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Ideal Dental Fillings

October 7th, 2011

Filling materials have changed dramatically over the last 40 years.  At that time, the most common fillings were silver amalgam.  First used in the mid 1800’s, the mixture of silver, tin and mercury remained virtually unchanged for decades.  It was easy to mix and place and lasted for a reasonable time in the harsh environment of the mouth. It had many drawbacks, not the least of which that mixing it could be toxic to the dentist and assistant from excess mercury exposure.  In the early 1970’s we saw the development of newer amalgams.  Copper was added to reduce the corrosion and tarnish and also strengthen the mix.  Powered mixers allowed for ideal mercury levels and no excess was present, leading to safer handling.  Then it became available pre-capsulated and no handling before mixing was needed.
Also in the early 70’s, the development of effective tooth colored fillings was begun.  They started as  types of cements and unfilled acrylic resins.  The fit was not very accurate and they did not last very long since they were not bonded and tended to leak around the margins.  They also were not dimensionally stable and shrunk as they hardened, leaving gaps around the margins.  Further development saw the introduction of filled resins, light activated materials, and smaller particle fillers.  All this has led us to today’s nano-filled light cured composite materials that have excellent strength, bonding ability, and longevity.
What is the best material?  The answer is, “It depends.”  There are applications where each of the materials has the best chance of success.  Your dentist will evaluate your needs including your decay rate, bite strength, esthetic needs and the associated costs.
Worried about the safety of filling materials?  You shouldn’t be.  Modern amalgam fillings have very low rates of exposure to mercury for the patients and the dental staff.  Pre-packaged capsules mean there is no free mercury in the office and that it comes out of the capsule mixed and ready to place.  The new composite materials, while containing some bisphenol-A (the stuff in some plastic bottles), it is a very minor amount which is removed by simply wiping off the filling when completed.

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