Composite fillings are a class of metal free fillings that are tooth colored. There are many, many, many different brands of composite fillings that have different properties. Here at Abbott Family Dentistry, LLC we evaluate the properties of the filling to find a quality product that provides both good aesthetics and durability. Think of it as different tiers of quality with the top tier being comprised of about 5 or 6 different brands. I have used most of the top tier brands and primarily have used Filtek Supreme Ultra which has consistently been a top rated material. All of these composites share a common chemical structure that simply put is a type of acrylic.
Then along comes Ormocer, a direct ceramic restorative material. My practice started using Ormocer technology because there are some physical properties Dr. Pierson likes when comparing this new material to traditional composite fillings. The agent that makes it turn to a solid when the light hits the material is called the monomer. The monomer in the new Ormocer material sets more completely which means there is less chance of bio-reactivity and the company claims it resists stain better too. To be honest, gum tissue reacting to the composite has not been a big problem but Dr. Pierson has seen it happen. Ormocer type fillings are reported to be more biocompatible. Additionally, in testing, this material holds up as well as the top tier composites. It does not cost more and is placed the same way as composites so from your perspective you won't notice the difference.
The use of silver/mercury amalgam fillings has become a political hot potato in dentistry. I actually had a dentist say that he thought it was malpractice to place a tooth colored filling on a back tooth. I have heard another dentist say that silver/mercury amalgam metal fillings are poison. Well........ I will tell you what I think. Silver fillings do have mercury in them. The FDA did change the classification of the material to a schedule II medical device and recommends that we consider other filling options on children under 5 and on pregnant women. For the rest of us it is thought to be safe and I agree with this. Let's be realistic, it has been used for over 100 years and people are not dropping dead. Then again, we are finding that trace amount of harmful things may hurt us in ways not previously conceived of. Having a cheaper alternative that works is what the silver filling offers, well at least that used to be the case. Metal prices have gone up so the cost of the silver fillings have too. Additionally, the government has set a deadline for requiring special plumbing that will capture this mercury containing material so it does not go into the sewage system. This special plumbing is good for the environment but does increase the cost of providing the silver filling. Basically, as time goes by the silver filling can't really be said to have a lower cost so why use it? Some dentist think it will last longer. Others say not so. From my experience, I find that the longevity of the two types of fillings is about the same, (this is assuming that if you brush and floss and don't bath your teeth in sugar and acidic food and beverages). Silver fillings conduct temperature so you are more likely to have tooth sensitivity than if you get a tooth colored filling. Basically, the only time I prefer the silver filling over a tooth colored one is when I have to drill though a metal crown to do a root canal and when finished the hole in a metal crown is better repaired with a metal filling than a tooth colored one.
Insurance companies often down grade your benefit to what they would pay for a silver filling when you get a tooth colored filling. You just need to be aware of this fact. What I don't like is that the FDA says consider other alternatives for children and pregnant women but the insurance company still down grades the benefit for these people. I say stand up and let them know this is not right! Really, call your human resources department and your insurance company and ask why they insist a material that the FDA says should not be used be the material of choice!
Abbott Family Dentistry, LLC
1601 Abbott Road, Suite 102, Anchorage, AK 99507 US
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