Types of Fillings

 

 

Amalgam


Made of: A mixture of silver, tin, zinc, copper, and mercury. Mercury is nearly 50% of the mixture.

Types: Traditional (non-bonded), bonded

Used for: Fillings in back teeth

Lasts: At least seven years, usually longer

Costs: The least expensive type of restorative material

Advantages

  • Amalgam fillings are strong and can withstand the forces of chewing.
  • They are relatively inexpensive, compared with alternatives.
  • An amalgam filling can be completed in one dental visit.

Disadvantages

  • Amalgam doesn't match the color of your teeth.
  • Healthy parts of your tooth often must be removed to make a space large enough to hold an amalgam filling.
  • Amalgam fillings can corrode or tarnish over time, causing discoloration where the filling meets the tooth.
  • A traditional (non-bonded) amalgam filling does not bond (stick) to your tooth. The cavity preparation (the "pocket" in your tooth) developed by your dentist requires undercuts or ledges to provide retention of the filling. Your dentist may have to remove additional tooth structure to establish good retention for the filling.
  • Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury exposure from fillings is similar to what people get from other sources in the environment.
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Composite Resin


Made of: A mixture of plastic and fine glass particles.

Types: Direct and indirect. Direct fillings are placed by your dentist using a bright blue light that hardens the soft material. For indirect fillings, your dentist prepares the tooth, takes an impression and a laboratory makes the filling. During a second visit, your dentist cements this filling into place.

Used for: Small and large fillings, especially in front teeth or the visible parts of teeth; also for inlays

Lasts: At least five years

Costs: More than amalgam, but less than gold

Advantages

  • Your fillings or inlay will match the color of your teeth.
  • A filling can be completed in one dental visit. An inlay may require two visits.
  • Composite fillings can bond directly to the tooth, making the tooth stronger than it would be with an amalgam filling.
  • Less drilling is involved than with amalgam fillings because your dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth.
  • Indirect composite fillings and inlays are heat-cured, increasing their strength.
  • Composite resin can be used in combination with other materials, such as glass ionomer, to provide the benefits of both materials.

Disadvantages

  • Although composite resins have become stronger and more resistant to wear, it's not clear whether they are strong enough to last as long as amalgam fillings under the pressure of chewing.
  • The composite may shrink when placed; this can lead to more cavities in the future in areas where the filling is not making good contact with your tooth. The shrinkage is reduced when your dentist places this type of filling in thin layers.
  • These fillings take more time to place because they are usually placed in layers. The increased time and labor involved also contribute to the higher cost (compared with amalgam fillings).
  • Indirect fillings and inlays take at least two visits to complete. Your dentist takes impressions at the first visit and places the filling or inlay at the second visit.
  • In large cavities, composites may not last as long as amalgam fillings.

 

Cast Gold


Made of: Gold alloy (gold mixed with other metals)

Used for: Inlays and onlays, crowns

Lasts: At least seven years, usually longer

Costs: More than most other materials; six to 10 times more expensive than amalgam

Advantages

  • Gold doesn't corrode.
  • Some people like the gold color better than the silver color of amalgam.
  • Gold fillings are durable enough to withstand chewing forces.

Disadvantages

  • You must visit the dentist at least twice to receive a gold filling. At the first visit, the dentist makes an impression of your tooth and a temporary filling is placed. The gold filling is made from the impression and is placed at a second visit.
  • The cost is high because of the high cost of gold and the work involved.
  • If gold and amalgam fillings are right next to each other in your mouth, an electric current can result from interactions between the metals and your saliva, resulting in discomfort. This is called "galvanic shock."

Ceramics
Made of: Porcelain, most commonly

Used for: Inlays and onlays, crowns

Lasts: Five to seven years

Costs: Can cost as little as composite or as much or more than gold, depending on the filling.

Advantages

  • Ceramics are tooth-colored.
  • Ceramics are more resistant to staining and abrasion than composite resin.

Disadvantages

  • Ceramics are more brittle than composite resin.
  • A ceramic inlay or onlay needs to be large enough to prevent it from breaking, so the tooth must be reduced in size to make room for the extra bulk.

Glass Ionomer
Made of: Acrylic and a component of glass called fluoroaluminosilicate

Types: Traditional (the material sets without a bright light), or resin-modified or hybrid composite (stronger than traditional glass ionomer; a bright blue light is used to set the material)

Used for: Most commonly used as cementation for inlay fillings, but glass ionomer also is used for fillings in front teeth or to fill areas around the necks of your teeth or on roots. As filling material, glass ionomer is typically used in people with a lot of decay in the part of the tooth that extends below the gum (root caries). It is also used for filling baby teeth and as a liner for other types of fillings.

Lasts: Five years or more

Costs: Comparable to composite resin

Advantages

  • Glass ionomer matches the color of the teeth, although it does not always match as well as composite resin. Resin-modified glass ionomer is usually a better match than traditional glass ionomer.
  • In some cases, no drilling is needed to place a glass ionomer filling. This makes this type of filling useful for small children.
  • Glass ionomers release fluoride, which can help protect the tooth from further decay.
  • Glass ionomer restorations bond (stick) to the tooth, which helps to prevent leakage around the filling and further decay.

Disadvantages

  • Traditional glass ionomer is significantly weaker than composite resin. It is much more likely to wear or fracture.
  • Traditional glass ionomer does not match your tooth color as precisely as composite resin.
  • If you are getting a resin-modified glass ionomer filling, each thin layer needs to be cured, or hardened, with a special bright blue light before the next layer can be added. This makes the tooth stronger, but can lengthen the time of the dental appointment.

 

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