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Know Your Options When Filling Cavities

Cavities seem to be a fact of life for most. Nearly 78 percent of Americans have had at least one by age 17, according to the American Dental Hygienists’ Association.

There are a few methods for treating cavities, depending on their severity. Fillings are most often the solution. First, the dentist drills the tooth to remove the decay. Then, he or she fills the area with material to prevent further damage.

Dental fillings through time

Throughout history, various materials were used to repair teeth. They included turpentine, resin, gum, metal, and stone chips, according to’s "History of Dentistry and Dental Care.” Pierre Fauchard, an 18th century French physician, is known for introducing lead foil and tin cylinders as dental fillings—as well as improving the drill.

More modern dental fillings, known as amalgams, came to the United States in the mid 1800s. They consisted of mercury and silver—and quickly became controversial due to concerns about harmful exposure to mercury. That controversy continues today, with the American Dental Association maintaining that such dental restorations are safe.

Modern restoration options

Today, several options exist depending on your dentist’s recommendation, your insurance coverage, and the extent of your tooth’s decay. They commonly include the following:


These are the standard, “silver” fillings that come to mind when we think of cavities. Amalgam fillings are a metal mixture consisting of liquid mercury and a powdered alloy composed of silver, tin, and copper, according to the Food and Drug Administration. They are often used to fill molars.

Their strength, lasting power and affordability make them an attractive and popular option. However, some individuals have mercury allergies, which make amalgam a poor choice. Concerns over mercury exposure scare others away from amalgam. The FDA and ADA stand by these fillings as safe for adults and children 6 and older.

Additional drawbacks include short-term tooth sensitivity to hot and cold as a result of these restorations and how noticeable they can be when speaking or laughing.


Gold filling options include cast gold and gold foil. Cast gold is an alloy used for inlays, onlays, and crowns; gold foil is used for small fillings in areas used for light chewing and to repair crowns, according to Colgate.

They may last longer than amalgam and boast similar strength, but gold fillings can cost 10 times as much and require two trips to the dentist’s office. Even though some prefer their color, they are still quite visible.


Those looking for dental restorations that blend in prefer composite resin. These fillings are made of tooth-colored plastic and glass mixture. According to the ADA, they are bonded to a cavity, which means less tooth structure is removed, and are generally placed on front or back teeth for small- to mid-size cavities.

Composites take longer to apply and can cost up to two times more than amalgam. The Academy of General Dentistry reports that their continued improvement means more insurance companies are likely to increase coverage, but typical benefits involve the patient paying the difference.

Fillings can last a decade or more, but they sometimes need to be replaced due to wear, additional decay, discoloration, cracking or loss. Lifestyle habits such as clenching and grinding can harm dental restorations. Practicing good oral hygiene will help your fillings last. Be sure to visit your dentist for regular checkups to keep an eye on their condition.

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