Fillings under the tooth magnifier: amalgam, plastic, gold or ceramic
To ensure that a diseased tooth remains intact, dentists drill out the affected caries, clean them and close any gaps that are created with various fillings. "However, with regard to the materials used for this, there is a large selection that differs primarily in price and durability, but also in compatibility and aesthetic features," explains Dr. Christoph Sliwowski, head of the Dental Implant Clinic Düsseldorf at St. Vinzenz Hospital, and describes in the following overview which criteria patients should consider when making their selection:
For a long time, doctors preferred amalgam as the best material for dental fillings - even if it is not the first choice aesthetically. After all, the inexpensive material not only ensures a good seal of the tooth, but also has a shelf life of over 10 years. However, amalgam fillings slowly dissolve over time and, due to the mercury they contain, are suspected of causing symptoms such as a constant feeling of fatigue, headache and jaw pain, but also muscle cramps. Therefore, more and more medical professionals are refraining from using it. From July 2018, use by children, expectant mothers and breastfeeding women is already legally restricted.
Dental fillings made of plastic, which dentists also refer to as composites, are considered a cheap alternative. Depending on oral hygiene, they usually last 4 to 9 years. However, this only applies to light-curing composites made from modern high-performance plastics, such as PEEK. With chemically curing plastics, microcracks often form during curing, in which bacteria find ideal shelter and lead to renewed caries formation. "Thanks to the improved material properties, there are fewer signs of wear and hardly any color changes when enjoying special foods such as coffee or red wine," says Dr. Sliwowski.
Gold is used as one of the longest lasting, most compatible, but also the most expensive materials for dental fillings. Due to the particularly hard property, doctors prefer to use the precious metal in the back of the molars. The chewing loads are greatest here and the striking appearance is least noticeable. Gold fillings usually last 10 to 15 years and close gaps to the edges, so they do not offer space for caries and other pathogens.
Since the color of ceramic can be precisely adjusted and its translucency is similar to that of the original teeth, the material is a favorite among dental fillings - especially in the posterior and anterior areas. Patients also appreciate it due to its good tolerance and long shelf life of 10 to 12 years. Unpleasant side effects, such as flaking of fillings that have become brittle, are a thing of the past here, too, thanks to further developed material technology and the use of high-performance ceramics such as zirconium oxide. The only disadvantage is the high purchase costs, which have so far not been fully covered by health insurance companies.
The general rule: The more careful the individual dental care, the longer the filling. Ideally, however, patients should not need any fillings. "Regular visits to the dentist, annual prophylaxis appointments and daily oral hygiene create the ideal conditions for a healthy mouth," emphasizes Dr. In conclusion, Sliwowski.