Boy…are there some misunderstandings and controversy out there! We are definitely a cosmetic practice, but there are some important facts and opinions I’d like to share with you.

In guiding patients to make good choices in restoring their teeth, I counsel people this way: If the majority, or over 50% of the tooth, is still intact, then a filling may be appropriate. I relate to patients how my dentist, back in 1958, placed seven amalgam fillings in my teeth…and I still have five of them. That’s over 46 years! The American Dental Association still endorses and recommends the use of this workhorse material after more than a hundred years of use, and millions of fillings placed. They also state there is NO evidence in their opinion of mercury poisoning from its usage in human teeth.

The other filling choice is tooth colored composite filling material. It is a blend of barium, glass and quartz crystals in a resin (plastic) base that has gotten stronger, more durable and stain resistant due to advances in the material itself over the years. When placed on front teeth with only biting pressures, the life expectancy is perhaps 15 years; but maybe half that time if placed on back teeth exposed to chewing pressure. The cost of these composite fillings is approximately 1 1/2 times as much due to the higher cost of the material, and the fact that is takes longer to place when done properly. Also, patients should know that the dental insurance companies will only pay benefits toward the amalgam fillings, and the patient has to pay the difference for the composite filling. The question I pose to patients, expressed as openly as I can is, “Are you willing to pay for a filling that looks more natural and costs more, but may last for a considerably shorter time?”

When there is a great deal of tooth loss, and it goes from putting “a filling in the tooth to putting a filling on the tooth,” that’s when we consider a Porcelain tooth-colored onlay or crown that covers the entire chewing surface of the tooth, and is more protective and durable. Porcelain is a form of glass, not plastic, and typically takes two appointments and is a good deal more expensive.

Porcelain restorations may chip or break just as enamel may chip or break on a natural tooth, but porcelain is much more durable and cosmetic than plastic when restoring back, chewing teeth. (See our lifetime warranty.)

So, what is best…and what do you need…and what might you want and eventually choose? Ask Dr. Gillespie or Dr. Ryerson for their recommendation, and make up your own mind.