Composite and Amalgam Fillings

Why do patients need dental fillings and what are they? Dentists use fillings to fix cavities, which are holes in the surface of a tooth. Cavities occur when bacteria interact with sugars in your mouth and produce acid. When acid wears away at the enamel, or hard covering of the tooth, it causes decay. If not removed, decay continues to spread and sometimes reaches a tooth’s nerve, causing it to die. This can cause pain for a patient and sometimes leads to an abscess around the tooth.  If an abscess forms,  a root canal may be necessary to save the tooth.  Our goal is to stop decay before it causes serious problems with a tooth.

Dr. Albers places two types of dental fillings: amalgam (silver colored) and composite (tooth colored). While most patients prefer composite fillings for cosmetic reasons, sometimes Dr. Albers recommends amalgam fillings.  When placing fillings, Dr. Albers almost always uses a rubber dam. (See Dr. Albers’ blog post on the benefits of using rubber dams.)

Composite Fillings

Composite dental fillings are made from a tooth colored resin. Many patients prefer composite fillings because they look more natural. It takes Dr. Albers longer to place a composite filling than an amalgam filling because more steps are involved.  With composite fillings, after Dr. Albers removes the decay, he etches the enamel, applies a bonding agent, places the composite material, then sets and hardens it with a curing light.

Amalgam Fillings

A good explanation of an amalgam dental filling comes from Mouth Healthy, a website maintained by the American Dental Association (ADA).

Dental amalgam is made from a combination of metals that include mercury, silver, tin, and copper. Sometimes described as “silver-colored” fillings, dental amalgam has been used by dentists for more than 100 years because it lasts a long time and is less expensive than other cavity-filling materials such as tooth-colored composites or gold fillings.

There has been some controversy in the past about the safety of amalgam fillings because they contain mercury. In addition to the Mayo Clinic noting the safety of amalgam fillings, the Mouth Healthy article lists other organizations which conclude amalgam fillings are safe:

It’s important to know that when combined with the other metals, it forms a safe, stable material. Be assured that credible scientific studies affirm the safety of dental amalgam. Study after study shows amalgam is safe and effective for filling cavities. The American Dental Association, U.S. Centers for Disease Control and Prevention, U. S. Food and Drug Administration and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer’s Association, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society—all science-based organizations like the ADA—also say that amalgam poses no health risk.

Composite Filling V. Amalgam Filling

Although composite dental fillings are more visually pleasing to many patients, Dr. Albers will sometimes recommend an amalgam filling. Why? Because amalgam fillings are stronger than composite fillings. If he needs to fill a larger cavity in one of the back teeth used for chewing, he will often recommend amalgam fillings as they tend to hold up better over time. Amalgam fillings are also less expensive than composite fillings, so sometimes they are a better financial option for a patient.

What Is The Best Dental Filling?

We’re going to borrow a few lines from the Mouth Healthy article on fillings:

“Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease  your risk of cavities and other dental diseases simply by:

• Brushing your teeth twice a day with fluoride toothpaste
• Flossing daily
• Eating a balanced diet
• Visiting the dentist regularly”

Remember, prevention is key!