Tooth fillings are tiny but incredibly important restorations that help keep your smile healthy and strong. When a cavity or decay is found in the mouth, fillings are used to seal the tooth off and prevent bacteria from entering. When a filling is installed, the decay is removed and the tooth is then fully cleaned. Then, the filling replaces the old decay to protect the integrity of the tooth. Ancient civilizations used materials like beeswax and crushed stone for early fillings. While silver amalgam was once the primary modern option, today, more cosmetic choices are available.
Composite resin fillings are the most common alternative to dental amalgam. They are sometimes called “tooth-colored” or “white” fillings because of their color. Composite resin fillings are made of a type of acrylic resin reinforced with powdered glass filler. Composite resin is often placed in layers to build up the final restoration, then cured with an “ultra-violet light”. This light energy speeds up a chemical reaction of the components causing the soft material to harden and bond to the tooth. This material is considered safe. The plastic and glass mixture can be customized to fully resemble the shape and color of your real teeth. It is usually hard to tell that a tooth has even been filled!
Composite resin fillings have several advantages. The “white” color that they provide is preferred by many patients due to its ability to blend in with surrounding teeth. Using composite material allows for more conservative preparations, preserving the natural tooth structure.
Some benefits of composite resin restoration include:
Natural looking restorations
Ideal for smaller fillings
Preservation of tooth structure
The procedure for placing a composite resin dental filling is a bit more complicated than
it is for an amalgam filling:
The dentist isolates and dries the tooth to prevent saliva contamination
The decayed or damaged portion of the tooth is carefully removed
An etchant and bonding agent is applied to bond the tooth to the composite resin
A special light is used to harden each layer of composite resin material
After the tooth is filled, the composite resin is shaped to resemble a real tooth.
Finally, the restoration is smoothed and polished to accommodate your occlusion.
If your fillings are in good condition and there is no decay beneath the filling, FDA does not recommend that you have your amalgam fillings removed or replaced. Removing sound amalgam fillings results in unnecessary loss of healthy tooth structure and may expose you to additional mercury vapor released during the removal process. However, if you believe you have an allergy or sensitivity to mercury or any of the other metals in dental amalgam (such as silver, tin, or copper), you should discuss treatment options with your dentist.
Dental amalgam is a filling material that has been used by dentists for over 150 years. A mixture of metals that typically includes silver, copper and tin, dental amalgam fillings (commonly referred to as “silver fillings”) also contain mercury, which has raised safety concerns among patients from time to time.
In response to those concerns, the U.S. Food and Drug Administration (FDA), American Dental Association (ADA) and other organizations have conducted numerous studies over several decades and have repeatedly found that the small amount of mercury released during placement and removal of amalgam fillings does not cause adverse health effects.
Amalgam fillings remain a safe, cost-effective and durable choice when it comes to the restoration of decayed teeth.
Why is amalgam still used to fill teeth when composite materials are available?
While composite (or “tooth colored”) fillings are more durable than ever thanks to advancements in technology, there are still many cases where amalgam fillings perform better (and longer). This is often the case with teeth that are naturally subjected to extensive chewing force, such as molars. Mercury is an important part of the amalgam mixture as it contains unique elements that allow it to be manipulated with ease during placement and then harden quickly after. In addition to the benefits of longevity, amalgam fillings are also more affordable than composites.
Mercury is a naturally occurring metal and one that we are exposed to in small amounts through water, air and food throughout our lives. Excessive exposure to mercury can negatively affect the brain and kidneys – however, it is important to understand that amalgam fillings do not cause dangerous levels of mercury exposure. Numerous scientific studies and thoughtful research have led the FDA to stand behind its position: amalgam fillings are a safe and effective restoration method for patients over 6 years of age.
A thorough summary of evidence ranging from 2004-2010 led the ADA to reaffirm its position that amalgam is a valuable and safe choice for patients.
Composite fillings are typically made of a resin and glass mixture, tinted to the color of your tooth, and commonly referred to as “white” or “tooth-colored” fillings. They serve an important purpose for teeth that are visible when smiling, providing an aesthetic benefit not afforded by silver fillings. While resin composite fillings undoubtedly look better than amalgam ones, they are generally considered to be less durable and therefore may not be ideal for teeth that are subject to extreme chewing and biting forces. It is worth noting, however, that composite materials continue to benefit from technological advancements, contributing to enhanced durability. The ADA supports composite materials in small or mid-size fillings on teeth that are exposed to moderate pressure from chewing and acknowledges that they are a good choice for a more natural-looking filling.
The ADA Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.
If you still have concerns about amalgam fillings, please don’t hesitate to call our office! It is important to us that you fully understand all available options when it comes to your oral health.
Replacing missing teeth with implant retained dentures
Usually, when you lose a tooth, it is best for your oral health to have it replaced. Missing teeth can affect your “bite” as well as your ability to speak and chew. Their loss can increase the burden on your remaining teeth and can cause muscle pain in your jaws and headaches. And of course, losing a tooth can affect your appearance. The following information reviews replacing missing teeth with an implant retained denture.
Although many patients have no problem wearing an upper denture, some people find it difficult to wear and eat with lower dentures.
One option is to have two implants placed in your lower jaw and a denture made that snaps onto these dental implants. This option allows your lower denture to be more stable while chewing than without implants. However, there will still be movement of your lower denture, and sore spots will occur if any food particles are caught under it. As with all removable replacement teeth, you still will need periodic appointments for denture adjustment.
Another option involves placing four to six implants, depending on your jaw size or shape, into your lower jaw. After healing is complete, the implants are connected with a custom-made support bar. Your denture will be made with special internal retention clips that attach onto the support bar, enabling the denture to snap firmly into place. This is called an “overdenture.” The advantage of this option is that it is much more stable than the first option and allows very little denture movement. Your denture is still removable for easy cleaning and maintenance.
A third option involves placing five or more implants in your jaw and attaching a permanent denture. Your denture is held in place by screws or clasps that secure it to the support posts or bar. It doesn’t touch the gum tissue, which allows you to clean under the denture without removing it. This denture will replace all your missing lower teeth and will not be removed except at maintenance visits. Although cleaning under your denture without removing it is more time consuming and requires more dexterity, many patients who want a permanent denture prefer this option.
A similar range of treatment options is also available for your upper jaw. However, because the bone is not as hard as that in the lower jaw, people often need more implants to support their new replacement teeth. Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.
Depending upon the number of implants to be placed, it may be possible to eliminate the need for covering the roof of your mouth with a complete denture. This option allows you to fully taste your food and gives you a better sense of its temperature. Your denture will feel more natural. You will still have a removable denture, which makes cleaning the support bar and denture much easier.
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