The "Permanent" Filling
One of the most frequent questions patients ask is, "Is this a permanent filling?" Without getting too involved in technical aspects of modern restorative materials, the answer is usually no. All filling materials have a life span of several to many years, depending on the restorative material used. As a rule of thumb for moderate to large restorations, the more it costs, the longer it will last.
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| Types of fillings |
Dental restorative materials constructed and processed in a dental laboratory will be stronger and harder and will last longer than silver amalgam (metal) fillings and office-placed composites (tooth-colored/bonded) filling materials. These laboratory-constructed materials include indirect restorations such as full cast crowns, inlays and onlays of porcelain, gold and gold alloys, ceramics, and resins. While the dentist will have certain preferences, you have the final decision over which material is to be used. To make the decision process easier, here is a brief summary of the advantages and disadvantages of materials commonly used in partial coverage restorations. Porcelain fused to gold alloy crowns are not included here as they are in a different category.
Cast Gold: The color of the cast gold is yellow, the same as a wedding ring. It can last 25 to 40 or more years - the longest of any dental material. Gold has a long history of success. Esthetics are poor to fair. The cost is high. However, the use of cast gold results in the fewest postoperative problems. It is excellent for medium to large tooth restoration. Two appointments are necessary to complete the restoration.
Technique Requirements: High
Laboratory-Processed Bonded Porcelains, Ceramics, and Resin: These materials produce excellent esthetics: they match the tooth color almost perfectly. The cost is moderate to high. With respect to longevity, it is probably not as long as cast gold, but should last for 12 or more years. Usually, less tooth preparation (drilling) is required than when using gold. These are relatively new dental procedures. They do not have the long-term history of success enjoyed by gold. These materials can break if overstressed. Resin is easier to repair than porcelain, is less expensive than porcelain and ceramic, and is an excellent choice for medium to large restorations. Two appointments are needed to complete these restorations.
Technique Requirements: High
Direct Resins: Direct resins also provide excellent esthetics. Minimal tooth preparation is involved. These are the best materials for small to medium tooth restorations. Direct resins are less costly than gold or porcelains. They are bonded to the tooth. Life expectancy of the material is 12 or more years, and this newer technology strengthens the tooth. Direct resins can be completed in one visit.
Technique Requirements: High
Silver Metal Amalgam: Silver amalgam was first used as a filling material in 1816. Proven longevity of 14 years, plus or minus 14 years. Silver amalgam does not strengthen the tooth. It is not conservative in tooth preparation. The esthetics are poor. It blackens, corrodes, and expands over time. It is the lowest in cost of all the restorative materials.
Technique Requirements: Low
We will select and recommend the restorative materials best suited to meet your dental needs. Insurance coverage (or lack of it) will never dictate what dental treatment we feel you need and deserve. Our goal is to be able to provide for you the best and longest lasting restorations possible. We will be glad to discuss these options with you.
If you have any questions about "permanent" fillings, please feel free to ask us.
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