Fillings are the most common type of ‘restorative treatment’. A filling replaces the part of the tooth that has been lost either because decay has caused a cavity in the tooth or because the tooth has broken. One option in restoring the tooth is by means of an Amalgam filling; a material which has been around for over 150 years and has been proved to be safe, reliable and long lasting
Despite the controversy regarding the use of mercury as a binding material within these fillings, there has been no scientific evidence to show any health risks associated with these restorations.
A measure of their standing is that virtually all teaching Dental Schools across the globe advocate and teach their usage to all undergraduates. Please feel free to discuss this issue with your Dental Surgeon if you are unsure or are confused by the propoganda put about by the companies manufacturing alternative filling restorations.
- A local anaesthetic will be given to numb the tooth and the surrounding tissue.
- The tooth will be thoroughly cleaned, all decay, food debris and tartar will be removed and the tooth will then be shaped to accept the amalgam restoration by mechanical retention rather than being bonded or cemented.
- Depending on the size of the filling, a band may be placed around the tooth which helps to hold the filling material in place whilst it is being packed into the tooth.
- The amalgam is packed into the tooth, then carved to the correct shape.
- Although amalgam hardens within a few minutes, it takes 24 hours for it to set fully.
White fillings, or composites, are an ideal aesthetic material for front teeth where appearance is very important but where bite forces are not that high. Recent years have seen the development of many generations of white filling materials for the back (posterior teeth). The early ones were very soft and did not last and whilst the current materials available are far better and stronger than their early cousins, they still offer advantages and disadvantages.
- They are aesthetically far more pleasing than amalgam fillings.
- They have to be placed in a completely dry field, moisture contaminates the material.
- They need to be placed under a rubber dam, which can be uncomfortable.
- They require a far greater level of skill and time to place correctly.
- This leads to a far higher cost to the patient.
- They do not have the strength of amalgam and are not suitable for large restorations.
- They are not suitable for patients with a hard bite or those who grind (bruxism).
- They are prone to shrinkage, resulting in early leakage below the gum level.
Notwithstanding this, there are a lot of patients who want aesthetically pleasing restorations in their back teeth and with care and diligence, composite restorations are a viable alternative tor decayed or previously restored teeth which have a substantive amount of sound tooth structure remaining.
For those patients who have teeth with litte or no sound supporting structure or who have a heavy bite or are grinders etc., then an alternative would be to place a ceramic restoration at this tooth.