Today the majority of fillings both on anterior and posterior teeth are composite or “white fillings”. There are a few reasons for a shift away from amalgam or” silver fillings”. These include:

  • Cosmetic reasons with the majority of people preferring the colour match of the white fillings.
  • A more conservative filling. Due to the bonding properties of white fillings, we can remove less sound tooth structure. As a result this does not weaken the tooth as much and reduces the incidence of later fracture. The size of the area of decay is relevant in determining the size of the filling and early detection is more important than ever.
  • A restoration free of mercury and heavy metals.
  • The reparability of white fillings

It is important to note that at this point research conducted by the scientific community has concluded that there is no serious health risks associated with mercury containing fillings.  In general its removal has not been shown to have any beneficial effects on a patient’s specific medical condition. There is an increasing awareness of the environmental issues with mercury and concern with possible health effects. .Although the strength of white fillings and placement technique has improved recently, they still have limitations. Teeth with larger cavities would be better restored with ceramic crowns or overlays.

It is also important to be aware that composites also contain chemicals that are being questioned as to their safety. They are more technique sensitive, take longer to place and are more expensive than amalgam restorations. It is important for all patients to determine for themselves the type of restoration with which they would be more comfortable.  Clinical circumstances will sometimes exclude the use of standard restorative materials.


Crowns are laboratory made restorations used to protect a weakened tooth from fracturing further. They completely surround the prepared tooth. They are usually recommended in the following situations: Root treated teeth, heavily restored teeth and can also be used to improve the cosmetics of teeth, matching the shape and colour of the existing teeth. Crowns are manufactured from many different materials including:

  • All ceramic – used when appearance is critical
  • Gold – used only on the very back teeth when space is limited.
  • Porcelain fused to metal – not as popular these days.
  • Bridges are used to replace missing teeth. The adjacent teeth are prepared for crowns. The laboratory made bridge is manufactured in one piece and is cemented onto the prepared adjacent teeth.

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