Dental restorations, or "fillings," are often the most appropriate treatment when teeth develop small- to moderately-sized decay, minor cracks, chips or wear. The damaged area of the tooth is precisely removed while the tooth is numb, then cleaned and replaced with either white composite resins or silver amalgam. The filling restores the tooth's size, function and health.
Both composite resin (composite) and silver amalgam (amalgam) fillings are safe and strong, but they each have different advantages and disadvantages:
Composite Resin Fillings
Composite is a tooth-colored, non-soluble, bonded restoration that is made from glass particles, resin and a "photoinitiator." It is pressed and shaped against the tooth and then cured with blue light that hardens the material. The bonding process knits the tooth and composite together. This creates an excellent seal underneath the filling and also strengthens the composite against chewing stress. Bonding allows Dr. Barnes to treat your tooth as conservatively as possible because she will not have to remove additional tooth structure beyond the defect to "lock-in" the composite or for minimal thickness, as is required for silver fillings. In addition, composite fillings closely match your tooth's color to create fillings that are beautiful and natural in appearance.
For the above reasons, composite will most often be Dr. Barnes's recommendation and preference.
However, composite has limitations: if saliva contaminates the tooth when the filling is being placed, it prevents proper bonding of the composite and leakage underneath your filling can occur. Unfortunately, this may increase the risk that the filling will fail. Dr. Barnes may use barrier techniques to keep your teeth "dry" but in some situations, this may be impossible. In these (relatively rare) circumstances, composites are not ideal and a different choice for your filling, like silver amalgam or lab-fabricated gold or ceramics, should be considered.
Silver Amalgam Fillings
Amalgam is one of the oldest materials used in dentistry. It is a metal alloy material made primarily from silver, copper, tin, and mercury. It has proven itself over generations of patients as a safe and reliable material with a history of success. Although there is controversy regarding the mercury content of amalgam, decades of scientific research has not shown any link between silver fillings and adverse health effects. (For more information about the safety of amalgam restorations, visit the American Dental Association site MouthHealthy.org and the FDA's page About Dental Amalgam Fillings)
Unlike composite, silver fillings do not bond to tooth structure but are instead condensed and burnished into the tooth. Because of this, silver fillings must be "locked-in" with retentive design features to keep them in place. Amalgam must also be a minimum thickness for strength. These two properties of silver fillings generally makes them less conservative than composite. But when properly prepared, amalgam is durable, strong and long-lasting. And importantly, amalgam can be placed with equally good results in "wet" and "dry" conditions.
At Berkshire Dental Arts, we believe careful consideration of the strengths and limitations of dental materials are crucial to their success.
We are always happy to discuss your options and help you make confident decisions about your treatment.