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Deciding Between Composite and Metal Fillings

Dentist performing her Work

When you've got a cavity, you need to remove it to prevent further damage to your teeth. The dentist fills the resulting space with either a composite filling, which is tooth-colored, or a metal or amalgam filling, which is typically a mix of silver, copper, tin, zinc, and mercury. Each type of filling has its pros and cons.

Looks

With how a filling looks, the tooth-colored composite filling is a clear winner. People won't even realize that you have a filling because it looks the same as the rest of the teeth. Metal fillings are more obvious and can sometimes make the rest of the tooth look grayish, which is why they're often used only in the back of the mouth.

Durability

Silver amalgam fillings are the clear winner in terms of durability. The composite fillings fail about twice as often as the amalgam fillings, meaning you'll need to replace your filling more often. This problem is more common when composite fillings are in the back of the mouth where chewing occurs.

Prevention of New Cavities

Sometimes after filling a cavity, a new cavity forms under or next to the filling. When this happens, the old filling needs removed along with the new cavity and a new, larger filling needs put in place.

Size of Cavity

The size of the cavity can help determine which type of filling is the best. Composite fillings work best when the cavity is small because they aren't as strong as amalgam fillings. Amalgam fillings work better for larger fillings. With particularly large fillings, a crown may be required instead of a simple filling.

Location of the Cavity

For cavities in the front of the mouth, people typically prefer composite fillings because these teeth are more visible. Dentists often prefer amalgam fillings in the back of the mouth because they can better withstand the pressure of chewing. However, metal right near the gums can cause them to recede, so porcelain may be needed.

Preservation of Tooth

Composite fillings may make saving more of the healthy part of the tooth possible. These fillings don't need as much tooth removed before the filling is applied. The filling also bonds to the tooth, so no expansion and contraction occurs with heat and cold in metal fillings that could lead to cracked teeth.

Appointment Length

If the person getting a filling isn't very good at sitting still for any amount of time, amalgam fillings may be the way to go. Dentists can apply these fillings up to 20 minutes faster than composite fillings.

Cost

Amalgam fillings tend to be the least expensive option available, although many dental insurance companies will cover composite fillings at least up to the cost of amalgam fillings, with the patient making up the difference. This lower cost is obvious even before taking into account the greater durability of amalgam fillings.

Safety Considerations

Some people worry about the mercury that binds the metals together and strengthens metal fillings. Research shows these fillings are safe because the amount of mercury is very small and contained within the filling. The mercury doesn't raise the risk of health problems, although fillings should be replaced if they start to deteriorate.

Other Alternatives

Gold fillings are another alternative. While gold fillings are long-lasting, they are also very visible and expensive. Porcelain fillings are another option that blends in with the teeth, but they can be fragile. Both of these types of fillings usually require more than one dentist visit because they are indirect fillings made formed outside the mouth.

The office of Jay A Hollander, DDS, can help you decide on the right type of filling for your situation. We can also help with any other dental care needs you may have. Call us today.