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| Black silver fillings |
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| White dental restorations |
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| A perfect smile |
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Good Guys in White Hats
In the early days of television, it was easy to see who the good guys and bad guys were. The Good Guys always wore white hats. The villainous Bad Guys in black hats were always caught and sent to jail. Today, dental patients are faced with a “Bad Guy” black hat versus a Good Guy white hat dilemma: whether or not to replace dark metal fillings with white fillings or to have a new metal filling.
“Bad Guys” in black hats
If you have fillings in your teeth, you likely have what are called “amalgam” fillings, those silver-colored fillings that eventually turn a dark grayish-black color. Because amalgam is a combination of several metals, including silver, mercury, zinc and tin, the filling darkens over time. When those dark fillings are in the back teeth, they are not so noticeable.
But, when teeth near the front of the mouth have dark amalgam fillings, a person may feel self-conscious about talking or smiling.
There is, however, a more serious concern when considering replacing (or having new) amalgam fillings. The amalgam is 50 percent mercury. Because mercury is a toxic metal, some believe an amalgam filling is hazardous to a person’s health. However, according to the American Dental Association, amalgam has been used in dentistry for a very long time without evidence that the mercury in a filling is dangerous to a person. There is a small amount of mercury vapor that leaks into the body when chewing. So far, it has not been proven that that small amount of vapor has harmed anyone.
Good Guys in white hats
White fillings, on the other hand, do not contain any metal. They are made from a combination of glass and acrylic and thus, are called a “composite” filling. A composite filling does not turn dark grayish-black; so you can let that smile shine through! The dentist can place a clear plastic coating over the composite to help to prevent any color change.
Composite fillings are not a new technology. They have been used since the early 1960s, but typically, only on front teeth because the composite was not strong enough to withstand heavy chewing pressure from the back teeth. In the 1980s a better bonding method was developed, and more recent technologies improved a composite’s strength.
A balancing act
When your dentist discusses filling options with you, you will need to weigh the advantages and disadvantages of the amalgam filling versus the composite filling. The chart below shows a comparison of the two filling types.
*Composite filling strength is embroiled in controversy as well. According to some in the dental profession, an amalgam filling is stronger than a composite filling. However, that must be balanced against the fact that the composite is directly bonded to the tooth. The composite is actually stronger than the amalgam because it is bonded to the tooth, making the tooth less likely to fracture.
Whether you choose the Good Guys in the white hats or the “Bad Guys” in the black hats, your dentist is a reliable source of information about filling options.
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Amalgam filling |
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Composite filling |
| Description |
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Composed of silver, mercury, zinc, tin, etc. |
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Composed of glass particles (quartz resin) and acrylic. |
| Color |
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Silver color that darkens over time. |
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White color: closely matches your natural tooth color and translucence. Can stain from heavy coffee, tea or tobacco usage. |
| Safety |
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Leaks a small amount of mercury vapor.
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No leakage. |
| Durability |
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Withstands forceful chewing.
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Moderate tolerance to forceful chewing. |
| Tooth preparation |
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Tooth needs to have extensive drilling. |
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Minimal tooth structure removal is done. |
| Placement time |
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Takes about 10-20 minutes longer to place a composite filling than an amalgam
filling. |
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Takes about 10-20 minutes longer to place a composite filling than an amalgam
filling. |
| Post-op |
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Takes 2 weeks to completely harden. |
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Special light hardens filling in 40 seconds. |
| Wear |
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Resistant to wear but is very brittle. Chips on filling edge.
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Moderately resistant to wear and is not brittle. |
| Breakage |
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Brittleness causes filling to chip under forceful chewing pressure. Silver
weakens the teeth, resulting in more tooth breakage. |
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Moderately resistant to breakage under forceful chewing pressure. New techniques
rival amalgam’s strength.* Drinking beverages high in alcohol content can
seriously weaken a composite filling. |
| Tooth sensitivity |
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Hot and cold foods cause sensitivity for as long as six weeks. |
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If the filling is adequately bonded to the tooth, sensitivity should be minimal—up to 2 weeks.
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| Cost |
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Generally less than composite, depending on size of filling. |
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Generally higher than amalgam, but depends on size of filling. |
| Office visits |
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Completed in one office visit. |
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Completed in one office visit. |
| Availability |
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Today, not all dentists do amalgam. Dentist needs no extra training to use amalgam. |
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Not all dentists offer composite. Must have special training in composite
fillings. Dental schools do not teach composite fillings as part of the
general curriculum because composite fillings are not tested during board
examinations. |
| Insurance coverage |
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Typically covered by most insurance companies. |
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Usually not covered by insurance because composites cost more than amalgam, and the insurance pays the lesser cost. |
You may also be interested in:
Alternatives to dental fillings
How do cavities get started?
Air abrasion-drilless fillings
Dental fillings
Tooth-color fillings
Disadvantages of metal fillings
How to replace a silver filling?
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