Dental Material Fact Sheet
What about the Safety of Filling Materials?
Patient health and the safety of dental treatments are the primary goals of California’s dental professionals and the Dental Board of California. The purpose of this fact sheet is to provide you with information concerning the risks and benefits of all the dental materials used in the restoration (filling) of teeth.
The Dental Board of California is required by law* to make this dental materials fact sheet available to every licensed dentist in the state of California. Your dentist, in turn, must provide this fact sheet to every new patient and all patients of record only once before beginning any dental filling procedure.
As the patient or parent/guardian, you are strongly encouraged to discuss with your dentist the facts presented concerning the filling materials being considered for your particular treatment. *Business and Professions Code 1648.10-1648.20
Allergic Reactions to Dental Materials
Components in dental filling may have side effects or cause allergic reactions, just like other materials we may come in contact within our daily lives. The risks of such reactions are very low for all types of filling materials. Such reactions can be caused by specific components of the filling materials such as mercury, nickel, chromium, and/or beryllium alloys. Usually, an allergy will reveal itself as a skin rash and is easily reversed when the individual is not in contact with the material.
There are no documented cases of allergic reactions to composite resin, glass ionomer, resin ionomer, or porcelain. However, there have been rare allergic responses reported with dental amalgam, porcelain fused to metal, gold alloys, and nickel or cobalt-chrome alloys.
If you suffer from allergies, discuss these potential problems with your dentist before a filling material is chosen.
Toxicity of Dental Materials
Dental amalgam is created by mixing elemental mercury (43-54%) and an alloy powder (46-57%) composed mainly of silver, tin, and copper. This has caused discussion about the risks of mercury in dental amalgam. Such mercury is emitted in minute amounts as vapor. Some concerns have been raised regarding possible toxicity. Scientific research continues on the safety of dental amalgam. According to the Centers for Disease Control and Prevention, there is scant evidence that the health of the vast majority of people with amalgam is compromised.
A diversity of opinions exists regarding the safety of dental amalgams. Questions have been raised about its safety in pregnant women, children, and diabetics. However, scientific evidence and research literature in peer-viewed scientific journals suggest that otherwise healthy women, children, and diabetics are not at an increased risk from dental amalgams in their mouths. The FDA places no restrictions on the use of dental amalgam.
Some Composite Resins include Crystalline Silica, which is on the State of California’s Proposition 65 list of chemicals known to the state to cause cancer.
It is always a good idea to discuss any dental treatment thoroughly with your dentist
Dental Materials- Advantages & Disadvantages
Fillings Dental Amalgam is a self-hardening mixture of silver-tin-copper- alloy powder and liquid mercury and it’s sometimes referred to as silver fillings because of its color. It is often used as a filling material and replacement for broken teeth.
Durable; long-lasting, wears well; holds up well to the forces of biting, relatively inexpensive, generally completed in one visit, self-sealing; minimal-to-no shrinkage and resists leakage, resistance to further decay is high but can be difficult to find in early stages, and frequency of repair and replacement is low.
Refer to “What About the Safety of Filling Materials”, gray-colored, not tooth-colored, may darken as it corrodes; may stain teeth, requires removal of some healthy tooth, remaining tooth may weaken and fracture, temporary sensitivity to hot and cold, and contact with other metals may cause occasional, minute electrical flow.
Composite Resin Fillings
Composite fillings are a mixture of powdered glass and plastic resin, sometimes referred to as white, plastic, or tooth-colored fillings. It is used for fillings, inlays, veneers, partial and complete crowns, or to repair portions of broken teeth.
Strong and durable, tooth-colored, single visit for fillings, resists breaking, maximum amount of tooth preserved, small risk of leakage if bonded to enamel, does not corrode, hold up well to the forced of biting, resistance to further decay is moderate and easy to find, frequency of repair or replacement is low to moderate.
Refer to “What About the Safety of Filling Materials”, moderate occurrence of tooth sensitivity, costs more than dental amalgam, material shrinks when hardened and could lead to further decay or temperature sensitivity, requires more than one visit for inlays, veneers, and crowns, may wear faster than dental enamel and may leak over time when bonded beneath the layer of enamel.
Glass Ionomer Cement
Glass ionomer cement is a self-hardening mixture of glass and organic acid. It is tooth-colored and varies in translucency. Glass ionomer is usually used for small fillings, cementing metal and porcelain/metal crowns, liners, and temporary restorations.
Reasonably good esthetics, may provide some help against decay because it releases fluoride, minimal amount of tooth needs to be removed and it bonds well to both the enamel and the dentin beneath the enamel, material has low incidence of producing tooth sensitivity, and usually completed in one dental visit.
Cost is very similar to composite resin, limited use because it is not recommended for biting surfaces in permanent teeth, as it ages, this material may become rough and could increase the accumulation of plaque and chance of periodontal disease, and does not wear well; tends to crack over time and be dislodged.
Cement Resin ionomer cement is a mixture of glass and resin polymer and organic acids that hardens with exposure to a blue light used in the dental office. It is tooth-colored but more translucent than glass ionomer cement. It is most often used for small fillings, cementing metal and porcelain metal crowns and liners.
Very good esthetics, may provide some help against decay because it releases fluoride, minimal amount of tooth needs to be removed and it bonds well to both the enamel and the dentin beneath the enamel, good for non-biting surfaces, may be used for short-term primary teeth restorations, may hold up better than glass ionomer but not as well as composite, good resistance to leakage, material has low incidence of producing tooth sensitivity, and usually completed in one dental visit.
Cost is very similar to composite resin (which costs more than amalgam), Limited use because it is not recommended to restore the biting surfaces of adults, and wears faster than composite and amalgam.
Porcelain is a glass-like material formed into fillings or crowns using models of the prepared teeth. The material is tooth-colored and is used in inlays, veneers, crowns, and fixed bridges.
Very little tooth needs to be removed for use as a veneer; more tooth needs to be removed for a crown because its strength is related to its bulk (size), good resistance to further decay if the restoration fits well, is resistant to surface wear but can cause some wear on opposing teeth, resists leakage because it can be shaped for a very accurate fit, and the material does not cause tooth sensitivity.
Material is brittle and can break under biting forces, may not be recommended for molar teeth, and higher cost because it requires at least two office visits and laboratory services.
Nickel or Cobalt-Chrome Alloys
Nickel or cobalt-chrome alloys are mixtures of nickel and chromium. They are dark silver metal color and are used for crowns and fixed bridges and most partial denture frameworks.
Good resistance to further decay if the restoration fits well, excellent durability; does fracture under stress, minimal amount of tooth needs to be removed, and resists leakage because it can be shaped for a very accurate fit.
Is not tooth-colored; alloy is a dark silver metal color, conducts heat and cold; may irritate sensitive teeth, can be abrasive to opposing teeth, high cost; requires at least two office visits and laboratory services, and slightly higher wear to opposing teeth.
Porcelain Fused to Metal
This type of porcelain is a glass-like material that is “enameled” on top of metal shells. It is tooth-colored and is used for crowns and fixed bridges.
Good resistance to further decay if the restoration fits well, very durable, due to metal substructure, the material does not cause tooth sensitivity and resists leakage because it can be shaped for a very accurate fit.
More tooth must be removed (then for porcelain) for the metal substructure, and higher cost because it requires at least two office visits and laboratory services.
Gold Alloy is a gold-colored mixture of gold, copper, and other metals and is used mainly for crowns and fixed bridges and some partial denture frameworks.
Good resistance to further decay if the restoration fits well, excellent durability; does not fracture under stress, does not corrode in the mouth, minimal amount of tooth needs to be removed, wears well, resists leakage because it can be shaped for a very accurate fit.
Is not tooth-colored; alloy is yellow, conducts heat and cold; may irritate sensitive teeth, and high cost; requires at least two office visits and laboratory services.
DENTAL BOARD OF CALIFORNIA
1432 Howe Ave. Sacramento, California 95825
CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS
The Facts about Fillings
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