Q: What types of cavity filling materials are available now? Do I have a choice?

A: Modern dental materials and techniques have allowed the patient and dentists to have numerous choices in creating pleasing and natural-looking smiles. The two major types of dental restorative materials available are amalgam and bonded restorations. Amalgam ('silver' filling material) has been used in dentistry for over 100 years.

While many question its safety, the major U.S. health organizations and international scientific organizations have been satisfied that dental amalgamn is a safe and effective restorative option. scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material. Its disadvantages relate primarily to esthetics and the fact that more tooth stucture may need to be removed for an amalgam restoration.

Bonded or composite fillings are tooth colored. Less tooth structure often needs to be removed for a bonded restoration because they are adhesively retained with the bonding procedure and are thus often a more conservative restoration. It generally takes longer and is more technique sensitive to place a bonded restoration, so they may be more expensive. Bonded restorations tend to discolor over time and the patient may experience more thermal sensitivity with a bonded restoration. Not all insurance companies cover the cost of bonded restorations for back teeth, considering them cosmetic in nature, so the patient must be aware that the co-payment is often greater for a bonded restoration on a back tooth. They are, however, far more esthetic and natural looking in appearance.