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Archive for December, 2008

Although I find myself placing composite fillings 99% of the time, but always review all of the options with patients before deciding on what type of filling material will be placed in their tooth. As a dentist I do not endorse products of one company versus the other, but I find peace of mind using products of reputable manufacturers. Dental fillings must survive in the extreme conditions of the mouth. The human mouth is a perfect environment to test any material to its limits. It is mostly neutral in pH (due to neutralizing effect of saliva), but depending on the food content it can have rapid upward or downward spike in pH. The same thing can happen with temperature swings of up 60 degrees Celsius (from ice cold to coffee hot). Any type of filling material has to endure normal chewing forces and also abnormal para functional grinding which can put up to 20 times more pressure on the teeth compared to normal chewing forces. Following is a comparison of different types of restorative materials for the prospective dental patient, because not all dental filling are created equal.

1. Amalgam Fillings: Composed mainly of Mercury, Silver, Tin, Copper and sometimes Aluminum alloys.
Advantages: Very durable; works in wet or dry environment when placed; releases antibacterial silver ions that fight future cavities that may form around the filling.

2. Composite Fillings: Composed of inorganic fillers such as Silicon Dioxide, organic resins and photo initiators.
Advantages: Color match with the tooth; can be polished to a very high luster; is bonded to the tooth vs. just sitting in it; the only type of filling that can be placed in very shallow cavities (does not require thickness for strength.
Disadvantages: Require dry field during placement; can absorb stains over time; more sensitive than other types of filling to left over decay in the tooth.

3. Porcelain or Ceramic Fillings (Onlay): Composed mainly of inorganic minerals.
Advantages: Excellent color match to the tooth; lasting luster and does not stain easily; very durable but prone to fracture in people who grind or clench their teeth; is bonded to the tooth; can be used on severely broken down teeth; excellent replication of the tooth anatomy since is made by a lab technician.