When a tooth is damaged or decayed, your dentist restores its original shape and function with a filling. There are a number of materials that can be used, including amalgam, tooth-colored composite fillings, or even crowns. The choice of material depends on the strength and stability of the remaining tooth, the strength of the material needed to restore the tooth, and how heavy your bite is, all of which influence the cost and longevity of the final treatment.
Amalgam vs composite fillings
When it comes to fillings, patients have a choice between two options: amalgam and composite. These are two common dental materials used to restore teeth that have been damaged by decay or trauma. While both materials have their benefits and drawbacks, there are some key differences to consider when choosing between the two.
White fillings are actually the natural tooth-colored materials, like resin-based composite fillings containing a mixture of quartz fillers, colorants, and acrylic plastics. These should not be confused with true porcelain fillings called inlays (fitted in small cavities less than a third the width of the tooth) or onlays (used to replace or anchor cusps tips).
Silver fillings, on the other hand, refer to the more conventional dental fillings, like those made of metal amalgam containing a mixture of copper, silver-tin alloy, and mercury that makes up about 50 percent of the blend and used to bind the other metals together to form a strong, hard, and long-lasting filling.
Longevity of restoration
Amalgam fillings typically have a longer lifespan than composite fillings. Amalgam fillings can last up to 10-15 years or more, while composite fillings can last up to 5-10 years or more. However, the longevity of both types of fillings can depend on various factors such as the size and location of the filling, the patient’s oral hygiene habits, and their diet and lifestyle.
Amalgam fillings are made of a durable material that can withstand the forces of chewing and biting, making them a good choice for larger cavities or for teeth in the back of the mouth. They are also less likely to break or chip compared to composite fillings. However, amalgam fillings can expand and contract over time due to temperature changes in the mouth, which can potentially cause the filling to crack or leak.
Composite fillings, while not as durable as amalgam fillings, are more aesthetically pleasing because they can be matched to the color of the patient’s teeth. They are also less likely to cause sensitivity to hot and cold temperatures, which can occur with amalgam fillings. However, composite fillings are not as strong as amalgam fillings and may not hold up as well in larger cavities or areas of the mouth with more chewing pressure.
Cost of fillings restoration
Composite fillings are more expensive than amalgam. On average, amalgam fillings can cost around $50 to $150 per filling, while composite fillings can cost around $90 to $250 per filling. However, the actual cost of the filling can vary depending on various factors such as the dentist’s location, the type of dental insurance, the size of the filling, and the complexity of the procedure.
The cost of amalgam fillings may be lower due to the material being more widely available and easier to work with. Composite fillings, on the other hand, are more expensive due to the material cost and the additional time and skill required to properly place them. Additionally, composite fillings require more specialized equipment and techniques that can contribute to the higher cost.
Ultimately, the cost of the filling may also depend on the patient’s individual needs and preferences, as well as the recommendations of their dentist.
Pros and cons of dental amalgam vs. composite
Dental Amalgam
Dental amalgam has been used as an efficient, safe, reliable, and durable filling material for more than a century, though some people have questioned their safety, arguing that mercury can seep into your mouth, posing a considerable health risk. However, these allegations are not supported by scientific fact. The mercury contained in amalgam is not pure but bound in intermetallic compounds, which means that there is no liquid mercury to pose any sort of health risk.
Dentists often prefer amalgam because it is stronger and easier to work with compared to resin-based composite. Many patients also prefer it for the same reasons, plus it is cost-effective and fast. An estimated 1 billion amalgam fillings are placed every year, mostly on back teeth because it can withstand the pressure from chewing. Amalgam fillings have an average lifespan of 15 years, though many last 20-plus years.
Composite fillings
These fillings are mostly used in front teeth or visible parts of the mouth, because the natural tooth-colored plastic material is not easily noticeable. Composite bonds directly to the tooth structure, which can strengthen the tooth and help prevent further decay. Resin compounds are, however, not suited for back teeth where greater durability is required, which may reduce their longevity to the lower side of 5 to 10 years.
Comparison table
| Amalgam Fillings | Composite Fillings | |
|---|---|---|
|
Longevity |
Amalgam fillings can last up to 15 years or longer with proper care and maintenance. |
Composite fillings may need to be replaced more frequently than amalgam fillings, typically lasting around 5-10 years. |
|
Durability |
Amalgam is a strong and durable material that can withstand chewing and biting forces. This makes it suitable for rear teeth and repairing larger cavities. |
While composite is strong, it may not be as durable as amalgam and may be more prone to chipping or breaking. |
|
Cost |
Amalgam is typically less expensive than composite, making it a more cost-effective option for some patients. |
Composite is typically more expensive than amalgam, which may be a concern for some patients. |
|
Appearance |
Amalgam is a silver-colored material that can be noticeable in the mouth, which may be a concern for some patients who are looking for a more natural-looking option. |
Composite is a tooth-colored material that can be matched to the color of the surrounding teeth, making it a more natural-looking option. This makes it suitable for front teeth to improve your smile. |
|
Mercury content |
Amalgam contains small amounts of mercury, which has raised concerns about potential health risks. While the American Dental Association and other health organizations consider amalgam to be safe, some patients may prefer to avoid it for this reason. |
There are no concerns of mercury with composite bonding. |
|
Tooth structure removal |
Amalgam requires more removal of tooth structure, which can weaken the tooth over time. |
Composite is conservative as it requires less removal of tooth structure, which can help preserve the natural tooth. |
Verdict
Amalgam is the most durable, least expensive, and strongest material used to fill a cavity, especially for your back teeth. The American Dental Association (ADA) and the Food and Drug Administration (FDA) approve it, though some patients still have concerns about the mercury in it, and how it appears in their smile. So if you want a more conservative treatment that is virtually unnoticeable in your smile, then composite fillings might be a more suitable option, especially for front teeth that are not subjected to very heavy chewing forces.
Ultimately, the choice between amalgam and composite depends on several factors, including the location and extent of the decay, personal preference, and cost. Your dentist can help you weigh the pros and cons and choose the best option for your specific needs.
