Qualities of Good Dental Fillings

You have a cavity that needs to be repaired. To do this, your dentist will clean the area and cover it up with a dental filling. But the choices are numerous: teeth can be filled with gold, porcelain or silver amalgam among others. Which one is best for you?

Choosing the right dental filling can be tough and depends on several factors like the location and extent of decay, the cost of the material, and your dentist’s recommendation. Compounding the problem is the fact that modern dentistry has yet to come up with the “perfect” filling.

In “The Whole Tooth”, Drs. Marvin J. Schissel and John E. Dodes said to be absolutely perfect, a filling material must have these important qualities:

It should be aesthetic. It should look exactly like part of the tooth that was replaced, both in form and color.

It must be nonpoisonous.

It must be readily manipulable in the mouth. High-fusing porcelain looks good and makes an excellent material for some types of fillings, but since it must be baked at tempera¬tures well over one thousand degrees Fahrenheit, it cannot be used for fillings that are to be shaped in the mouth.

It must be resistant to abrasion, both from the wear of chew¬ing and at contact points with neighboring teeth.

The material must be stable. A filling must not dissolve in or react chemically with anything likely to enter the mouth. It must not break down with temperature changes or the pas¬sage of time.

It must have good crushing and edge strength. The forces of chewing are tremendous. A filling must be resistant to break¬ing, crushing, and chipping.

The material, once placed in the cavity, should not flow over the edges when subjected to stress.

The ideal material does not conduct temperature changes or electrical impulses. Thermal and electrical shock can damage the pulp of a tooth.

The material must have a favorable coefficient of expansion. This is the amount a material expands when heated. If the filling material expands more or less than the tooth structure, then every time you drink coffee or ice water the filling and the tooth change dimensions at different rates. This results in filling margins that leak and may lead to the filling actually popping out. (Next: Pros and cons of gold fillings.)

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