When you think about a trip to the dentist, the farthest thought from your mind is probably “How much materials science and engineering went into my time in the dentist’s chair today?” At first, the thought that quite a bit of materials science goes into dental work may seem startling, but as you consider the matter further, it’s both no surprise and quite a comfort that advances in the science of composite materials are making their way into dental care. Because, as unpleasant a fact as it is, it remains true that sometimes caries happen, particularly when you are just starting to use a proactive caries management strategy and getting regular caries risk assessments. When you have a cavity that has progressed far enough to require a restoration, commonly called a filling, there are currently multiple choices your dental care team and you can discuss for what materials of which your filling can be made.
What Materials are Out There?
There are several options that are currently used for fillings. There are several uncommon options, including glass ionomer, gold, and porcelain ceramic. In addition to being pricey, each of the uncommon options has distinct downsides. Glass ionomer has trouble holding up over the long term and so is generally used as a part of a filling rather than as a filling by itself. Gold fillings usually require multiple visits to complete, remain visible, and sometimes are uncomfortable if they come into contact with other types of metal. Porcelain ceramic fillings also require multiple visits to complete in most cases and, although they are extremely long-lasting, they can have a slightly rougher surface that can cause irritation over time.
So What’s Left?
The common choices you and your dental team will look at when deciding on a filling material are dental amalgam or composite resin. Each material has its own relative strengths, and it’s worth taking a moment to learn about each option.
Tried and True
Amalgam fillings are made of a mix of metal, an alloy. They are commonly called silver fillings because of their silver color, but they do not contain silver. They are usually a mix of mercury, tin, and copper. Amalgam fillings have been used for over 100 years. They last well in the mouth and are economical in price, leading most dental insurance providers to cover the cost of amalgam fillings. Unfortunately, they are obvious in the mouth, so they are more likely to be placed on rear teeth instead of front teeth where they are easier to see. They also tend to require more drilling than composite fillings in order to be placed properly. An extremely small percentage of people are allergic to metals and can have an uncomfortable reaction to having metal in their mouth. There is also concern about the environmental impact of using mercury. Some people also prefer not to have mercury in their body out of concern for its possible health risks, even though the FDA has stated that amalgam fillings are safe for adults and children over the age of 6.
Composite fillings are a plastic resin mixture, often including glass, that can be used to fill cavities. They are also called tooth-colored fillings. They are visually similar to the natural tooth surface, so they are less visible once they are completed. Composite fillings bond well to tooth surfaces, so they frequently require less drilling. They are usually cured with a special light, so the filling can take longer to complete, and the fillings tend to be more expensive than amalgam fillings. Dental insurance companies may only pay part of the cost of a composite filling. There is also concern that the fillings may not hold up as well as amalgam fillings, although the materials have continued to improve each year and further studies of the most current materials being used are needed to draw definitive conclusions about how long the newest composite resin fillings can last in the mouth and how they compare to long-lasting amalgam fillings.
What’s the Best Option?
That’s really something you and your dental care team need to discuss together, taking into account all the factors specific to your situation. You can make the decision factoring in your desire for an aesthetic solution, how long you expect the filling to last, the cost of the filling, and your tolerance for the metal in your mouth.
Ideally, you would not need a filling at all. If your teeth have not progressed to the point where a restoration is inevitable, raising your oral pH to help your teeth remineralize and using oral care products with nanohydroxyapatite to support remineralization are good ways to avoid needing to decide which restorative material to consider. Even if a restoration (filling) is required, a tooth gel with nanohydroxyapatite can help decrease sensitivity following dental treatment and may help reduce the need for future treatment.
At the end of the day, you have options. Working with your team to achieve your goals for oral health can help you be as satisfied as possible with your oral health and any possible restorations needed.