Thursday, September 11, 2014

[Dental Fillings Part II] WHITE OR METAL Fillings? How to make the RIGHT choice?



Your tooth need fillings because they are broken or cavitated. Hole forms in a tooth, our body cannot repair it. Dental filling.is hard, tooth like material used to replaced the tooth structure after you have the bacteria in the cavity professionally removed.

Previously, we have discussed about the two commonly used dental fillings materials, Amalgam and Composite. But how to choose? There are difference in your choice...


"MORE: [Dental fillings Part 1] introduction to dental fillings, Are you scare of dental fillings?"

Q: WHITE OR SILVER FILLINGS, WHICH ONE TO CHOOSE, ?

A: There are few factors you have to consider before you decide which type of fillings to choose, Amalgam (silver/ metal) or Composite (white/ tooth color)

1 – Amalgam fillings are stronger than composite fillings. 
Amalgam usually used on the back teeth. This is because that is where the majority of the forces are when you bite down. Since amalgam is made of various metals, it is a very strong material. Composite resin fillings wear down faster than amalgam fillings and need to be replaced more often. However, the strength of composite resin is improving with newer technologies. 
2 – Composite fillings are more expensive than amalgam fillings.
 At Malaysia private clinic, dentist will charge RM80-100 a amalgam filling in a back tooth and RM90-150 for a large composite filling in a back tooth. If you’re on a tight budget, amalgam may be your best choice.
3 – Amalgam fillings last longer than composite fillings. 
I’m sure that with future technological advancements, composite fillings will probably last as long as amalgam fillings. But for right now, if you want your filling to last a long time, you should choose amalgam.
An old mercury-silver (amalgam) dental filling that needs to be replaced.
Look! This is an example of  fillings that's probably been placed for 20+ years!
4 – Composite fillings are less noticeable/ looks more natural than silver amalgam fillings.
Silver metal filling may stain your teeth over time, and causing you to have silver smile. If you don’t like seeing silver in your mouth at all, then a composite filling is probably the way to go.
Amalgam Silver staining on the teeth, which can be very unsightly when you smile 
The old, worn and stained composite 
5 – Amalgam fillings contain mercury. 


Mercury is used to incorporate the metals in the 
amalgam. According to America Dental Association
it is safe to used as the release of mercury from the 
fillings is extremely in small amounts.
The mercury in the amalgam fillings gets incorporated into the filling, thus the release of mercury is extremely in small amounts. The amount of mercury released is less than the amount of mercury you’d get from eating fish, but this does pose a problem for people with a mercury allergy.
Amalgam has been used for over 180 years without any major problems. The only absolute contraindication for an amalgam filling would be a mercury allergy. But if you are having amalgam fillings in your mouth, We don't recommend you to remove it. Because this will release the mercury inside the fillings, and thus more toxic than you keep it in the fillings. If you are concern about the mercury toxicity, Composite will be your filling material of choice.
.
6 – Composite fillings may leak out Bisphenol-A.
Bisphenol-A is a chemical that can be toxic in large enough doses. Based on the current evidence, Composite is still a safe material to use as research have shown that the amount of bisphenol-A released from a filling is unlikely to cause any harm. 
The other products that contain Bis-phenol A
7 – Amalgam fillings require the dentist to remove healthy tooth structure.


Amalgam fillings involving more tooth structure removed to
keep the filling in place. Composite fillings bond to structure,
without the extra tooth structure 
Amalgam fillings don’t bond to the tooth like composite fillings, the dentist has to make the filling wider at the bottom than it is at the top so that the tooth will hold the filling in place. In order to do this, the dentist usually has to cut away healthy tooth structure. With composite fillings, the dentist can simply remove the decay and then place the filling without cutting away healthy tooth structure to retain the filling.
8 – Composite fillings shrink when they harden. 
Composite fillings Shrink when they harden, causing
leakage ( gap between filling and tooth), will lead to
new cavity Post-operative sensitive
Most composite fillings get somewhere between 2-5% smaller when they harden. Sometimes this can lead to gaps between the filling and the tooth which allow bacteria to enter and start a new cavity. Other times, when a large composite filling shrinks as it hardens, it can put stress on the tooth which results in increased post-operative sensitivity of the affected tooth. The effect of the shrinkage can be minimized if the dentist adds the composite in small, incremental layers. Now, the new composite has reduced the shrinkage problems, and I believe in short future we can have a composite filling with no or very few shrinkage. 
9 – Composite fillings are more technique-sensitive. 
More steps are need for placing a composite fillings than
amalgam. Dentist with good experience will produce a
good job, and it can last a longer time.
This means that the dentist has to pay close attention to detail when placing a composite filling. There are more steps that your dentist must follow precisely when filling your tooth with a white filling. If it is not properly done, the filling may not attach to the tooth tightly and could end up leaking and ultimately needing to be replaced after only a year or two.  Most dentists have lots of experience doing white fillings and will do a good job.  As long as they are following the steps mentioned below for the composite filling procedure, the filling should last you a long time.
Hopefully the above tips will help you figure out which type of filling will work best for you. Even if you are still uncertain, at least now you know what issues or concerns to further discuss with your dentist.


For more questions, don't hesitate to ask us :)



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