Dental Fillings: What Goes into That Restoration?

The materials in today’s dental fillings offer far more variety than were available a generation ago. “Today, there is a big variety of materials that match the color of your teeth and give you a natural-looking smile,” says Dr. Carol Ford from her Phoenix dental office. “There are also new techniques for fillings that allow more choice for our patients than the amalgam filling,” Dr. Ford says.

cosmetic_dentalThe most common filling material was amalgam—known as “silver,” although it is made from a mix of silver, tin, copper and mercury. Because the metal doesn’t bond to the tooth, the dentist would first remove the decay, and then undercut the edge to hold the metal. “Undercut” means to remove material by first going down into the tooth, and then across, creating a ledge to hold the metal. “Amalgam fillings required the removal of more of the tooth than other fillings,” says Dr. Ford.

While amalgam fillings could take the great pressure of chewing and were often used in back molars, there has been a controversy about the safety of fillings containing mercury. The American Dental Association reports the fillings to be safe, but most European countries have (or are developing) legislation banning mercury-containing amalgam fillings. The Food and Drug Administration (FDA) has added more cautionary language to using amalgam fillings. As with all controversies that require decision-making on the patient’s part, this one is worth discussing with your dentist.

The current material of choice is a resin-based composite. These have been developed to be stronger and longer-lasting, and there is a bigger selection of materials. “There is no doubt that composites look more natural,” says Dr. Ford. “Particularly for fillings close to the front of the mouth, which are more visible when laughing or speaking.”

Today there are choices, even among resin fillings, depending on the location, how much pressure they will take, and how closely they can match the surrounding tooth. “One of the best pieces of information about resins is that they bond easily with tooth enamel,” says Dr. Ford, “and that means a better fit and a better smile.

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