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  1. Dental Amalgam Fillings

Treatment Options for Dental Caries

Direct Fillings

While the uses of dental amalgam has been declining through the years, other materials are widely used to fill tooth cavities caused by dental decay. Like dental amalgam, these direct filling (restorative) materials are used to restore the biting surface of a tooth that has been damaged by decay.

Your dentist can discuss treatment options based on the location of cavities in your mouth and the amount of tooth decay. Other restorative materials used to fill tooth cavities include the following:

Every restorative material has advantages and disadvantages.


Composite Resin Fillings

Composite resin fillings are the most common alternative to dental amalgam. They are sometimes called "tooth-colored" or "white" fillings because of their color. Composite resin fillings are made of a type of plastic (an acrylic resin) reinforced with powdered glass filler. The color (shade) of composite resins can be customized to closely match surrounding teeth. Composite resin fillings are often light cured by a "blue-light" in layers to build up the final restoration.

Advantages of composite resin fillings include:

  • Available in colors that blend in with surrounding teeth
  • High strength
  • Allows for minimal removal of healthy tooth structure for placement

Disadvantages of composite resin fillings include:

  • May not bond to the tooth as well in the presence of moisture
  • May be more difficult to place than dental amalgam in certain clinical situations and can blend in with tooth structure making removal difficult without removing tooth structure
  • Potentially lower durability than dental amalgam and therefore may be at greater risk for fracture and the need for replacement
  • Higher cost of placement

Glass Ionomer Cement Fillings

Glass ionomer cements contain organic acids, such as eugenol, and bases, such as zinc oxide, and may include acrylic resins. Like some composite resins, glass ionomer cements include a component of glass filler that releases fluoride over time. Also, like composite fillings, glass ionomer cements are tooth-colored. The composition and properties of glass ionomer cements are best suited for very small restorations. Unlike composite resin fillings, glass ionomer cements are self-curing and usually do not need a "blue light" to set (harden).

Advantages of glass ionomer cements include:

  • Available in colors to blend in with surrounding teeth
  • Minimal removal of healthy tooth structure for placement

Disadvantages of composite resin fillings include:

  • Unsuitable for large restorations
  • Not as durable as dental amalgam

Indirect Fillings

Other options for replacement of lost tooth structure is through the use of indirect fillings, for example "caps," which are made from ceramics or precious metals such as gold, and the most durable and costly treatment options.

 
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