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Amalgam vs. Composite Fillings
Every dental material used to rebuild teeth has advantages and disadvantages. Dental amalgam or silver fillings have been around for over 150 years. Amalgam is composed of silver, tin, copper, mercury and zinc. Amalgam fillings are relatively inexpensive, durable and time-tested.
On the flip side, they are considered unaesthetic because they blacken over time and can give teeth a gray appearance, and they do not strengthen the tooth. Some people worry about the potential for mercury in dental amalgam to leak out and cause a wide variety of ailments.
Composite, resin or white fillings have been around for about two decades. Composite fillings are composed of an organic polymer known as bisphenol-aglycidyl methacrylate (BIS-GMA), and inorganic particles such as quartz, borosilicate glass, and lithium aluminum silicate.
They have the advantage of requiring a more “conservative” tooth preparation (e.g., less drilling required); can have a strengthening effect on the tooth; are very aesthetic; and virtually blend in with the tooth. Composite fillings are the material of choice for repairing the front teeth. On the down side, they are more technique sensitive for the dentist to place, are highly susceptible to tooth decay in the future if placed improperly and usually cost more than an amalgam.
Porcelain is sometimes used for dental fillings and are called inlays. Porcelain is a non-crystalline glass composed of silicon and oxygen. It has the advantage of being highly aesthetic, and is the restoration of choice for people who place the highest value in the appearance of their teeth. Porcelain has the disadvantage of being brittle, and, therefore, susceptible to breakage. It is also even more technique sensitive to use than composite, requires two dental visits to place the filling, and costs significantly more than amalgam or composite fillings. Porcelain can also cause accelerated wear of the opposing tooth when biting.
Gold is sometimes used for dental fillings, most commonly as an inlay. Gold is not used in its pure form, but as an alloy containing 75 percent gold, as well as copper, silver, platinum, palladium and zinc. Gold is extremely durable; fairly aesthetic; does not damage the opposing tooth when biting; and is very well tolerated by the gums and other intra-oral tissues.
A well-done gold filling can last two to four times longer than any other dental material, and might be considered the "gold standard" for dental fillings. Gold inlays, like porcelain inlays, take two dental visits to complete and are also much more costly than amalgam or composite. They are also not nearly as aesthetic as composite or porcelain. In addition, gold inlays are fairly difficult to prepare and place -- just ask any third or fourth year dental student. They are usually required for graduation from dental school.
It's a good idea to talk to your dentist about what material he or she recommends as filling for your cavities. Tell your dentist what your priorities are regarding cosmetics, durability, economics, etc. Together, you and dentist can make the best decision for how to rebuild your teeth.
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Amalgam Fillings
Composite Fillings
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