Dental Materials – Advantages & Disadvantages

PORCELAIN FUSED TO METAL GOLD ALLOY This type of porcelain is a glass- Gold alloy is a gold-colored like material that is “enameled” mixture of gold, copper, and other on top of metal shells. It is tooth- metals and is used mainly for colored and is used for crowns crowns and fixed bridges and The Facts and fixed bridges some partial denture frameworks Advantages Advantages About Fillings ❤ Good resistance to further ❤ Good resistance to further decay if the restoration fits well decay if the restoration fits well ❤ Very durable, due to metal ❤ Excellent durability; does not substructure fracture under stress ❤ The material does not cause ❤ Does not corrode in the mouth tooth sensitivity ❤ Minimal amount of tooth needs ❤ Resists leakage because it can to be removed be shaped for a very accurate ❤ Wears well; does not cause fit excessive wear to opposing teeth Disadvantages ❤ Resists leakage because it can • More tooth must be removed be shaped for a very accurate (than for porcelain) for the fit metal substructure • Higher cost because it requires Disadvantages at least two office visits and • Is not tooth colored; alloy is laboratory services yellow • Conducts heat and cold; may irritate sensitive teeth • High cost; requires at least two office visits and laboratory services

DENTAL BOARD OF CALIFORNIA 1432 Howe Avenue • Sacramento, California 95825 www.dbc.ca.gov DENTAL BOARD OF CALIFORNIA 1432 Howe Avenue • Sacramento, California 95825 Published by www.dbc.ca.gov CALIFORNIA DEPARTMENT OF CONSUMER AFFAIRS 5/04

The Facts About Fillings PORCELAIN NICKEL OR COBALT- Dental Materials Fact Sheet (CERAMIC) CHROME ALLOYS Porcelain is a glass-like material Nickel or cobalt-chrome alloys formed into fillings or crowns are mixtures of nickel and What About the Safety of Filling Materials? using models of the prepared chromium. They are a dark silver teeth. The material is tooth- metal color and are used for Patient health and the safety of dental treatments are the colored and is used in inlays, crowns and fixed bridges and primary goals of California’s dental professionals and the veneers, crowns and fixed most partial denture frameworks. Dental Board of California. The purpose of this fact sheet is to bridges. provide you with information concerning the risks and benefits Advantages of all the dental materials used in the restoration (filling) of Advantages ❤ Good resistance to further teeth. ❤ Very little tooth needs to be decay if the restoration fits removed for use as a veneer; well The Dental Board of California is required by law* to make more tooth needs to be re- ❤ Excellent durability; does not this dental materials fact sheet available to every licensed moved for a crown because its fracture under stress dentist in the state of California. Your dentist, in turn, must strength is related to its bulk ❤ Does not corrode in the mouth provide this fact sheet to every new patient and all patients of (size) ❤ ❤ Minimal amount of tooth needs record only once before beginning any dental filling procedure. Good resistance to further to be removed decay if the restoration fits well As the patient or parent/guardian, you are strongly encouraged ❤ Resists leakage because it can ❤ Is resistant to surface wear but to discuss with your dentist the facts presented concerning the be shaped for a very accurate can cause some wear on fit filling materials being considered for your particular treatment. opposing teeth * Business and Professions Code 1648.10-1648.20 ❤ Resists leakage because it can Disadvantages be shaped for a very accurate • Is not tooth colored; alloy is a Allergic Reactions to Dental Materials fit dark silver metal color ❤ Components in dental fillings may have side effects or cause The material does not cause • Conducts heat and cold; may tooth sensitivity allergic reactions, just like other materials we may come in irritate sensitive teeth contact with in our daily lives. The risks of such reactions are Disadvantages • Can be abrasive to opposing teeth very low for all types of filling materials. Such reactions can be • Material is brittle and can break caused by specific components of the filling materials such as under biting forces • High cost; requires at least two mercury, nickel, chromium, and/or beryllium alloys. Usually, office visits and laboratory • May not be recommended for services an allergy will reveal itself as a skin rash and is easily reversed molar teeth when the individual is not in contact with the material. • Slightly higher wear to • Higher cost because it requires opposing teeth There are no documented cases of allergic reactions to compos- at least two office visits and ite resin, glass ionomer, resin ionomer, or porcelain. However, laboratory services 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.

2 The Facts About Fillings 7 Dental Materials – Advantages & Disadvantages GLASS IONOMER RESIN-IONOMER CEMENT CEMENT Toxicity of Dental Materials Glass ionomer cement is a self- Resin ionomer cement is a Dental Amalgam hardening mixture of glass and mixture of glass and resin polymer organic acid. It is tooth-colored and organic acid that hardens with Mercury in its elemental form is on the State of California’s and varies in translucency. Glass exposure to a blue light used in Proposition 65 list of chemicals known to the state to cause ionomer is usually used for small the dental office. It is tooth reproductive toxicity. Mercury may harm the developing brain of fillings, cementing metal and colored but more translucent than a child or fetus. porcelain/metal crowns, liners, glass ionomer cement. It is most Dental amalgam is created by mixing elemental mercury (43- and temporary restorations. often used for small fillings, 54%) and an alloy powder (46-57%) composed mainly of silver, cementing metal and porcelain tin, and copper. This has caused discussion about the risks of Advantages metal crowns and liners. ❤ Reasonably good esthetics mercury in dental amalgam. Such mercury is emitted in minute amounts as vapor. Some concerns have been raised regarding ❤ May provide some help against Advantages decay because it releases ❤ Very good esthetics possible toxicity. Scientific research continues on the safety of dental amalgam. According to the Centers for Disease Control fluoride ❤ May provide some help against ❤ Minimal amount of tooth needs decay because it releases and Prevention, there is scant evidence that the health of the vast to be removed and it bonds fluoride majority of people with amalgam is compromised. well to both the enamel and the ❤ Minimal amount of tooth needs The Food and Drug Administration (FDA) and other public dentin beneath the enamel to be removed and it bonds health organizations have investigated the safety of amalgam ❤ Material has low incidence of well to both the enamel and the used in dental fillings. The conclusion: no valid scientific evi- producing tooth sensitivity dentin beneath the enamel dence has shown that amalgams cause harm to patients with ❤ ❤ Usually completed in one Good for non-biting surfaces dental restorations, except in rare cases of allergy. The World dental visit ❤ May be used for short-term Health Organization reached a similar conclusion stating, “Amal- Disadvantages primary teeth restorations gam restorations are safe and cost effective.” ❤ May hold up better than glass • Cost is very similar to compos- ionomer but not as well as A diversity of opinions exists regarding the safety of dental ite resin (which costs more composite amalgams. Questions have been raised about its safety in preg- than amalgam) ❤ Good resistance to leakage nant women, children, and diabetics. However, scientific evi- • Limited use because it is not ❤ Material has low incidence of dence and research literature in peer-reviewed scientific journals recommended for biting suggest that otherwise healthy women, children, and diabetics are surfaces in permanent teeth producing tooth sensitivity ❤ Usually completed in one dental not at an increased risk from dental amalgams in their mouths. • As it ages, this material may The FDA places no restrictions on the use of dental amalgam. become rough and could visit increase the accumulation of Composite Resin plaque and chance of periodon- Disadvantages tal disease • Cost is very similar to compos- Some Composite Resins include Crystalline Silica, which is on ite resin (which costs more than • Does not wear well; tends to the State of California’s Proposition 65 list of chemicals known amalgam) crack over time and can be to the state to cause cancer. • Limited use because it is not dislodged It is always a good idea to discuss any dental treatment recommended to restore the biting surfaces of adults thoroughly with your dentist. •Wears faster than composite and 6 amalgam 3 Dental Materials – Advantages & Disadvantages

DENTAL AMALGAM FILLINGS COMPOSITE RESIN FILLINGS Dental amalgam is a self-hardening mixture of silver-tin-copper alloy Composite fillings are a mixture of powdered glass and plastic resin, powder and liquid mercury and is sometimes referred to as silver sometimes referred to as white, plastic, or tooth-colored fillings. It is fillings because of its color. It is often used as a filling material and used for fillings, inlays, veneers, partial and complete crowns, or to replacement for broken teeth. repair portions of broken teeth. Advantages Disadvantages Advantages Disadvantages

❤ Durable; long lasting • Refer to “What About the ❤ Strong and durable • Refer to “What About the ❤ Safety of Filling Materials” Safety of Filling Materials” Wears well; holds up well to ❤ Tooth colored the forces of biting • Gray colored, not tooth colored ❤ Single visit for fillings • Moderate occurrence of tooth ❤ Relatively inexpensive • May darken as it corrodes; may sensitivity; sensitive to ❤ Generally completed in one stain teeth over time ❤ Resists breaking dentist’s method of applica- visit • Requires removal of some tion ❤ Maximum amount of tooth healthy tooth ❤ Self-sealing; minimal-to-no preserved • Costs more than dental shrinkage and resists leakage • In larger amalgam fillings, the amalgam ❤ Small risk of leakage if bonded ❤ remaining tooth may weaken Resistance to further decay is only to enamel • Material shrinks when high, but can be difficult to and fracture ❤ hardened and could lead to find in early stages • Because metal can conduct hot Does not corrode further decay and/or tempera- and cold temperatures, there ❤ Frequency of repair and ❤ Generally holds up well to the ture sensitivity replacement is low may be a temporary sensitivity to hot and cold. forces of biting depending on • Requires more than one visit product used • Contact with other metals may for inlays, veneers, and cause occasional, minute ❤ Resistance to further decay is crowns electrical flow moderate and easy to find • May wear faster than dental ❤ Frequency of repair or replace- enamel ment is low to moderate • May leak over time when bonded beneath the layer of he durability of any dental restoration is enamel Tinfluenced not only by the material it is made from but also by the dentist’s technique when placing the restoration. Other factors include the supporting materials used in the procedure and the patient’s cooperation during the procedure. The length of time a restoration will last is dependent upon your dental hygiene, home care, and diet and chewing habits.

4 The Facts About Fillings 5