Procedures

While some dentists still place silver mercury amalgam fillings, Dr. Highsmith doesn't use that material. Dr. Highsmith has not placed a silver mercury amalgam filling in over fifteen years! They believe there are better materials to use for repairing teeth.

A composite resin is a tooth colored mixture of acrylic resin and ceramic filler particles. Introduced in the 1960s, dental composites were confined to the front teeth because they were not strong enough to withstand the pressure and wear generated by the back teeth. Since then, composites have been significantly improved and can be successfully placed for smaller restorations in the back teeth as well. Composites are not only used for restoring decay, but are also used for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Following preparation, the dentist places the composite in layers, using a light specialized to harden each layer. When the process is finished, the dentist will shape the composite to fit the tooth. The dentist then polishes the composite to prevent staining and early wear. Several steps are necessary to bond the material to the tooth.

Because a composite is more difficult to place than silver fillings, it takes the dentist about 10-20 minutes longer to place. Placement time depends on the size and location of the cavity.

Prices vary, but composites average about two times the price of a silver filling. Most dental insurance plans cover the cost of the composite up to the price of a silver filling, with the patient paying the difference. As composites continue to improve, insurance companies are more likely to cover the cost of composites.

Esthetics are a big advantage, since dentists can blend shades to create a color nearly identical to that of the actual tooth. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulate the tooth from excessive temperature changes.

Other than being a black filling versus a white one (most people don't want black teeth), the biggest difference is that the composite bonds to the tooth and the amalgam does not. Whenever an amalgam is placed into a tooth, the tooth is weakened. After a time, the part of the tooth that is holding in the amalgam starts to crack and break. When the dentist uses magnification and extra light to remove the amalgams, he can see the problems underneath. The vast majority of amalgam fillings that we remove have decay (cavity) underneath, as well as fracture lines in the dentin of the tooth. For this reason, as well as others, we have chosen to have an amalgam free practice. There have not been any amalgams placed in this practice in over fifteen years! We would rather make teeth stronger than weaker.

Not always. The material is best used in small cavities, especially those that do not go in between the teeth. The material is not as strong as gold or porcelain, so it does not hold up well when it replaces a large portion of the tooth. Sometimes gold or porcelain is a much better choice.