Fillings

No one type of filling is best for everyone. What’s right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

• Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark colour, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.
• Composite resins (white fillings) are matched to be the same colour as your teeth and therefore used where a natural appearance is desired. The filling is placed directly into the cavity, where it is then hardened using a blue light. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco and compared to the other materials last for a shorter period of time.
• Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the colour of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.

You should replace amalgam fillings only when they are worn, broken or when there is decay beneath the filling. There’s no evidence that they can cause a problem. Removing good amalgam fillings results in unnecessary loss of healthy parts of the tooth and can release more mercury. If you are concerned about amalgam, discuss your options with your dentist.

In certain cases your dentist may replace or avoid amalgam fillings. If there is a suspected allergic reaction to the amalgam filling a replacement with a different material will be advised. During pregnancy your dentist will if at all possible avoid removing or placing an amalgam restoration. Research has not shown any health effects from amalgam fillings in pregnant women, however, mercury can cross the placenta. Mercury exposure is at its highest during placement and removal of amalgam fillings.