White Fillings

A white-colored composite resin filling is clearly the most conservative restorative option for a decayed or broken tooth in dentistry today.  The composite resin filling material is available in many shades to match the color of the tooth that it will be placed in.  However, using a white filling material is not just about aesthetics.  The most important reason to use composite resin as filling material is conservation of tooth structure.  When a tooth has decay present and needs to be fixed, a white filling only requires the removal of the diseased tooth structure (the “cavity”)--nothing more.  In stark contrast, when using the silver-mercury amalgam metal filling material not only does the decayed tooth structure need to be removed but also a great deal more.  Healthy enamel and dentin needs to be removed unnecessarily due to a 19th century theory known in dentistry called “extension for prevention”.  The principle of the theory is that the tooth has decay in one location of the tooth, but in order to restore it with either amalgam or gold the preparation of the tooth needs to be extended to unblemished areas of the tooth and needs to be at least 2.5mm deep into the tooth.  This extension and depth is necessary to allow for the bulk placement of metal to prevent metal fracture and to protect the tooth from getting decay in other parts of the tooth at a later time.  This theory no longer pertains to modern dentistry because of the advanced tooth colored materials dentists have available for their patients.  

Amalgam fillings vs. Composite resin white fillings

Amalgams

• Do not seal teeth
• Do not reinforce the remaining tooth structure
• Do not allow conservation of tooth structure
• Are not aesthetic

Composite resins

• Seal teeth
• Chemically bond to enamel and dentin=strength and durability
• Very conservative of healthy tooth structure
• Are very aesthetic

You can’t solve today’s problems with yesterday’s techniques and still be in practice tomorrow.  We no longer remove tooth structure to satisfy the requirements of the dental restorative material (amalgam).  We now only remove the diseased or broken part of the tooth, nothing more.  We save all of the healthy, intact enamel and dentin and place a conservative tooth-colored filling in replacement of the diseased or broken part of the tooth.  That is dentistry for the 21st century. 

BEFORE AND AFTER

Replacement of failing amalgam fillings - work performed by Dr. Allen

We now can remove the failing amalgam metal filling and any recurrent decay caused by the filling and then replace it with a tooth-colored filling material that is chemically bonded to the remaining enamel and dentin ensuring a long-lasting, pain free and nice looking result.