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How to Choose the Best Dental Fillings for Your Teeth-Good Oral Tooth Care and Dentists

Updated on May 23, 2011

Even In Ancient Times Dental Work Was Done on Teeth

Since the days of ancient Egypt, dental care has been practiced in one form or another. Throughout time, dentistry has become a specialized profession. Back in the Middle Ages, dentists worked on teeth and also cut hair. In the 15th Century, Italian dentists filled cavities with gold, only for the wealthy. Modern technology has afforded us many choices in dental care, and many choices in dental fillings.

Prior to 1819, cavities in teeth were filled with gold alloy. Amalgam fillings (silver and mercury) were invented as a cheaper substitute, over 150 years ago. Amalgam fillings is 50% mercury and 50% metal powder that consists of silver, zinc, copper and tin. In 1979, the University of Iowa, and later in 1981 by Ohio State University, found that mercury was released from these amalgam fillings. The vapor release was increased from brushing, chewing, and from acidic and hot drinks and foods. In 2009. Congress wrote a bill to ban amalgam fillings, but the bill was never passed. Norway, Scandinavia, Denmark and Finland have stopped the use of these fillings because of the threat of mercury.

Mercury is of Concern in Silver Fillings

90% of American dentists use amalgam fillings. In addition to the threat of mercury vapors, amalgam fillings are done in such a way that they can cause cracks in the tooth being filled. This may lead to the need for root canal. The positives of amalgam fillings is that they can last for decades.F;ouride use has helped the enamel on teeth become stronger and more cavity resistant. Regular dental exams are important to detect cavities that may exist underneath the enamel layer. Resin composite fillings are a good alternative to the amalgam fillings. These resin composite fillings are tooth colored and synthetically imitate the existing tooth naturally in functionality, aesthetics, and structure.

Silver Amalagm Fillings are Very Durable

Amalgam fillings are made up of about half mercury and half silver, with a very small amount of other metals including tin and copper. These filings are extremely durable and can last 20-25 years. They are inexpensive and easy to work with. Amalgam isn’t a pretty looking material. The idea that mercury is in the amalgam has many negatives.Mercury releases a vapor and can be absorbed by the body and could have detrimental affects. When old fillings are removed, the mecury is vaporized. Although there is no scientific evidence to support the mercury in fillings could be causing illnesses, some people may have more sensitivities than others. Pregnant women should not be exposed to amalgam fillings. It is best to avoid removing or inserting amalgam fillings in expectant mothers. Mercury is known to cross the placenta.

Composite Resin is Good for Children's Teeth

In children, non mercury fillings are best used to repair tooth decay. A popular alternative to amalgam fillings is composite resin or white fillings. They are also known as bonding fillings or plastic fillings. Technology has made these type of fillings easier to work with, aesthetic to look at and stronger than ever.It is the same color as teeth, and can be matched closely in shade, and can be used on front teeth without attracting attention.Only recently are they being made strong enough for back teeth. May last 5-10 years on back only teeth. More expensive to produce, harder to work with. Secondary tooth decay can develop around the edges with composite resins.Gold and porcelain are alternatives to dental amalgam and composite resins. Gold and porcelain are more expensive, but precise in the ability to work with. Offer the most durability.

Before You Get Fillings - Know Your Choices

Whether the mercury is safe in fillings is still being debated.Mercury is a liquid that binds with amalgam alloy which is a combination of metal - silver, copper, tin, and zinc. The combination of metals is soft and malleable so the dentist can use it to fill cavities. When it hardens it becomes a strong filling. The American Dental Association states that mercury in the amalgam is stable and safe.Mercury contaminated fish is unsafe. Both sides debate about the safety in tooth fillings. People vary on how much mercury is absorbed. Genetics, things like teeth grinding, chewing gum and the number of fillings play a part in the amount of mercury vapor absorbed.Because of the concern about mercury content, other fillings are starting to be designed. So far amalgam (silver colored fillings) are the longest lasting and the least expensive.Millions of people have amalgam fillings. Before you get your cavities filled, know whatever you can about the things going into your mouth.

Silver Amalagm is the Most Common Fillings for Cavities

The FDA needs to define a safe dosage of mercury from the fillings. The current mercury vapor safety metric calculated by the EPA (Environmental Protection Agency). Dental amalagm is the most common material used to fill dental cavities. Amalgam was introduced in the U.S. by 2 French businessmen in the early 19th century. Prior to amalgam, tin, lead and gold were used to fill molars. Tin did not last long. Lead was poisonous and gold leaf was expensive and time consuming to apply to teeth. In 1910, gold cast became available and became a better, gentler and lower cost alternative to filling teeth.

Coca Cola Was Invented and Cavities Became More of a Problem

In colonial America and prior most people lost their teeth to gum disease than to tooth decay. People’s diet consisted of low sugar and high fat. Only the rich could afford the expensive commodity of sugar. Tooth decay was known as a rich man’s diseases In America, sugar was cheaper, but people rarely indulged. Around the same time Coca Cola was introduced in 1886, dental cavities became more prevalent. Even today, The Coca Cola Company is the biggest purchaser of sugar in the world. Back then Coke was made with real cocaine, so people got hooked on it easily. Its popularity swept across the country quickly, and so did rotten teeth. Dental cavities are the most common ailment across the globe.

Advantages and Disadvantages of Fillings

Type of Fillings
Gold Alloy Fillings
lasts 10-15 years or longer
doesn't corrode
requires at least 2 dental visits
strong - can withstand chewing
can cause a galvanic shock if next to silver
non toxic - pure
silver fillings (amalgams)
durable - lasts 10-15 years
healthy part of teeth are removed to fill cavity with amalgam
can withstand chewing
can create a grayish hue to surrounding teeth
less expensive
amalgam can crack over time
contains mercury
composite resin
aesthetics - matches tooth color
only lasts 5 years
bonds well to give greater support
doesn't stand up to chewing
can be used for fillings and chipped teeth
can take up to 20 minutes longer to fill cavities
less tooth destroyed when filling cavity
may require multiple dental visits
can chip
can cost almost 2x as much as amalgam
porcelain (ceramic and glass)
more resistant to stains than composite
can cost as much as gold
lasts a long time
somewhat brittle
can be used alone or fused with gold
can fracture
matches teeth color
multiple dental visits
non toxic
glass ionomer (glass)
good for small or temporary filling
weaker material
contains flouride for more protection
cracks easier
only need one visit
more prone to wear
good for young children
not good for back chewing teeth
comparable in cost to composite resin
lasts 5 years or less

A Dental Exam

Take Good Care of Your Teeth With Common Sense Habits

Be knowledgeable about your dental filling choices will help you make the right decisions for your teeth and dental health. The best way is to take good care of your teeth. Brush twice a day. Eat nutritiously, eat low sugar. Avoid sticky foods like raisins, and American cheese, sugary and drinks and use dental floss regularly for better oral health and less cavities. Drink fluoridated water, ask your dentist about tooth sealants, and visit your dentist regularly. Common sense and good habits are the best way to take good care of your teeth.


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    • profile image 5 years ago

      toknowinfo - great information. I have been going to the dentist since I was two. My Mom was ill while she carried me and I did not have any enamel on my teeth. As my permanent teeth cane in, they were capped. When I was in my twenties, I had to have my teeth recapped - these lasted until my sixties. Pascale comments are quite valid.

      Thank you for writing such a good Hub


    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Pascale, Thank you so much for adding your very valuable comments. You offer a lot of wisdom in the things you say. And you are so right. It is very important to have a skilled dentist, it really does make all the difference. I am so glad you stopped by and read my hub. I appreciate the up vote too.

    • Pascale1973 profile image

      Pascale Skaf Saliba 6 years ago from Orange County, CA

      Coming from a person in the dental industry. Amalgam fillings are terrible, the office i go to no longer offers them at all and any reputable dentist will offer you the best choices and avoids the bad stuff, why even mention it if you really wouldn't want your patient to make a bad choice and only have the best. As far as crowns, although material is important, its importance is no where near how good the workmanship is. Although they set a time limit, ive seen them last double the time and I've seen crows replaced after a year no matter what the material is because a bad job was done on the margins and decay, decay, decay. Or the decay wasn't completely cleaned before the filling. Find a good dentist, one that takes the time and is detailed, one that doesn't hire others but does the work himself and everything else won't matter. Great article though! Voted up.!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Ruby, I am glad you stopped by to visit. Thanks, also for your kind comments.

    • Ruby H Rose profile image

      Maree Michael Martin 6 years ago from Northwest Washington on an Island

      Thanks for all the great information. Congratulations on the contest. Way to go.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Fay, Thanks for sharing what happened to your daughter. That is some story. I appreciate your up votes.

      If you would like to vote for my Totem Pole hub in the Top of the Class Contest, I would appreciate it very much. Thanks for voting for my Totem Pole Hub

    • profile image

      Fay Paxton 6 years ago

      Excellent and valuable information. My daughter was often ill and no one could figure out why. I had her silver fillings replaced with resin and afterwards she was just fine.

      voted up/very useful

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Ripplemaker, Thanks for stopping by and commenting. So I brought you back to your dental student days. What memories you must have!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Jean, I am glad to know this hub educated you. Thanks for stopping by and sharing your story. Good luck when you visit the dentist.

    • ripplemaker profile image

      Michelle Simtoco 6 years ago from Cebu, Philippines

      I enjoyed reading your hub as this brings me back to my college years as a dental student! :) Congratulations on your win!

    • profile image

      Jean Bakula 6 years ago

      Congrats! I have a front tooth that always needs to be bonded, I've had it done about 3X in my adult life. I can see the small beginning of the cavity, so thanks for the info, now I can go back to the dentist more informed!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Cog, Knowledge is power and I am glad I got you thinking about asking your dentist some questions. Thanks for your kind words. On a different note, my hub about Totem Poles was nominated for the Top of the Class Contest. If you like and want to vote today for my Totem Pole hub, I would appreciate it.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Steph, I am glad you found this helpful, even though the dentist is not our favorite place. On a different note, my hub about Totem Poles was nominated for the Top of the Class Contest. If you like and want to vote today for my Totem Pole hub, I would appreciate it.

    • Cogerson profile image

      Cogerson 6 years ago from Virginia

      Great information toknowinfo....I think the next time I am at the dentist I will be asking lots more questions, kudos on writing an interesting hub on a generally scary subject for lots of people out there

    • stephhicks68 profile image

      Stephanie Hicks 6 years ago from Bend, Oregon

      Good job - I hate the dentist, but this is a helpful read. :)

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Simone, Thank you for the news. I am very appreciative.

    • Simone Smith profile image

      Simone Haruko Smith 6 years ago from San Francisco

      Great Hub- and congratulations! This Hub won the Day 25 Daily Drawing prize in the HubPages So You Think You Can Write Online contest!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Tom, I am glad this info is helpful to you. Thanks for commenting. A Happy Week to you too!

    • kashmir56 profile image

      Thomas Silvia 6 years ago from Massachusetts

      Hi toknowinfo, all great information and advice to take care of and keep your teeth in tip top shape .

      Have a great week my friend !!!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi CHS, I am glad my hub is more pleasant than going to the dentist. Thanks for your comments. Dentists are unpleasant for sure.

    • chspublish profile image

      chspublish 6 years ago from Ireland

      I've always had a fear of dentists and drills and the like, though I do go and get stuff done. I prefer to read you hub though. Thanks.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Betty, Wow the things we didn't know. The mercury in amalgam is still being debated, but forewarned is forearmed. Thanks for adding to the discussion.

    • Betty Johansen profile image

      Betty Johansen 6 years ago

      Oh my goodness! Mercury in our mouths? I thought everybody on the planet was avoiding mercury like the plague these days. When I was a kid (dinosaurs roamed the Earth, then), we used to play with mercury. It was a lot of fun, rolling around our hands, breaking apart, and coming back together again. Nobody died, but now I wouldn't put it in my mouth. I vote for porcelain.

      Thanks for all this great info!

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Jaye, It is nice to see you again. Dental care is very expensive, but at least if you need some work, you are more educated now. Thanks for stopping by and reading.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Amillar, If your teeth look as good as your hair, you are going to the right dentist and the right hair stylist. Glad you stopped by because it is always nice to see you.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Tam, I feel for you, having to get your filling replaced. I hope all goes well, and I am happy if this helps educate you. Wishing you all the best.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Mentalist, Thanks for stopping by. Now at least you can ask him some questions. But hopefully, you will avoid getting cavities and this won't be an issue for you.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Pdog, I know things can be ruff being a dog. Glad I made your life easier.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Cathy, I am glad you found my hub to be useful. The internet can be full of false information, and when people read my hubs, I want my readers to trust my info. I usually spend a great deal amount of time making sure my sources are reputable and that my articles can be relied upon. I am very confident before I state anything. Please check out my other hubs to reassure yourself. I pride myself on the info I give out. However, I am human, and would appreciate you pointing out any inaccuracies you find. It is nice to get to know you. Feel free to contact me, should you have any other questions.

    • JayeWisdom profile image

      Jaye Denman 6 years ago from Deep South, USA

      Very good info, and I like your use of the table.

      Unfortunately, I have a mouthful of dental work that was performed back in the days before I retired (when I still had dental insurance and an undiminished income). I know that some of my fillings and other hardware should be replaced, but can't afford to have it done. That's true for a lot of senior citizens these days.


    • amillar profile image

      amillar 6 years ago from Scotland, UK

      My dentist doesn't give me any choice, he just fills me up with whatever he likes. I don't mind though, as long as he knows I'm not there for a haircut.

      This looks like it will be very useful for USA readers, so up and useful.

    • Tamarajo profile image

      Tamarajo 6 years ago

      I'm sitting right now in the dentist office waiting to have my silver filling that I swallowed replaced. Not going with the silver because of the debate concerning the mercury.

      Useful article.

    • Mentalist acer profile image

      Mentalist acer 6 years ago from A Voice in your Mind!

      I think my dentist only knows how to use silver,thanks toknowinfo.;)

    • profile image 6 years ago

      The table you give on pros and cons is a very useful summary. Rated this - thanks for doing the research tki. Now I don't have to!

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      he's a cautious guy and many hubs i've read contain innaccuracies that i catch because of my medical training. your hub sounded authoritative and i was aware of the amalgum issue with mercury, but marc, being the cautious guy he is, wanted more. your candid answer will probably reassure others who stop by to read your good hub, too. thanks.

    • toknowinfo profile image

      toknowinfo 6 years ago

      Hi Cathy, It is always good to ask your dentist the right questions. But there is every possibility that your dentist did not want to use fillings that contain mercury. When I had a cap put on my tooth a few years ago, I asked the dentist the pros and cons of different materials. He told me, and I chose a gold cap. No one can see it, it is pure and reacts well with the body, and I won't have to worry about it needing replacing like a porcelain cap would. But if it was in a noticeable spot, I would not hesitate for aesthetic purposes to choose porcelain. As far as my sources, I read and research and double check my sources very thoroughly before I write on any subject. I want my info to be accurate and trustworthy. Some of my info I got from my readings, some are from the American Dental Association, some from the FDA, and abcnews. Hope this helps. For my curiosity, why does your husband want to know my sources?

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      my husband wants to know the source of your info for this hub. can you provide this?

      voted useful and up.

      i think you included a gazillion keywords in your title - kudos.

    • cathylynn99 profile image

      cathylynn99 6 years ago from northeastern US

      i think my dentist uses composite. she never told me it would only last 5 yrs. thanks for the info.