Amalgam is the dental material commonly seen in “silver fillings”. Amalgam is possibly the oldest and most thoroughly
researched dental material.
Its advantages are abundant. It is strong, durable, and withstands biting forces amazingly well. It is easy to place, selfsetting,
barely shrinks on setting, and has little leakage (bacteria cannot get through the filling-tooth interface to cause
decay). It can be placed while the region is still wet (important in small children), and is the cheapest of all the dental
While amalgam is clearly great, it does have significant limitations. Amalgam does contain traces of mercury, a toxic
substance. While agencies like the FDA, CDC and WHO have not found evidence of harm from dental amalgam, there are
still online groups and some dentists that warn patients that amalgam may be toxic. The American Dental Association,
who has studied this issue extensively, says it is unethical for a dentist to tell patients that their silver fillings are
dangerous and need to be replaced. There is simply no evidence that this is true.
The greatest drawback to amalgam is its appearance. Being silver, your dentist is most likely to use it for back teeth,
such as molars, only. With the advent of tooth-colored dental materials, more and more patients are requesting “white
fillings” even with the great advantages that amalgam provides.
Composite resin is a filling material designed for aesthetic dental restorations. Formulated to resemble the color of your
natural tooth, composite resin is often used for filling dental cavities or for dental bonding front teeth.
Composite resin consists of glass or quartz filler added to a resin medium, which produces a tooth-colored filling. The
invention of composite resin offers a substitute to the amalgam dental fillings we've grown so accustomed to. This plastic
and glass mixture contains no metal and can be shaped to resemble a real tooth. Onlookers usually can't tell that a tooth
has even been filled!
For years, amalgam was the only option for filling teeth. Those who wanted natural-looking restorations had to opt for
more expensive cosmetic treatments, such as a dental crown. Composite resin enables dentists to cosmetically treat
dental cavities without using invasive procedures.
Although composite resin has only recently gained popularity, white fillings were originally introduced in the 60s. At that
time, composite consisted of a different material, and was not sturdy enough to be used on back teeth.
The first composite fillings tended to wear down easily, subjecting the tooth to even more tooth decay or breakage. It
has taken years of development for scientists to find the right mixture of composite resin and justify it as a safe,
effective filling material.
A dental crown, commonly referred to as a “cap”, is a tooth-shaped covering placed over a damaged tooth to restore its
shape, size, strength or to improve its appearance.
The tooth is first reduced in size and then the dental crown is cemented on to encase the tooth above the gums. Dental
crowns are made of metal and/or ceramic porcelain.
When are crowns required?
When the majority of a tooth's surface becomes an issue, but the root structure is of good health, a dental crown is
often recommended. What sort of circumstances does this include?
Tooth is worn down beyond simple repair. This can result from general use over a lifetime, teeth grinding while asleep
(bruxism), or from acid foods that dissolve away the enamel (erosion).?
The decay that is too large to fill with dental material. If dental decay grows too large, there will not be enough sound
tooth structure to hold a filling in place.
Misshapen or discolored tooth needing coverage. Cosmetic dentists often place crowns on unaesthetic teeth to mask
Weakened tooth needing support. Various reasons can lead to a tooth being weakened and prone to fracture – one
prevention technique is to place a dental crown.?
Support needed for dental bridge. A bridge holds an artificial tooth in the space of a missing tooth by attaching onto
nearby natural teeth. The natural teeth are given crowns and the artificial tooth is welded to them.
Types of dental crowns
There are two main types of dental crowns: temporary and permanent. Permanent crowns are what most people know as dental crowns or caps. As the name suggests, temporary crowns are intended for short-term use only. Temporary crowns are made from plastic resin during the appointment, are bonded to the tooth with temporary cement (so they can be removed at a later date), and are used in all sorts of dental treatments. Many treatments require that the patient leave the dental office with a prepared tooth while the dental laboratory makes the final dental crown, thus the need for a temporary crown. Once the final crown is fabricated, the temporary crown is removed and the final product is inserted.
Permanent crowns are similar to the temporary crown, but made of different material and with more care. Instead of plastic resin, permanent crowns are made from metal and/or porcelain to provide a more natural appearance and last for decades. Unlike temporary crowns, the permanent variety are fabricated at a dental laboratory (not beside the dental chair) and placed in the mouth at the next appointment.
Permanent crowns are made from one of three types of material: all metallic, all porcelain, or porcelain-fused-to-metal. Each has its advantages and disadvantages that you need to be aware of prior to making your decision.
All metallic crowns are made from gold or other metal alloys, such as palladium or nickel-chromium. Metallic crowns have many advantages over other crown types; they wear down opposing teeth less, withstand biting and chewing forces best, rarely chip or break and less tooth structure needs to be removed for them to fit the tooth. Unfortunately, they are metallic in color but are a great choice for back teeth such as molars that are rarely seen when you smile or speak. All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns ar
e a good choice for front teeth, but no matter what your dentist tells you, modern all-porcelain crowns cannot withstand the demands of being placed on molar teeth. The most popular choice for dental crowns is the middle-road option of porcelain-fused-to-metal crowns. They can be color matched to look like natural teeth (unlike all metallic crowns), however they do not wear down opposing teeth, chip or break like all-ceramic crowns. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
Again, our office staff will discuss which of these restorations is best for you.