Sometimes, when looking for a simple answer to a question, we unexpectedly run into a complicated argument. Such are the pitfalls of looking for a simple answer to which dental filling materials are the best choice for treating dental caries. Given the complexities of the situation, it’s time for the dental filling materials showdown!
In this corner, coming in with years of experience, is our first contender, dental amalgam fillings. And in the other corner, the scrappy young contender, composite fillings, taking on the established champ.
Let’s head on to the first round of the matchup…
Amalgam fillings land the first blow in this round with a longstanding reputation for durability. They are expected to last 10-15 years. Studies on the lifespan of amalgam vs composite fillings often find that amalgam fillings should last longer than composite fillings, particularly in larger caries.
Composite fillings come back swinging, however, with newer studies suggesting that improvements in materials used for composite fillings and improved technique in applying composite fillings can make composite fillings a reliable filling with success rates comparable to amalgam fillings.
The result of this round is that more information is needed to be sure if current composite filling materials and techniques have closed the durability gap with amalgam fillings. If you want to go with the tried and true long-lasting material, amalgam is an available option. If you elect to use composites, there’s plenty of reason to believe you are making a reasonable choice.
This round goes to composite fillings, no contest. Composite fillings are sometimes referred to as tooth-colored fillings. They look like natural teeth, and a skilled dentist can blend the colors in to match the existing tooth surface in most if not all cases. Tooth-colored composite fillings are particularly well suited to fillings on the front teeth where the filling would be visible. A composite filling can leave you looking like you never had a filling at all.
On the other hand, amalgam fillings are silver in color and remain visible. While they may be subtle in the back teeth where people are less likely to see and notice them, in the front teeth, they are hard to miss. Some people do not like seeing the silver in the back of their mouth while they brush and floss, even if other people can’t see them. Composite fillings are more cosmetically desirable for many patients.
Both contenders come out swinging in this round. Amalgam fillings may contain mercury, leading many patients to have concerns about using them. Similarly, composite fillings can contain BPA, a chemical that many people also have concerns about using internally.
Both amalgam fillings and composite fillings have been studied and deemed safe to use. There are also some BPA free dental composite resins available to dentists.
This round is something of a draw. If you have concerns about the materials used in your fillings, talk to your dental care team before having any fillings done and make sure you understand and are comfortable with your care plan.
Amalgam fillings take this round. Amalgam fillings are generally less expensive to have put in than composite fillings, and because amalgam fillings are considered more durable than composite fillings, the long-term cost of amalgam fillings can be lower since they need to be replaced less often. Further, according to a major dental insurance provider, dental insurance coverage varies on composite fillings for the back teeth. So, it’s possible your dental insurance plan may expect you to share a larger portion of the cost for composite fillings on your molars. If cost is the sole consideration, amalgam fillings will probably win the day.
So, the clear winner in this dental materials showdown is….
Patients who take the time to learn and educate themselves about their choices in healthcare win, they can participate more effectively in their care and feel more confident about the care they receive. Whether you and your dental care team select composite, amalgam, or a combination of both, you can be part of the conversation and help advocate for and select the solution that’s right for you.