Amalgam

Made of: Mercury mixed with silver, tin, zinc and copper. Mercury is nearly 50 Percent of the mixture.
Types: Traditional (non-bonded), bonded
Used for: Fillings in back teeth
Lasts: At least seven years, usually longer
Costs: The least expensive type of restorative material

Advantages:
- Amalgam fillings are strong and can withstand the forces of chewing.
- They are inexpensive and convenient.
- The filling can be completed during one dental visit.

Disadvantages:
- Amalgam doesn’t match the color of your teeth. Healthy parts of your tooth must often be removed to make a space large enough to hold an amalgam filling.
- Amalgam fillings can corrode over time, causing discoloration where the filling meets the tooth. A traditional (non-bonded) amalgam filling does not bond to the tooth. It just sits in a pocket created by your dentist.
- Some people may be allergic to mercury or be concerned about its effects, although research shows the amount of mercury exposure from fillings is comparable to what people get from other sources in the environment.

Composite Resin:

Made of: A mixture of plastic and fine glass particles
Types: Direct or indirect
Used for: Small and large fillings, especially in front teeth or the visible parts of teeth; inlays
Lasts: At least five years
Costs: One-third to twice as much as amalgam, but less than gold

Advantages:
- Your fillings or inlay will be invisible. Your dentist chooses a resin that matches the color of your teeth.
- A filling can be completed during one dental visit. An inlay may require two visits.
- Composite fillings can bond directly to the tooth, making the tooth stronger than it would be with an amalgam filling.
- Less drilling is involved than with amalgam fillings because your dentist does not have to shape the space as much to hold the filling securely. The bonding process holds the composite resin in the tooth. Indirect composite fillings and inlays are heat-cured, increasing their strength.
- Composite resin can be combined with glass ionomer to provide the benefits of both materials.

Disadvantages:
- Although composite resins have become stronger and more resistant to wear, it’s not clear whether they are strong enough to last as long as amalgam fillings under the pressure of chewing.
- These fillings take 10 to 20 minutes longer, or sometimes more, to place than amalgam fillings because each thin layer of the filling must be cured, or hardened , using a visible blue light.
- Indirect fillings and inlays take a least two visits to complete. Your dentist takes impressions at the first visit and places the filling or inlay at the second visit.
- In large cavities, composites may not last as long as amalgam fillings.

Cast Gold:

Made of: Gold alloy (gold mixed with other metals)
Used for: Inlay and onlay, crowns
Lasts: At least seven years, usually longer
Costs: More than most other materials; six to 10 times more expensive than Amalgam
Advantages:
- Gold doesn’t corrode.
- The gold color is more pleasing to some people than the silver color of amalgam.
- Gold fillings are durable enough to withstand chewing forces.

Disadvantages:
- You must visit the dentist at least twice to receive a gold filling. At the first visit, the dentist makes an impression of your tooth and a temporary filling is placed.
- The gold filling is made from the impression and is placed at the second visit.
- The cost is high because of the gold and the work involved.
- If gold and amalgam fillings are right next to each other in your mouth, an electric current can result from interactions between the metals and your saliva, resulting in sharp pain.

Ceramic- Cerec

Made of: Porcelain
Used for: Inlays and onlays, crowns
Lasts: At least five years usually longer
Costs: More than most other materials; five times more expensive than amalgam

Advantages:
- Less tooth reduction than gold or a standard designed crown
- Ceramics are tooth-colored
- Ceramics are more resistant to staining and abrasion than composite resin
- Complete in one visit

Disadvantages:
- Initial high investment

Fluoridation in water has been the greatest achievement in dentistry. Fluoride in water replaces the calcium minerals in teeth, which makes children’s growing teeth (up to age 14) stronger.

However, as more people move into towns with well water children are not receiving fluoride. Also, many people are no longer drinking tap water with fluoride. Instead people are drinking bottled water, which does not have fluoride. For children to age 14, we prescribe oral fluoride in the form of drops for babies and chewable tablets for children.

Today, people are living longer and eating more sugars than ever before. Aside from radiation treatments, teeth will only decay in the presence of sugars from food. “Weak teeth” are a very rare occurrence. Some people are more prone to decay because their bacteria or plaque produces stronger acids that attack the teeth.

Decay will progress until it finally reaches the nerve. This will most likely cause pain or discomfort. Prior to decay reaching this point, it is removed, and a material is used to replace the lost tooth structure. Decay also occurs under “old fillings”. As the metal corrodes, a gap between the tooth and the filling develops in which bacteria will easily penetrate and cause more rapid destruction of the tooth structure.

Fluoride in prescription dose rinses and gels are an added insurance to preventing decay and extending the life of fillings and crowns. The ultimate and best insurance policy in preventing decay is brushing and flossing two to three times per day. Decay is preventable, however once it starts, it will most often result in restoring the tooth.

Fluoride can also be beneficial to those who have been diagnosed with periodontal, or gum disease. In periodontal disease the bone level supporting the tooth decreases which often leaves root surfaces exposed in the mouth which are normally covered by gum tissue. These areas are very susceptible to decay and the use of fluoride can re-mineralize the root surfaces, thus making it more difficult for decay to occur. Fluorides can also aid in “tightening” the gum tissue, which will decrease the amount of bleeding and also help to minimize the pocketing around the tooth.

Children often get cavities due to poor homecare habits. They forget to brush after breakfast or before bed and when they do brush, they rarely will clear plaque from all tooth surfaces. Rarely will children floss effectively. Children wearing orthodontic appliances like braces face an additional burden to keeping their tooth surfaces cavity-free. Fortunately, the extra protection offered by fluoride treatments can counter these threats and reduce the risk a child will develop cavities.