When it comes to restoring damaged or crooked teeth with a filling, there are several options. Often, patients get confused in choosing a filling which is not only durable but also restores their smile and is, of course, cost-effective. So, how do you choose the best dental filling? This article provides an overview of different types of dental fillings commonly used, and then compares their properties so that you can make an informed decision the next time you need a filling.
Direct And Indirect Fillings
Before we proceed, it is important to learn the difference between direct and indirect fillings. Based on their method of fabrication, there are generally two types of fillings: direct and indirect. The direct fillings are placed directly into the mouth, while the indirect ones are first prepared in a dental laboratory, and then they are attached to the prepared tooth with adhesive cement. Examples of indirect restorations include veneers, crowns, and inlays.
The following direct and indirect filling materials are used commonly in dentistry for restoring teeth:
- Dental Amalgams – these filling materials have been in use for more than 150 years. These fillings are made by mixing mercury with silver and copper-based alloy. Although these fillings are extremely strong, durable and cost-effective, they are not used commonly nowadays owing to their unaesthetic metallic appearance. Also, for placing amalgam fillings, a lot of healthy tooth structure needs to be sacrificed. Finally, a few research studies have pointed out the adverse effects of mercury on the human body.
- Glass Ionomer Cements – These are tooth-colored fillings which are made by mixing glass powder with an acid, and are commonly used for restoring teeth in children, and for the treatment of root caries. Advantages of these filling materials include the ability to form a strong chemical bond with the tooth structure, and fluoride release which makes the teeth stronger and more resistant to the development of teeth cavities. On the downside, glass ionomer fillings are not very durable as they wear easily. Therefore, they cannot be used for restoring teeth which receive high chewing forces.
- Composite Fillings – as their name suggests, these fillings are basically a mixture of polymeric resins and inorganic fillers and are mercury free. The fillers are added to the resins to enhance the strength and durability of the filling. One of the best qualities of composite fillings is their ability to match the shade and color of the adjacent teeth. Composite fillings are also tooth-conservative, as they do not require the sacrifice of healthy tooth structure for their attachment. Due to their excellent aesthetics, ease of placement and sufficient strength and durability, composite fillings are most commonly used throughout the world for restoring damaged teeth.
- Ceramic Restorations – indirect restorations such as veneers, crowns, inlays, and onlays made from ceramics can also be used for restoring teeth. Ceramic fillings not only possess excellent aesthetics, but are also quite durable and safe for use in the body. They also possess excellent dimensional accuracy and precision, as they are prepared in the laboratory. However, their drawbacks include longer preparation time and the need to sacrifice healthy tooth structure for their attachment.
- Gold Fillings – although very common a few decades back, gold fillings are not commonly used nowadays due to their obvious unaesthetic appearance and high cost.
So, coming back to the question which filling is best? The answer is that there is no such thing as the best filling, and the choice has to be made according to the extent and location of the damaged tooth, aesthetic requirements and budgetary constraints. For example, an amalgam filling may be suitable for restoring back teeth which are not visible. However, it is not suitable for restoring the front teeth. In this case, a composite direct filling, or porcelain or composite veneer may be suitable. Your dentist is the best person to help in choosing a filling material that is best suited to your dental needs.
Dr. Jose Lage qualified at ISCSEM (Egas Moniz Higher Institute of Health Sciences) in Lisbon - Portugal in 2001. From 2001 to 2003, he worked in Portugal in private practices and was dental assistant in the Department of Endodontics (Root Canal Treatments) at ISCSEM in Lisbon. He currently works exclusively at Natureza Dental Practice since June 2009. Jose speaks English, Portuguese and Spanish and is trying to improve his Italian and French. Outside dentistry José loves football, swimming, painting, music and reading.