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Restorative Options for Fillings
Dentistry, like all of health care, has been affected in every way by
the advancements of science and technology. We have materials and techniques
that were not even dreamed of a generation ago. These changes have given
us a wide range of treatment options to consider. The best option is relative
to each individual patient and to what that patient values. For example,
for some, cost is the most important factor. In that case, the least expensive
option that adequately solves the problem would be the best choice. For
another patient, longevity is most important. In that case, the material
that will last the longest would be chosen. Someone else might be most
concerned with appearance. For that person, the most esthetic technique
that is appropriate for their situation is the best alternative.
Sometimes, because of the nature of the problem, there might be only
one good treatment plan. Most of the time, however, there are choices.
Those choices fall into three basic categories for individual teeth.
Silver amalgam is the material that has been the mainstay of restorative
dentistry for over 150 years. It is relatively inexpensive, can be placed
in one visit, and can last 15 years or more in most situations. There
are two major drawbacks to amalgam fillings. Firstly, it is unaesthetic.
It starts out silver colored, and turns black as it ages. It also discolors
the tooth over time, creating a grayish shadow to the tooth structure
around the filling. The second drawback is that a silver filling does
nothing to strengthen the tooth that has been broken down by decay. It
simply fills a hole, and can leave the tooth weakened and prone to breaking.
This problem is directly related to the size of the filling, the bigger
the filling, the weaker the tooth is likely to be.
Gold is also a material that has been used for hundreds of years. It
has the unique characteristic of being inert in the mouth. Gold restorations
can look as smooth and shinny after thirty years of service as they did
on the day they were placed. Gold is, without question, the longest lasting
material we can use. That is its claim to fame. The shortcomings to gold
are probably obvious. The appearance, for many people, is a drawback.
Gold restorations need to be cast from an impression, and therefore require
two visits to complete. Additionally, because of the technique that requires
two visits, and the cost of the material, gold restorations are expensive.
Tooth colored material is the third option. This is the cutting edge
of dentistry today. These materials have been evolving for thirty years.
Today they are a predictable, reliable restorative material. Their longevity
compares to silver amalgam. From an esthetic standpoint, they are beautiful.
They make a tooth look brand new. Because they are placed with a bonding
technique, they add strength to a tooth that has been weakened from decay
or fracture. Tooth colored restorations can be placed in one of two ways.
If the cavity is not too large, they can be placed directly into the tooth
in one visit. Otherwise, it is made from an impression and bonded in place
at a second visit. The cost of these restorations falls in between a silver
amalgam filling and gold.
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