What alternatives are there to metal fillings, we would call them amalgam fillings, but basically the silvery black things that were put in all through the 60’s ,50’s and 70’s, 80’s and less so now. So there’s three.
Well, to start with, the alternatives are really simple. My favourite alternative to amalgam in a molar that’s big teeth at the back is actually gold, which is still metal, but is by far the best dental material. The other alternatives involve tooth coloured materials, so they’re usually generically split into composite resins or into porcelain. A better way of thinking of it is plastic versus non plastic.
So plastic means that it’s some sort of a material that eventually cures. Generally, we use two types composite resin and glass ionomer. The other material we use the non plastic materials are either porcelain or ceramic. So in this practice, we basically decide which one of those materials we’re going to use based on the amount of tooth structure that’s still remaining and also the potential longevity of what we would call the restoration.
So we don’t really use the word filling anymore because filling implies exactly what it is. That’s like a hole and you fill it in. What we do more now is to reconstruct the tooth, to make it more like the original tooth before it had any destruction.
In our practice, we use ceramic quite a lot and we use it as a CAD cam. So it’s a one visit ceramic and we get excellent longevity out of that. We’ve been using that since 2001, one of the earliest practices to use it. And it’s proven itself to be very reliable. It has many benefits. It’s aesthetic. So it looks great. It’s one visit, which is fantastic. So you don’t need to have a temporary restoration. It’s all done in one visit.
And also it requires it doesn’t require it also allows preservation of natural tooth structures. So not as much teeth has to be removed to put one in, however, does have to be a certain size to warrant that. Otherwise we use composite resin.
So composite resin is a very good material. It doesn’t last quite as long, probably as ceramic, but it’s still a very good material. So we use it in smaller restorations where the forces are not as great, etc. Glass Ionomer, which is the other material I mentioned, we use more as material for interim restorations, something we like doing before we do, and another procedure as in a ceramic.