Gold Fillings and Porcelain Alternatives

When are gold fillings and other alternatives like porcelain needed to fix a tooth?  This page will help answer that question for you.

In cases of a lot of damage to a tooth due to extensive decay, fracture or other damage, a normal filling (such as amalgam or composite) may not give a good long-term option.

Such a tooth may need/benefit from:

  • An inlay/onlay.  See indirect fillings below.
  • A crown.
  • A veneer.
  • Root canal treatment.  In the case of nerve damage to the tooth, this is needed before the outer part of the tooth is repaired.

 

Image of gold fillings inlays

Gold inlays (indirect fillings) made up on a dental cast

Indirect Fillings

Amalgam and composite fillings are placed directly into the tooth, they are ‘direct’ fillings.

Another type of filling is an ‘indirect’ filling.  Here the filling is made outside the mouth using a mold (or scan) of the tooth.  It is then fitted later.  They have the advantage of being stronger than direct fillings so can last longer, especially when the filling is large.

Indirect fillings are one of  either:

  • Inlays. These lie within the tooth.
  • Onlays.  These extend to cover some of the outer part of the teeth.

Indirect fillings can be made from composite, gold or a ceramic (such as porcelain).

 

Gold Fillings

Gold as a filling material in teeth has a history stretching back many years.  While it has been super-ceded by modern filling materials gold fillings still retain some uses in dentistry.  Gold is mixed with other metals in various quantities to form a gold alloy which is used on teeth for gold fillings.

Gold can be used on most surfaces of teeth but predominantly used for:

  • Inlays, i.e. gold fillings.  As an alternative to a regular filling.
  • Onlays.  To cover larger areas of tooth damage.
  • Crowns.

 

Gold fillings can be used to fill front teeth, but this use will vary with cultural and personal tastes.

As with the other types of filling materials, gold fillings will have pros and cons: 

Advantages of Gold:

  • The main advantage with gold is its strength and durability.  It is the most long-lasting filling material.  It can last for many years.
  • Gold fillings and crowns will not tarnish and discolour over time.
  • Aesthetically more pleasing than amalgam (according to personal taste).

 

Disadvantages of Gold:

  • Cost.  A gold filling is more expensive than other filling materials.
  • Time.  As gold fillings are made at the laboratory, it will take more than one visit to complete this treatment.
  • If placed next to an amalgam filling, one may experience discomfort in the form of ‘galvanic shock’.  This is a due to a small current being passed between the two materials.
  • Aesthetically less pleasing than white materials (according to your taste).

 

 

Porcelain for Fillings

Ceramics, most commonly porcelain, are an excellent material in terms of their aesthetic properties. Traditionally they have not been as strong as other materials such as gold.  However newer materials have been developed with excellent strength properties.

 

Uses of Porcelain As a Dental Material:

  • Inlays.  As an alternative to a regular filling.
  • Onlays.  To cover larger areas of tooth damage.
  • Crowns.
  • Veneers.

 

Let’s look at the pros and cons of using porcelain as a material for fillings:

Advantages of Porcelain

  • Excellent aesthetic properties to mimic natural teeth.
  • Do not stain as easily as white fillings.
  • Do not change colour over time.
  • A new tool is the use of CAD/CAM technology.  Here a machine produces the inlay/onlay using computer technology, so the treatment can be placed in one visit.

 

Disadvantages of Porcelain

  • Ceramics are not as strong as gold fillings.  They are more prone to fracture.  However newer materials are reducing this difference.
  • Cost.  A ceramic restoration is more expensive than a normal filling.
  • Time.  If made at the laboratory, it will take more than one visit to complete this treatment.
  • May need more tooth substance to be removed than as for another material.

 

 Summary

Gold fillings and ceramic are the main alternatives to the common amalgam or composite fillings.  They are useful when there is little of the tooth left to hold a filling.  Gold is used less and less for fillings.  New CAD/CAM technology is becoming a more common way of producing ceramic crowns and inlays for teeth.

 

Return to the main page on teeth fillings here.

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