We’ve all heard of cavities and most of us have fillings, but do you know exactly what these are and how you can prevent them? Let’s start with cavities. A dental cavity is the result of tooth decay, which leaves you with a hole in your tooth. When you have a small or medium-sized cavity, the remaining decay can be removed and the cavity, or open hole, filled. Of course, the larger your cavity gets, the weaker your tooth becomes. Once about half the width of your tooth has been filled, it generally becomes so weak that it will predictably break at some point. If too much tooth structure has been lost to support a proper filling, Dr. Funderburk will recommend another type of tooth restoration that’s right for you – usually an onlay or crown.

Different materials can be used to fill the hole in your tooth. Today, the most popular material used for fillings is dental composite, also called tooth-colored fillings. For over 150 years, silver/mercury amalgam fillings were the go-to choice, but these are rapidly becoming more uncommon for many reasons. Other materials more suitable for use as fillings for your teeth are ceramic and gold.

The location and size of the damaged area is important to consider when deciding which treatment option is best for you. Front teeth typically form cavities in between the teeth (along the gumline), or chip and break along the edges or corners of the teeth. If these cavities, chips or breaks are small- to medium-sized, fillings are usually a great option. In these cases, tooth-colored composite is the choice simply for esthetic reasons. However, if the damaged area is too large, an all ceramic crown is recommended instead of a filling. Ceramic crowns can be made to fit any tooth, making these a great treatment choice for damaged areas in any location.

Different Types of Fillings

Amalgam effect on teeth is likened to splitting a log with a wedge.

Silver/Mercury Amalgam Fillings

Silver/mercury amalgam fillings are less expensive, but they don’t strengthen the already damaged tooth as much as other fillings do and, in fact, may even work to weaken the tooth. Because of this, silver/mercury amalgam fillings are a less than desirable choice. Still, silver/mercury amalgam fillings treat the decay, which is much better than leaving the decay untreated. Think of it like this: your tooth decay is treated, but your tooth is not as strong as it could be. Here at Comfort Dental, we often compare this to splitting a log for firewood with a metal wedge. Also, there is more and more research supporting the prevailing thought that the mercury in amalgam serves as a health danger to the rest of your body. For these reasons, Dr. Funderburk does not prefer silver/mercury amalgam fillings to other available techniques. However, he feels strongly a properly done amalgam filling is much better than an untreated cavity!

Tooth-Colored Composite Fillings

Tooth-colored composite fillings are less invasive to an already damaged tooth. In fact, tooth-colored composites actually bond to, and strengthen, your remaining tooth structure. Another plus: tooth-colored composite fillings blend nearly seamlessly with your natural tooth structure, leaving you with a much more natural look overall. The only drawbacks to tooth-colored composite fillings are they are more expensive and they tend to wear more rapidly, requiring repair or replacement more often. Overall, Dr. Funderburk recommends a composite filling over a silver/mercury amalgam filling if at all possible.

Ceramic Fillings

Tooth colored ceramic fillings are stronger than composite fillings, and last much longer. The upfront cost is greater, but they are more durable and last longer, making tooth-colored ceramic fillings the better investment. These ceramic fillings, known as inlays, are also strong enough to overlap one or more cusps of the teeth and protect the tooth from additional fracture due to bite forces. When a cusp is covered, the inlay filling is then called on onlay. An onlay serves much the same purpose as a dental crown (often called a cap), but requires much less removal of your tooth structure. Dr. Funderburk prefers to remove as little natural tooth structure as possible to properly restore your teeth’s function and natural beauty.

Gold Fillings

Gold fillings (yes, that’s real gold), when properly done, preserve the most of your tooth structure. Gold fillings are also extremely long lasting and are highly biocompatible. As a result, many patients (and most dentists) still choose gold for onlays and crowns on back teeth. Although not tooth-colored, gold is seen by some as quite beautiful. Regardless, there is no denying the metal’s strength and durability. The only real drawback to gold fillings is the cost. Gold is currently the highest cost material used for fillings (upfront, that is). Long term, gold fillings may very well be the best long term restorative investment.