Alternatives to Conventional Fillings
If you get a cavity, chances are that your dentist will recommend a filling. There are two common types of fillings available, amalgam (aka silver) and composite resin (tooth-colored). Although silver fillings have a proved track record of long-term success, there has been a general trend away from them in practice. This is due to a number of factors, which include concern over the mercury content and the outcome.
However, the composite resin /tooth-colored filling materials have a number of limitations as well. In order to understand these limitations, we must first discuss a little about how they work.
Composite resin is a form of plastic that starts out as a gelatinous solid. Once the decay in your tooth has been removed (with a drill), the composite is packed into the hole, and molded to fit the defect. The dentist then shines a blue light on the material and small molecules within the material start a hardening reaction that makes it transform into a very hard solid.
One major concern with composite resin is that it must remain dry while it is being inserted. This can be very difficult in the oral cavity sometimes particularly around the posterior teeth. Saliva contamination will interfere with the setting reaction which will create voids in the material and predispose the filling to decay in the future. Another problem with composite resin is that it shrinks during the setting reaction. Again, this can create little gaps between the filling and the tooth where bacteria can cause decay. The amount of shrinkage depends on brand of composite and the dentist’s technique. Finally, there are issues with the strength properties of this material in larger fillings.
So, is there an alternative to the mercury-containing silver fillings and the hard to use, decay prone composite resin?
Yes. Instead of conventional fillings, we can use ceramic or gold restorations, called inlays or onlays. Inlays are smaller and onlays are larger versions of the same thing. They are fabricated in the laboratory and cemented into place, similar to a crown. These restorations are made of inert (safe) materials, are tooth-colored, do not shrink, and are easier to fit into place. The long-term data on these restorations is excellent, so what is the catch? The differences between inlays/ onlays and conventional fillings are time and cost. Inlays and onlays require two appointments and are closer to the price of a full crown.
If you would like to discuss alternatives to conventional fillings with Dr. Bryan Limmer, please call us at 720-242-6803 to schedule a consult.