When you see a dentist for a filling, the question often arises about which type of filling is the best; Silver amalgam, porcelain, composite or even gold? Depending on your particular dental situation the doctor can explain the pros and cons of each. Remember that no matter the material, advantages and disadvantages will always exist.
Silver fillings, often called amalgam, are actually a mixture of about half silver and half mercury with small additions of tin and copper. They’ve been in use for over 100 years, so they've definitely stood the test of time. The material is pliable and hardens quickly. Silver amalgams can last for many years, and they're less technique sensitive to place than other materials. They are, however, less aesthetically pleasing. If you're allergic to silver or concerned in any way about the use of amalgam, other choices are available
Composite Fillings: These fillings -- made of acrylic plastics, quartz fillers, and colorants -- have become a popular choice in the modern dental office. They maintain their size and shape, they are mercury free, and they are cosmetically pleasing. Composite fillings can generally be used in any area of the mouth because they blend in with your natural tooth color. They're resistant to breakage and easier to polish. Composites can also be chemically bonded to the tooth. This often means that the cavity preparation can be more conservative.
Porcelain inlays and onlays: Large composite fillings don’t always hold up very well. Porcelain inlays and onlays are stronger and can be bonded into a large cavity to help hold the tooth together. These kinds of fillings can be made by a laboratory, similar to a crown, or they can be made in the office with a CAD/CAM computerized machine, such as Cerec. They are tooth colored and contain no metal.
Gold Fillings: Gold inlays and onlays have also stood the test of time. Gold is very biocompatible and possibly lasts the longest of any dental filling material. There’s a reason why most dentists I know have their own cavities restored with gold!
Most dentists have their own a preferences when it comes to fillings, so talk to your doctor about your options.
Peter J. Samuels, DDS is a local Gettysburg dentist and a clinical instructor at the University of Maryland School of Dentistry.