Dental Fillings: How to Choose.
Once lost due to decay or trauma, dental tissue does not regenerate. To restore normal chewing function and aesthetics, various treatments can be undertaken, such as dental fillings.
If the cavity created by decay is small, the treatment is called a filling; if the cavity is extensive and includes an aesthetic area or one involved in chewing function, it is called a “reconstruction”.
The dentist has many materials with different properties to replace the lost tooth portion.
Dental fillings that we can find in our mouths are either metallic or the same color as the tooth, thus aesthetic.
Materials for Dental Fillings
Metallic materials are gradually being replaced by aesthetic materials for several reasons:
- Aesthetics
The dark color of the metal is especially evident on teeth shown in a smile, making the filling impossible to camouflage.
- Invasiveness
Metal does not adhere adhesively to the tooth but must be retained inside, as if set in place.
This implies that more tooth material must be removed for the filling than dictated by the actual shape of the decay or chipped tooth, but by the retention needs of the material.
The tooth is consequently weakened, with internal micro-fractures that are difficult to diagnose, causing pain primarily during chewing and to thermal stimuli.
These fractures can also reach the nerve, leading to devitalization, or extend to the roots, causing tooth loss.
- Reactions of Mucous Membranes and Gums
This material may not be well tolerated by the body, generating a reaction in gums and mucous membranes (lichenoid reaction) that often resolves once the filling is replaced. Sometimes it is associated with a pre-cancerous lesion such as Oral Lichen Planus.
Furthermore, the metal can leave a permanent gray-blue mark on surrounding tissues, known as “amalgam tattoo”.
- Toxicity
The Harms of Metal Dental Fillings
Currently, although the scientific community does not unanimously agree on their actual toxicity, there are many elements in the literature to consider these materials potentially dangerous to health.
To reinforce this, it’s worth noting that in Scandinavian countries its use is now banned, and the World Health Organization prohibits its application in patients under 15 and in pregnant or breastfeeding women.
This invites careful reflection.
- Environmental Impact
The problem of the environmental toxicity of heavy metals is not to be underestimated, so much so that the European Union is considering undertaking a plan to definitively dispose of this material.
Aesthetic Adhesive Fillings
Thus, aesthetic adhesive fillings are preferable and advantageous mainly for two reasons:
- Aesthetics
The infinite combinations of color allow for a completely mimetic restoration that adapts to the great variability of colors found in nature.
- Minimally Invasive
The material adheres to the tooth through an adhesive bond, perfectly fitting the shape of the cavity to be restored without the need for removal of additional healthy dental tissue.
The listed advantages and patient satisfaction in receiving a filling that blends and harmonizes with their smile make it clear that adhesive materials are the ones we will continue to prefer in the future.
