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Besides mercury
fillings, there currently are three other choices of materials
that can be used to repair and restore teeth. All of the materials
are more expensive than mercury fillings, however, two of these
materials will last considerably longer. As with most things, we
often "get what we pay for."
If you have
dental insurance, you will likely find that they may only pay for
mercury, as their goal is to provide the most basic of dental services
and at the cheapest cost to the insurance company. They are not
concerned whether it may be a health risk to you. Please see our
insurance page for information about dental plans that may be helpful
to you.
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| Composite
fillings |
Composite
fillings are also known as white fillings or bonded fillings.
They are placed directly in the tooth at the same time/appointment
that a cavity is cleaned or an old filling is removed. Composite
materials were first introduced around 1960 and they have gone
through many stages of development. They are made up of microscopic
glass particles in a Bis-GMA resin. Their use has increased tremendously,
especially in the past ten to fifteen years. Initially they were
intended for the front teeth only, but as the concern over mercury
fillings has increased, research has brought about newer materials
designed for the back teeth.
Advantages:
Composite fillings are relatively inexpensive to porcelain and
gold and they can be placed in one visit. They bond (adhere) to
tooth structure and hence they can be placed in very conservative
tooth preparations.
Disadvantages:
Composite fillings will only last 7-10 years on average,
depending on the size and location of the filling. They are slightly
porous and they will become stained in this length of time, and
may need to be replaced for esthetic reasons. When placed about
30% of the material does not cure making it weaker and not as
wear resistant. For this reason composite fillings are best
placed in front teeth or used for smaller fillings only.
They often
cause initial sensitivity to cold and pressure that can
last from 3 to 6 weeks. This sensitivity is caused by a multitude
of factors including the bonding process and shrinkage of the
material as it is cured. For this reason, fillings that are very
deep or large are more likely to be sensitive and for longer periods
of time. Back teeth are more often sensitive than front teeth
as there is considerable more biting pressure on the back teeth.
We do everything we can to eliminate the sensitivity, but it is
still the most common problem associated with the composite fillings.
Other problems are the material is not as strong as ceramic
or gold, and if it is large it can chip and/or break.
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| Porcelain/Ceramic |
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Porcelain has
been used to fill teeth for more than thirty years. Porcelain fillings
(inlays) are often done by taking a mold or impression of the prepared
tooth. A laboratory will then make a custom fitting piece of porcelain
that will be inserted approximately two weeks later. In this
office, however, we have equipment (Cerec) to provide custom porcelain
fillings (inlays, onlays, veneers and crowns) in one appointment.
Advantages:
Porcelain can be matched to the colour of your teeth. The fit is
very precise and it will seal the tooth better than a filling when
done properly. The material is also much stronger and wears better
than composites, hence it will last 15 years or longer.
Disadvantages:
In most offices this requires two appointments. Porcelain can sometimes
chip even though it is much stronger than composite. The initial
cost is more than composite, however this is offset in the long
term.
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| Gold |
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Gold is the
standard by which all other materials have traditionally been compared.
The reason for this is it has been in use for over one hundred years,
it is very biocompatible and is still one of the most durable materials
in the mouth. There is some breakdown (galvanic reaction) of the
material when it comes in contact with mercury fillings, but by
itself it has not been shown to cause any health concerns or risks.
Much like porcelain, a dental laboratory will make a custom fitted
filling which is placed at a second appointment.
Advantages:
Fit, durability and wear of gold restorations is excellent. They
will last 15 years or longer, and we have several patients
with gold restorations lasting over 25 years.
Disadvantages:
The colour can be an esthetic concern if it is visible, and as it
requires a laboratory step, two appointments are necessary. The
initial cost is greater than composites, but in the long term the
overall costs will be less and the benefits much greater.
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| Summary:
Porcelain or gold are both excellent choices and the best material
if you prefer durability, minimal long-term problems and the finest
quality for your teeth. Composites are good for small fillings and
are adequate for larger fillings provided you understand their limitations. |
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©
2001 - 2008 Dr. Peter A Balogh Inc. Dr. Edward T.W. Kwok Inc. All
rights reserved.
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