For many years , tooth coloured fillings have been used in the dental profession.
In the fifties and Sixties, the tooth coloured filling materials were comprised
of plastic and silicate type components.

Although they looked better than the basic, standard amalgam filling, they tended
to be prone to leakage and breakage because of their weak compressive strength.

They also were unstable to the point where they were subject to staining readily
and loosing their colour.

Since the late nineties and early twenties, these composite resin filling materials
have become much improved and are now more widely used even in the posterior teeth
(chewing teeth) of the mouth.

That being said however, current composite tooth coloured filling materials, are
still not as durable as the old standby silver alloy fillings.  

They are certainly more esthetic,come in a wide range of colours and when bonded to
hard tooth structure, add strength to the teeth.

The disadvantages of tooth coloured restorative material are;

      * less likely to survive in the posterior teeth as opposed to amalgam or gold
fillings.

      * Extremely technique sensitive

      * Takes 50% longer to place than alloy fillings

      * Therefore, ……….. they cost more

As I mentioned earlier, the modern bonding techniques have made the composite type
filling materials much more suited for placement in posterior molars and bicuspids.

Hence, there has been and increasing unpopularity of silver type fillings being used
and many patients are now demanding that their old amalgam fillings be replaced.

Unless it is absolutely necessary, I would not recommend having your old amalgam fillings
replaced especially for only esthetic reasons.

Unfortunatey, the public at large has become a very, VANE Society. The placement of a
tooth coloured restorations in the posterior teeth is  extremely technique sensitive ,
even in the hands of the most highly, skilled ,competent dentist. 

In the last 20 years of my dental practice, I saw more failed or compromising composite
restorations than amalgam ones. Although I considered myself to be a very good dentist
with good hands , I rarely placed LARGE composite fillings in the bicuspid and molar teeth.

Infact, quite often, I either convinced the patient requesting such a filling to change
their mind or I asked them to have the treatment done somewhere else.

If you don’t mind having your white fillings in the posterior teeth replaced periodically ,
costing more money and being subjected to another series of dental appointments, be my guest.

Hopefully one day there will be tooth coloured restorative materials  that will be as durable
or more durable that the amalgam types fillings that have been used for well over 100 years.

Keep in mind that dentists, who advocate the replacement of older silver type fillings that
do contain mercury, may be more interested their own pocketbook rather than yours.

Amalgam restoration are thought to leach trace amounts of mercury and while some concerns
for your safety have been raised, there is no current , conclusive evidence that any of
the mercury remains in the body nor that dangerous levels are reached. 

In my next blog, I will discuss the use of gold material as a filling material instead
of amalgam and /or composite in the posterior teeth.

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