Dental Fillings

Amalgam fillings are one of the most cost-effective options for filling cavities. They’ve been used as a corrective measure for more than 150 years and are considered extremely safe.

An amalgam is a mixture of mercury and one or more additional metals. About half of the mixture is mercury, and various other metals, such as tin, silver or copper, are used.

This is a strong and  long-lasting type of filling that requires little to no maintenance over time, and it’s one of the most common fillings used in dentistry.

You might have heard the term “silver fillings” used to describe them because of their initial color. Because of their color, your dentist is most likely to recommend amalgam fillings for cavities in your back teeth.

When Fillings Are Needed

The disease dental caries (tooth decay) is caused by bacteria in the mouth that multiply and eat away the enamel on your teeth. Over time, this can create a hole in the tooth, commonly referred to as a cavity. If the decay is caught early enough, your dentist can actually reverse the process and prevent more serious problems. If it’s left unchecked, however, the cavity will continue to grow and will never heal on its own. A filling can be created and placed in a cavity to strengthen the structure of the affected tooth and to prevent the condition from worsening.

Benefits of Amalgam Fillings

• Cost-effective—One of the cheapest forms of tooth correction
• Fast—Usually placed in one visit
• Minimal maintenance—Infrequent repairs

Direct Restoration Fillings

Amalgam fillings are one of several types of direct restoration fillings. Similar options include composite, glass ionomer and resin ionomer fillings.

Composite Filling

This type of filling is made of acrylic resin and other materials. It creates an appearance that mimics the natural color of your teeth. It can be used for fillings or to replace missing portions of a tooth.

Glass Ionomer

This is a more fragile sort of filling, so it’s used only in places that don’t require a lot of bite pressure, such as near the roots of teeth. It’s made of glass powder and acrylic acids. Glass ionomer is another tooth-colored filling.

Resin Ionomer

Resin ionomer fillings are most likely to be used in baby teeth or in places that aren’t actively involved in chewing. They’re made of acrylic acids and resins, as well as glass filler. Once the resin ionomer is placed, it’s exposed to blue light, which causes it to harden.

Indirect Restoration Fillings

Indirect restoration fillings sometimes require two or more visits to the dentist’s office to install. The first visit may require some prep work on the tooth or teeth, and the dentist will make a mold of your bite (or the area where the filling will be placed). A lab then creates the filling, which is placed on a second or subsequent visit.

The two main types of indirect restoration fillings are porcelain and gold alloys. Porcelain is tooth-colored but tends to be brittle. Gold alloys are extremely durable but are also the most expensive restoration option.

How Amalgam Fillings Are Placed

Depending on the amount of work required, your dentist may offer a numbing agent for the procedure. She’ll then drill the affected area to remove any decayed portions of tooth. She’ll also shape the area so that the filling can be placed. The powdered alloy materials are then mixed with a sample of liquid mercury, which forms a putty-like substance. It’s then placed in the cavity and allowed to harden.

Costs

An amalgam filling for one tooth will average between $110 and $200 as of 2011, depending on several factors. Prices may vary depending on your dentist, the area where you live and your insurance. If a tooth requires more than one filling, the cost will go up.

Read more about the cost of dental fillings.

Advantages of Amalgam Fillings

As long as you take good care of your teeth, amalgam fillings tend to last almost twice as long as other composite fillings. They have a life span of about 12 years. The metals in the material make them extremely durable and less likely to crack under pressure when compared to porcelain and other types of fillings.

When placed correctly, amalgam fillings create a strong seal between the tooth and the filling itself. This prevents food and debris from getting inside the filling and causing more tooth decay. It is unlikely that any additional decay will happen to a tooth in the same area. Amalgam fillings are also one of the best options when working with small children or special needs patients because they are made of one of the only filling materials that can be used in a wet environment.

Risks

Any material, including an amalgam, that’s used for dental fillings poses a risk for an allergic reaction. Although the risk is real, its actual rate of occurrence is extremely rare. Reactions typically manifest in the form of a rash. If you have a history of allergies, be sure to let your dentist know, because that can be significant in the choice of the type of filling to use.

Talk to your dentist about any health concerns or conditions you have during your office visit. Let her know if you’re pregnant or nursing or if you’re taking any medications. These things can affect decisions about whether to use fillings, the type to use and the timing of placing them.

Mercury Concerns

Amalgam fillings are about 50 percent elemental mercury by content. Some people have concerns about toxicity from the mercury used in fillings. A tiny amount of mercury is released as vapor when the amalgam is created and placed. More of this vapor can be released when chewing food, grinding your teeth or drinking hot liquids. The mercury vapor can be inhaled and absorbed into the bloodstream. However, the amounts from dental fillings are found to be much lower than the safety limits set by government agencies. In addition, the type of mercury used is considered much less toxic than organic mercury, which is found in seafood.

Research into the safety of mercury in amalgam fillings is ongoing. The U.S. Food and Drug Administration, the World Health Organization and other groups have declared the mercury in amalgam fillings to be safe. Government agencies have not found sufficient evidence to recommend discontinuing the use of amalgam fillings.

Maintenance and Care of Fillings

Amalgam fillings require little to no direct care once they’ve been placed. Once you have a filling, the best way to prevent the need for additional fillings is to maintain a regimen of good oral health. This includes brushing and flossing and keeping up with your regular dental checkups.

Finding the Right Dentist

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