So you need a cavity filled? The assistant called it a "restoration". Uh, oh!! Sounds like you might need a building permit! And it raises a lot of questions. How could this happen? Weren't those old fillings supposed to last for ever? How come you need to replace them anyway? Did the last dentist do a bad job? How can you be certain that the next one will last? How long should a filling last anyway? It'll probably hurt and cost a fortune! Should you just put in the cheapest filling or just what the insurance pays for? The insurance company will only pay for a silver filling, but the dentist wants to do a gold one. Why should you do that? Why should you have to pay so much for the work anyway? If the insurance doesn't cover it, is it necessary? Certainly the insurance company knows best....don't they? After all, they pay for a lot of fillings. Maybe you should get a second opinion? Can you really trust the second opinion? Yikes!! What's a patient to do these days? The following will give you more insight into this myriad of choices.

Shotless, painless, noiseless cavity preparation is now a possibility. To learn more, click here.

Dental Filling Materials: Pro's and Con's

Composite Resin Fillings
Glass crystal epoxy resin fillings also known as direct composite resin fillings have revolutionized dentistry for more than 20 years now. These tooth colored fillings are fairly strong, very esthetic and almost invisible when placed in a tooth. Statistics show that composites are increasing in popularity and are replacing amalgams in many offices nationwide. Are they all they seem to be? Is there a downside you should know about? Even though patients are asking for them in increasing numbers, there are significant advantages and disadvantages that you should be aware of.

Advantages:
1. Composites look like real teeth.
2. Composites are chemically bonded directly to the tooth & create a better seal.
3. Composites are light cured which makes them hard instantly.
4. Composites have excellent strength for small to medium size fillings.
5. Composites are poor conductors of temperature..

Disadvantages:
1. Composites get weaker when the cavity is too large.
2. Composites are brittle and don't have good edge strength.
3. Composites cannot be placed in a wet area (under the gumline).
4. Manufacturers give them a relatively short lifespan. (5-7 yrs.)
5. Some composites are sensitive afterwards and don't get better. It is not clearly understood why this happens, but it does. Sometimes, you take your chances having a composite done.

Silver Fillings:
Over the past 100 years, silver fillings have proven to be very reliable and still the most widely used restorative material in the United States. Perhaps you have one of these metallic fillings yourself. Are they safe? What is all the hoopla about their toxicity?

Silver fillings have become controversial in recent years because they are mixed with mercury at their placement. Critics in recent years have stated that this mercury is toxic to human beings and have begun an extensive movement to educate the public against their use. In many cases, this educational program has caused panic, misinformation and inappropriate use of composite throughout the mouth, weakening the teeth.

Regardless of the bad press, extensive studies have been done by the Centers for Disease Control, the National Institute of Health and the American Dental Association and as of this posting, silver is still recommended for restoration of small to medium large cavities. For more on this important topic, see our article on mercury toxicity

Advantages:
1. Fairly strong from small to large fillings.
2. Fairly good edge strength, so it doesn't tend to chip until late in it's life.
3. Relatively cheap.
4. Placed in one appointment.
5. Can be used in a wet field.
6. Can last 5-20 years or longer in some cases.

Disadvantages:
1. It flows under pressure and may cause teeth to crack.
2. It is not bonded to tooth structure and tends to leak
3. Used inappropriately as silver crowns when gold or porcelain should be used.
4. Needs to set after placement and is weak for first 10 hours or so.
5. Conducts temperature very well and may contribute to cold sensitivity.
6. Unproven claims of metal upsetting the electrical meridians of the body have been made.
7. Mercury toxicity has been suggested but not proven.

Regardless of the controversy, we still see silver fillings that have been in place for decades. The durability of this material must be weighed alongside it's accused drawbacks.

Porcelain
Porcelain remains the most beautiful restoration we place in dentistry. Unlike silver or composite which is placed in one appointment, porcelain must be fabricated by a laboratory technician and is baked in an oven at almost 2000 degrees Fahrenheit, requiring a minimum of two appointments to complete treatment.. Porcelain is one of the most durable cosmetic materials in dentistry and has launched a complete revolution in cosmetic possibilities this past decade. It has definite pluses and minuses as well.

Advantages:
1. Porcelain is extremely esthetic and lifelike.
2. Porcelain is extremely strong and has lifetime characteristics.
3. New "Empress" (type) Porcelain is the most lifelike porcelain available today and can create outrageously beautiful cosmetic results.
4. Porcelain can be bonded directly to tooth structure.
5. Porcelain is not a good conductor of temperatures.

Disadvantages:
1. Porcelain is harder than enamel or gold & can cause excessive wear.
2. Very expensive
3. Requires a minimum of two appointments to fabricate and place.
4. Porcelain is brittle and can fracture.
5. Technique sensitive. Requires artistry to maximize the esthetic possibilities.

Gold
Gold has been the benchmark of the highest quality permanent dentistry possible for almost a hundred years. It continues to be used today in many areas of dentistry and is still considered one of the standards of the profession. Why would you want gold fillings anyway? Is it really worth the price and rigmarole to place in your teeth? As all things, there are advantages and disadvantages, even with the best materials.

Advantages:
1. Extremely accurate and durable material.
2. May be cast to extremely fine marginal detail.
3. Gold is about the hardness of enamel and wears at the rate of the teeth.
4. Gold is not brittle and cannot fracture.
5. Gold can have porcelain bonded to it for fabrication of cosmetic crowns.
6. Gold is bio-compatible and non-toxic.

Disadvantages:
1. Gold is very expensive.
2. Gold requires two appointments to fabricate and place.
3. Gold is a great conductor of temperature.
4. Yellow gold may not look esthetic when used in cosmetic zones.
5. Gold is not bonded to tooth structure and may leak over time.
6. Gold may interfere with the electrical meridians of the body.

The New World of Cosmetic Dentistry
Our Cosmetic Goal & Philosophy
Teeth Whitening (Bleaching)
Porcelain & Empress Veneers
Non Metallic Crowns & Bridges
Tooth Colored Restorations
Designer Smiles