Fillings

By: J. Shahangian, DDS, MS- San Diego Board Certified Pediatric Dentist

What’s in a Filling?
Amalgams, the clinical term for fillings, are made out of synthetic materials that are used to repair a part of the tooth that has been damaged due to traumatic injury or decay.  There are three main materials that are used for fillings including metal alloys and gold.

The standard synthetic material used in fillings is a silver colored material. In fact, many amalgams are comprised of various metallic alloys such as mercury, silver, tin, and copper.  In recent years, mercury has come under the scrutiny of health experts for its possible long term health problems.

Is Mercury in a Dental Filling Safe?
The ADA (American Dental Association) has cautioned the public about over-reactions to the recent studies that have claimed the amalgams are responsible for an assortment of disease.  According to the ADA, there is no evidence to support that amalgams are harmful due to the minute amounts of mercury, and the ADA has shown it does not pose a threat to human safety.  There have been cases of patients having allergic reactions to the amalgams, but these cases have been rare.

Alternative Materials
Porcelain and composite resin are alternatives for the standard gold and metal amalgams.  These new materials are colored to match the original color of the tooth enamel.  The only downside to the porcelain and composite resin materials is composite resin is not as durable as the other amalgams (silver and gold), and thus has to be replaced more.

Alternative amalgams:

• Composite fillings -A mixture of fine particles and resin created to replicate the color of the natural teeth.  Composite fillings provide an aesthetically pleasing appearance, but are not as strong as dental amalgam.
• Ionomers – These materials, like composite resin, are tooth colored.  Ionomers are also made from a mixture of materials.  This includes acrylic resin and ground glass.  Ionomers serve several purposes.  These fillings are placed near the tooth root or gum line, where there is not much biting pressure.  Ionomers are more fragile than the dental amalgam.  Ionomers release a small quantity of fluoride to help fortify the teeth enamel in the affected area.
• Porcelain (ceramic) – Porcelain is usually made of a mixture of ceramic, powder, glass and porcelain.  The typical candidates for porcelain fillings are inlay and onlays, veneers, and crowns.  Porcelain fillings, unlike ionomers, are more durable, but more susceptible to fracture when exposed to biting pressure for a prolonged time.[1]