When it comes to fixing broken down teeth, there are 3 basic options: Gold, Silver or White. 🙂 While most of our patients nowadays do request tooth-colored restorations, we offer all 3 kinds for a number of reasons.
Tooth-Colored Fillings, aka Composite Resin aka “Bonding”
Advantages of Tooth-Colored Fillings
The most obvious advantage of tooth-colored fillings, which are made of a composite resin, is that they blend in well with your natural teeth. In fact, once they’re done, you shouldn’t even be able to tell they are there! These are the automatic choice for any fillings in teeth that show in your smile, but most of the time, we can do them for back teeth, too.
Besides the more natural look, however, there are 2 other important benefits of tooth-colored fillings:
- The composite fillings are bonded to the tooth, and the bonding process reinforces the tooth, to the point that it may be as strong as the tooth was before it was ever damaged by decay or trauma, and
- Because the filling is bonded in, it doesn’t need as much physical retention to hold in. This means we don’t need to drill as much of the tooth away to keep the filling in place, as is needed with silver fillings. So tooth-colored fillings are more conservative.
Disadvantages of Tooth-Colored Fillings
There is really just one significant disadvantage to tooth-colored dental fillings, and that is their strength. When it comes to really big fillings that cover a large portion of the tooth, especially cusps (the pointy chewing parts of the back teeth), bonded fillings simply are not as hard and strong as either silver fillings or porcelain crowns. That means they won’t last as long and will need to be replaced more often.
One other small disadvantage, is that tooth-colored fillings usually do NOT work well for kids’ teeth. The structure of enamel in baby teeth is different and does not bond well, so we almost always recommend silver fillings for baby teeth.
Silver Fillings, aka Amalgam Fillings
First off – Dr. Oz doesn’t know SQUAT about silver fillings, so PLEASE don’t listen to him on this subject. It’s been studied to death, and plain-and-simple, silver fillings are perfectly safe. How safe? Well, both of my parents are my patients, and both of them still have silver fillings that were done decades ago, and I have ZERO intention of replacing them until absolutely necessary. And if my own daughter (7 years old as of 2013) needed any fillings done on her baby teeth, I would have no hesitation using silver fillings. And now that’s out of the way…… 🙂
Advantages of Silver Fillings
There are 4 advantages to silver fillings:
- They’re less expensive, because they’re a bit easier to do, especially for really big ones;
- Because they’re metal, they’re very strong, so even huge silver fillings can last a long time;
- They seem to be more resistant to tooth decay for patients who seem to get cavities easily;
- They’re less technique-sensitive, so silver fillings that are only “so-so” can last a long time, and even if a little saliva contaminates them, they can do fine.
Disadvantages of Silver Fillings
Well, this one’s so easy, I probably don’t need to say it, but just so no one misses it…….silver fillings are kinda ugly. No two ways about it; we can polish them to a high shine that almost looks pretty, and even give them really nice shape, but not matter what, they don’t look like your teeth.
What’s the Difference Between a Filling, an Onlay, and a Crown?
When a tooth is broken down, there’s kind of a limit on how big one can make a filling before you run into problems with strength and durability. When that point is reach, we start recommending either an onlay or a crown. Most people know what a crown is, but Onlays seem to be less well known, so here’s the difference in words, then pictures:
Just like a filling, an Onlay will only cover part of the tooth, but that part usually includes 1 or more of the cusps. This means that an onlay is more conservative than a crown – it saves more healthy tooth. However, an onlay is made in the same way that a crown is made, either with porcelain or gold, so it has the same strength and durability as a crown. This means that an onlay is stronger and longer-lasting than a filling – you won’t need the tooth worked on as often. However, it does also mean that an onlay costs the same as the crown, not as a filling.
In this photo, you can see a gold onlay, 2 porcelain crowns, and a tooth-colored filling.
Porcelain or Gold for Your Onlay or Crown?
Gold is Still the “Gold Standard” for Lasting Longest
Simply put, if you want an onlay or crown on a back teeth that is most likely to last for many decades, there’s still only 1 choice…..gold! Now, to be honest, we don’t do many gold crowns in our office, even though I try very hard to talk people into them, but most people just want WHITE teeth these days, not gold. But the “gold standard” for onlays and crowns is still gold. You’ll pay a bit more up front, but I can’t begin to tell you how many gold crowns I’ve seen that are older than I am (42 years old in 2013 as of this writing), and they look as good as they day they were put in. Gold onlays and crowns can be very thin and still wonderfully strong; for people who grind their teeth, it’s the best!
One-Visit Porcelain Onlays & Crowns with CEREC
But since most people want their teeth to look like teeth, not like jewelry, 90-95% of the onlays and crowns that we do are made with Emax porcelain, which is made right in our office with CEREC AC Bluecam system. Emax is INCREDIBLY strong once it’s bonded to your tooth, and it’s the same porcelain that most labs use to do the same thing, so why not get it done in 1 visit with us, instead of multiple visits somewhere else?
And if we need something even stronger than Emax, there’s another material available through our lab called Zirconia. Zirconia is basically a white metal, and when oxidized it becomes a ceramic, and it’s almost 3 times stronger than Emax, even when 1/2 as thick. It’s not the prettiest material (getting better quickly), but it can also be very thin and still unbelievably strong.