The world of cavity treatments has expanded beyond the traditional “silver” fillings. While these silver fillings remain an option, there are newer alternatives like tooth-colored fillings and materials that release fluoride to protect against new cavities. Let’s dive into the choices available, outlining their advantages and considerations, without stepping on any copyright lines.
Gold Inlays or Onlays
Gold restorations are truly the “gold standard” for fillings. No other restorative material has the same longevity. Unfortunately, few dentist are trained to prepare and deliver gold inlays and onlays today.
Amalgam fillings, often recognized as silver fillings, are a blend of mercury, silver, tin, copper, and trace metals. Their robustness makes them an excellent choice for back teeth’s chewing surfaces, as they can endure chewing forces without cracking. These fillings tend to last longer than alternatives.
Concerns about mercury content have been addressed by numerous government agencies and health organizations, which generally consider amalgam fillings safe. Amalgam fillings should only be replaced if they are broken, there is recurrent decay, or based on the patient’s aesthetic desires. Be careful if someone suggest replacing amalgam fillings because they are “leaking”.
Resin composites, a plastic tooth-colored option, can repair cavities in any tooth. They are particularly popular for front teeth due to their color-matching ability. While they can handle chewing forces comparably to amalgam, they may not have the same longevity. Small cavities may develop around their edges as the bond to tooth breaks down, necessitating replacements.
A clean, dry application surface is crucial for resin composites, making them less suitable for those who struggle to remain still during treatment. Composites ideally should be placed under a rubber dam or other isolation device. However, they’ve gained popularity among older children and adults for their natural appearance.
Glass ionomers, another tooth-colored material, gradually release fluoride – a cavity fighter. They’re less sensitive to blood and saliva during placement, making them versatile. While suitable for non-biting areas and primary teeth, they might not withstand the chewing forces adults exert on their fillings. Glass ionomers are often used to patch or repair crowns on root surfaces, especially in geriatric patients. They however, don’t perform well in dry mouth (xerostomia) patients.
Silver Diamine Fluoride (SDF)
Silver diamine fluoride (SDF) provides a unique approach. It’s directly applied to cavities and halts their progression, although it doesn’t restore the tooth’s working surface. SDF is easy and cost-effective, commonly used for quick fixes, especially in baby teeth and geriatric patients. It’s worth noting that SDF isn’t tooth-colored; treated areas might turn areas of active decay black. SDF has FDA approval for treating root sensitivity.
Cavity treatment options have diversified. You and your dentist can discuss the best fit for your unique needs, considering factors like the affected tooth’s location and required treatment duration. With these choices at your fingertips, maintaining your oral health is more flexible and personalized than ever before.