Deciding which dental filling option is right for you is a joint decision between both yourself and your dentist.

Your dentist will look at your tooth from an aesthetic and structural point of view and let you know the best options to fill the cavity. The size, location and depth of the cavity will all influence your dental filling options. Some dental fillings may not be suitable for certain teeth as they’re not strong enough, or some may not give a good enough finish for a front tooth.

Then it’s down to your preference. Some people don’t mind having a silver filling at the back of their mouths, while others only want invisible white fillings.

In this article, we’ll look at the main dental filling options, see how they’re placed and weigh up their pros and cons.

Amalgam Dental Filling

dental filling

What is it

Amalgam fillings are exactly that.

An amalgam of different metals which harden to make the filling. These metals include zinc, copper, tin, silver and mercury.

This type of dental filling is mixed up and packed into your tooth.

Appearance

When first placed this filling appears to be a shiny silver colour. Over many years the filling will darken and appear blacker.

How is it placed

If you pay attention you’ll hear the dental nurse pop the capsule and put it in the mixer.

This mixes up and amalgamates the different parts.

Once ready the dentist will place the filling in the cavity and pack it down.

The packing consolidates the filling to give it strength. This is why you’ll feel pressure on the tooth during this filling.

Advantages

  • Inexpensive.
  • Durable and long lasting.
  • Strong so ideal for fillings on back teeth where biting forces are larger.
  • Can’t be contaminated by saliva (unlike composite, as we’ll see in a minute) so less likely to fail because of this.
  • Quick to place so you have less time in the dental chair.

Disadvantages

  • The dark filling can shine through the teeth to make them appear black. This can resemble decay although it isn’t.
  • They don’t stick to the tooth and need to be locked in to stop them falling out.
  • They have no give in them, so can cause small cracks in the teeth over time.
  • Some people may not appreciate the mercury content, although the FDA states amalgam use is safe on children over 6 years old.
  • Can cause a shock if placed opposite or next to a different metal filling.
  • Allergic reactions – these are very rare but can occur.

Composite Dental Filling

composite-tooth-filling

What is it?

Composite dental fillings are made up of two components, a resin and a filler.

This is premixed in a tube. When used it’s squeezed out and sculpted.

It’s great for filling in cavities, but also for composite bonding and veneers.

Appearance

Composites are a white dental filling. They come in many different shades to match all tooth colours. The shapes are mixed and matched, with certain stains added to make the dental filling invisible in your tooth.

How is it placed

Before it’s set, a composite filling is a plasticine-like material. It’s soft and mouldable.

Prior to placing the composite filling, we need to place a shampoo (called etch) and a conditioner (called bond) to your teeth to get them ready.

The composite is then placed and moulded into the correct shape.

Once it’s looking good we use a blue light to set it and make it hard.

Advantages

  • Highly aesthetic when done well. Can be made to look invisible and blend perfectly into your teeth.
  • Unlike amalgams, they bond to your teeth so there’s no extra pressure to cause cracks.
  • Due to the bonding, they don’t have to be locked in. This makes them perfect for front teeth.
  • Can be added to and changed at a later date.

Disadvantages

  • Takes longer to place so increased time in the dental chair
  • Need a completely dry area to place them. Any moisture and they will fail.
  • More expensive than amalgam.
  • Less durable for back teeth so life expectancy is less.

GIC (Glass Ionomer Cement) Dental Filling

GIC dental filling

What is it?

Again, this is a mixture of two components: an acid and a base.

A polymeric acid (liquid) is mixed with a basic glass (powder). When these are mixed together a chemical reaction starts where the two cause the material to harden into a filling.

GIC can be used for fillings, as a base under a composite or amalgam dental filling, or to seal the tops of teeth to stop decay getting in.

This dental filling can also be used as a cement to stick in crowns and orthodontic brackets, for example.

Appearance

GIC is another white dental filling and comes in many shades.

However, it doesn’t have the same aesthetic finish as a composite. This is because it can’t be built up in layers and several shades to match the colour of the tooth as well.

How is it placed

This material is versatile and comes in many forms.

This dental filling can come in a capsule, which you will hear mixing in the same machine as the amalgam, or as a separate powder and water.

If separate the nurse will mix this tooth filling to the right consistency for its use. For example, a filling may be thick, but if sticking in a crown it may be runny.

A light setting GIC is also available, where the dentist will use the blue light to harden the material once it’s placed.

Advantages

  • Releases small amounts of fluoride. This protects the teeth and helps stop cavities.
  • Can be placed quickly and with less worry about saliva, so great for fidgety children.
  • It can stick to the different layers of your teeth without needing shampoos.
  • It’s a white filling so matches the tooth to a degree.

Disadvantages

  • Short term material. Softer and less tough than composite and amalgam for fillings.
  • Will wear down a lot quicker.
  • Not as aesthetic as composite white dental fillings. They look more opaque when placed.

Ceramic Dental Filling

What is it?

Appearance

Ceramic dental fillings are made of porcelain.

They are invisible fillings made to match your tooth surrounding the cavity. They can be coloured and stained and made to look completely lifelike.

How is it placed

Ceramic fillings are placed in two appointments.

At the first appointment, the dentist will prepare the cavity and remove decay if needed. They’ll take a mould once the cavity is ready and place a temporary filling.

This mould is then sent to a dental technician.

The technician uses the mould to construct a bespoke white porcelain filling for your tooth. This takes roughly 7-10 days.

Once it’s ready your dentist will remove your temporary filling and glue in the ceramic filling.

Advantages

  • Beautiful appearance. The translucency matches the tooth well and looks very natural.
  • Bespoke to your tooth and fit perfectly.
  • Aren’t prone to staining, unlike composite dental fillings.

Disadvantages

  • More expensive as requires a lab technician to make them.

Gold Dental Filling

gold dental filling

This procedure is exactly the same as that of the ceramic filling. The only difference is the material the technician is using to make your bespoke filling.

What is it?

The shiny stuff we wear around our necks.

In fact, there’s a spectrum of gold as you probably know. It can be very pure and equally expensive or diluted with other metals to make it more affordable.

The cost of your filling will be dependent on the cost of gold at the time if you’d like it pure. The price can be reduced by creating alloys which appear gold, but aren’t.

Appearance

Golden!

It doesn’t matter if your filling is pure gold or not, the technician will make it look so.

How is it placed

Like the ceramic dental fillings, it’s over two appointments.

The process is almost identical, whereby the filling is manufactured by a dental technician outside of the dental surgery.

Once it’s ready your dentist will glue the gold dental filling in place.

Advantages

  • Durable and long lasting.
  • Strong so can be used on back teeth.
  • Some people may like a bit of bling in their mouth.

Disadvantages

  • If you want real gold you’ll pay the price for the metal.
  • Need two visits to place it so more time missing work.
  • Like amalgam, can cause shocks when touching a different metal in your mouth.
  • Not an invisible filling.

If you’re happy about the material you’d like to use to fill your tooth but are worried about the process then read my post called ‘The Tooth Filling Process – Put Your Mind at Ease‘.

 


AUTHOR

Dr Gareth Edwards Dentist AuthorDr Gareth Edwards BDS (Hons) MFDS RCPS (Glasg) is a Poole and Bournemouth based dentist who qualified with honours. He has a keen interest in orthodontics and aesthetic dentistry and is a certified Invisalign and Six Month Smiles provider. For more information click here.

 

 

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