Amalgam and resin-based composite are the two most common materials used for minor restorative procedures in dentistry today. Composite is a relatively new addition to dentistry, while amalgam has been used for tooth restoration for over 150 years. Some dental practices offer both composite and amalgam restorative options while others have phased out amalgam completely and only offer composite.
Amalgam is a mixture of silver, tin, copper, and the elemental mercury that has made it quite the controversy. Amalgam is the least expensive restorative material for teeth, which makes it ideal for patients on a tight budget, or to put in baby teeth that children will lose anyway. Some big insurance companies will only cover amalgam filling cost and you are responsible for any cost difference if you choose to have composite fillings instead. Amalgam is also a very strong filling material so it can last years longer than other materials. You may also have to take away more tooth structure when you’re drilling in order to use the amalgam material. This can be negative because if it fails one day, the less tooth structure you have, the less likely you are able to fix it with another filling and the more likely you are to need a crown. There is also the discussion of the mercury it contains. The mercury changes when mixed with the metals and to this day, the FDA has continued to approve the use of amalgam for Dentistry.
Resin composite filling material is made of ceramic and plastic compounds. It’s been around to fill anterior for quite some time because it mimics the look of the natural teeth. In the last decade there have been new additions and materials to make it durable enough to use on the posterior teeth. Because these materials are so new to the world of dentistry, we’ve been unable to see exactly how well they hold up over time.
Composite fillings are a little harder for the dentist to place. The tooth has to be completely dry, and in some situations it is nearly impossible to keep it dry and away from saliva for the time it takes to complete the procedure. As stated above, resin composites are also a more costly option and one that not all insurances will cover. Resin-composite fillings may be a more costly option now, but you don’t need to take away quite as much tooth structure in order for the treatment to succeed. This could save you from a crown or other major procedure later on in life. The biggest patient pro is that they’re tooth colored so cosmetically, they’re the better option.
With the dental industry progressing so quickly and new materials and concepts being discovered all the time, it is undecided if amalgam fillings will one day be a thing of the past, or if they’ll continue their pattern in history and still be a leading filling material one hundred years from now.