Cavity Fillings — What Type Is Best?

Cavities (tooth decay) are permanently damaged areas of the surface of your teeth that have created tiny holes. If cavities are left untreated, they will grow larger and affect the deeper layers of your teeth, leading to much bigger problems, such as infections, severe toothache and tooth loss.

Cavities that have progressed beyond the earliest enamel-erosion state are treated by removing the decayed portion of the tooth and then “filling” the area where the decayed portion was removed. The “filling” cam be made of one of the following:

  • Resin-based composite, which is tooth-colored, plastic, and glass materials
  • Silver amalgam, which consists of mercury mixed with silver, tin, zinc, and copper
  • Porcelain
  • Gold

At Enlighten Dental Care, to treat the typical cavity, we use composite resin fillings; however, there are some instances in which silver amalgam is the better choice. Gold may also be used when bite forces dictate a stronger, more supportive restoration than a filling, but there is ample healthy tooth to preserve without doing a crown. And as stronger porcelains have become available, they may also be used for this purpose.

Resin-based composite is a natural, tooth-colored material that was used for many years to fill front teeth and is much more aesthetically pleasing. Over the last few decades, with technological advances, the material has been made strong enough to withstand the pressure of chewing in the back teeth; however, it is still less durable than silver amalgam. Resin-based composite has the added benefit of bonding to the tooth structure, which provides further support.

Silver amalgam has been used for more than 150 years to fill teeth and is strong and durable. There have been concerns over the safety of amalgam because of the use of mercury as a bonding agent.; however, no scientific studies have shown that it is a risk. In addition, the American Dental Association maintains that dental amalgam remains a safe, affordable and durable cavity filling choice for dental patients. While silver amalgam is less expensive than composite resin fillings, it can cause the tooth to crack and fracture over time.

When treating our patients’ cavities, we consider the pattern of decay in the tooth before recommending which type of filling material to use. It is extremely important to end up with a tight seal to prevent leaving any space that opens the door to further decay. Other considerations include the patient’s budget and insurance coverage. If you have questions about which material is right for your treatment, we are always happy to talk with you about the pros and cons of the materials, as well as the cost. Please call us at (336) 765-0904. 

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