In the past the choice of dental fillings used to be quite limited, as back teeth tended to be filled with amalgam or with gold. The invention of new materials means there is now a much greater range available; these modern materials have an excellent aesthetic appearance, and are virtually undetectable to most people.
But what is the best choice? This can largely depend on the tooth being filled, the size of the filling, and the depth of your wallet.
Inlays and Onlays
These are used for replacing larger areas of decay in back teeth. An inlay will replace the central part of the tooth, while an onlay is used to replace this central area, plus one or more cusps. The cusps are the outer part of the tooth that is slightly more elevated than the rest of the tooth. Inlays and onlays can be made out of composite, porcelain or gold. They are a good way of helping to preserve as much of the healthy tooth structure as possible, and are an alternative to crowning the tooth. As they are made in the dental laboratory, you’ll need at least two trips to see your dentist.
Amalgam fillings are still used by some dentists, and in spite of the controversy have been classified as being safe. Numerous clinical tests have shown the amount of mercury released during the placement and removal, and during the lifetime of an amalgam is negligible. They can be good for fillings right at the back of the teeth, and are especially useful for larger cavities.
However the dentist needs to remove more of the healthy tooth structure in order to make room for an amalgam, and this material tends to contract and expand when coming into contact with cold and hot liquids. Over time this may cause teeth to fracture. Amalgams tend to last a long time, but nowadays many people are choosing to have them replaced, not only because of worries over the mercury content, but also because other choices are much more aesthetically pleasing.
Gold fillings can be inlays or onlays, and are often used for filling cavities in back teeth, and have the advantage of being very hard wearing and durable. A gold filling can also look quite nice, and is certainly better than an amalgam. The disadvantages of gold fillings are that they can be quite expensive, and will always be visible. These will also need at least two visits to the dentist as they have to be custom made in a dental laboratory.
Composite fillings are very popular, and made out of a type of resin which is matched closely to the natural tooth shade. They are ideal for repairing teeth which are highly visible, and as they chemically bond to the tooth they can give additional support.
Composite can be used to repair teeth which have become chipped or decayed, or which have become worn. Their placement requires removal of very little healthy tooth structure. They are not as durable as some other kinds of fillings, and do need replacing every five years or so. They can also become stained quite easily. Composite fillings can directly placed by your dentist in just one visit, or they can be inlays or onlays and are made in a dental laboratory.
Ceramic fillings are constructed out of porcelain in a dental laboratory, and require at least two visits to your dental surgery, but can be extremely durable. The ceramic won’t stain, and it should be relatively long-lasting. This is a good choice of material for filling quite large cavities in back teeth as this material is suitable for inlays and onlays. It is especially good if you want your fillings to be invisible. The major disadvantage of ceramic fillings is the cost, although their longevity can make them more economic role in the longer term.
Glass ionomer fillings
Glass ionomer fillings are made out of a type of glass and acrylic, and are used for filling cavities around the gum line. They are not as durable as composite, and will need replacing more frequently. They are placed by your dentist in just one visit.