Acid producing bacteria damage the enamel of your tooth. This damaged portion of the tooth needs to be drilled out, causing a cavity. Dental plaque provides a home for these acid causing bacteria. That is why good oral hygiene is extremely important for healthy teeth. (See our Cleaning and Periodontal Disease section above). Dental fillings are inserted as restorations in the treatment of dental cavities, after drilling out the cavities. However, once the infected hard tissues have been removed, the resulting cavity preparation must be filled in order to restore structural integrity to the tooth. This will prevent further damage to the tooth and hopefully avoid the eventual need for the tooth to be extracted.
Amalgam (silver filling)
Amalgam fillings are an alloy of mercury (from 43% to 54%) along with silver, tin, zinc and copper. Due to the known toxicity of mercury, the main component of amalgam fillings, there is an ongoing dental amalgam controversy on the use of this filling material. (See Dental Amalgam Controversy)
Composite resin (white or plastic filling)
Composite resin fillings are a mixture of powdered glass and plastic resin, and can be made to resemble the appearance of the natural tooth. They are strong and durable and cosmetically superior to silver or dark grey colored amalgam fillings. Composite resin fillings are usually more expensive than silver amalgam fillings.
Besides the aesthetic advantage of composite fillings over amalgam fillings, the preparation of composite fillings requires less removal of tooth structure to achieve adequate strength. This is because composite resins bind to enamel (and dentin too, although not as well) via a micromechanical bond. As conservation of tooth structure is a key ingredient in tooth preservation, Dr. Somani prefers placing composite over amalgam fillings when possible.
Fillings have a finite lifespan. Fillings fail because of changes in the filling, tooth or the bond between them. Amalgam fillings expand with age, possibly cracking the tooth and requiring repair and filling replacement. Composite fillings shrink with age and may pull away from the tooth allowing leakage. As chewing applies considerable pressure on the tooth, the filling may crack, allowing seepage and eventual decay in the tooth underneath.
The tooth itself may be weakened by the filling and crack under the pressure of chewing. That will require further repairs to the tooth and replacement of the filling. If fillings leak or the original bond is inadequate, the bond may fail even if the filling and tooth are otherwise unchanged