Research Shows Decline of Silver Filling

Main Category: Dentistry
Article Date: 24 Apr 2005 - 0:00 PDT


A new array of dental materials -- many of them tested at Creighton's internationally acclaimed Center for Oral Health Research -- is offering patients more options than ever. Will this new crop of materials spell the end for the old, reliable silver filling?

No longer is the silver amalgam the only option in the dentist's armamentarium for filling cavities. Recent advances in polymers (plastics) have made possible filling materials nearly as strong as silver and formulated to match the color of teeth.

Tooth-colored fillings, termed "composite resin," are placed using a special dental adhesive and literally "bonded" to the tooth, often minimizing the amount of tooth that needs to be removed. These more conservative cavity preparations can lead to lengthening the life of the filling and the tooth itself.

The research program at Creighton's School of Dentistry has been focused on evaluating dental materials used in daily dental practice for 20 years. It has featured an emphasis on translating the results of research into improved teaching and clinical practice and better patient care.

Dental decay is still a widespread finding in children and adults and is considered pandemic in children. For children, cavities are a common problem that begins at an early age.

Given the growing need for dental care, especially among economically disadvantaged children and families, the loss of silver amalgam as a cost-effective option could adversely affect the health of millions of Americans. Particularly in young children, where moisture control might prevent using composite resin, silver amalgam may represent the best way of treating a decayed tooth and helping to maintain the oral health of the child.

The Center for Oral Health Research in the School of Dentistry enjoys a national and international reputation as a leading research institution in dental materials, especially dental adhesives and composite resin fillings. As a result, many large dental corporations seek Creighton faculty input for product development and sponsor-funded research at the school. The center is used for coordinating laboratory and clinical trials of new dental materials and devices and innovative treatment techniques.

Creighton has been a leading academic center in providing the clinical evidence that tooth-colored fillings are suitable alternatives to silver amalgam. Creighton research also has documented the effectiveness of the latest generation of dental adhesives. However, this does not mean that silver amalgam is outdated, nor should it be retired from service. Silver amalgam may still be a material of choice in very large fillings where it can resist biting forces better than composite resin. Also the materials for placing a composite resin are more expensive and take more time to place successfully.

While there have been many reports in the press of the potential harmful effects of dental amalgam, there is no scientific basis for any disease or illness that has been ascribed to this filling material.

In many situations, dentists and patients prefer composite resin materials. When aesthetics are of prime concern and cost is not a significant factor in the treatment planning decisions, modern composite resins and adhesives can produce a long-lasting restoration.

However, despite the progress made in composite resin materials, silver amalgam is still considered the most cost-effective material for numerous clinical situations.

The Creighton University School of Dentistry is celebrating its 100th anniversary in 2005. The first class was held Oct. 2, 1905, at the Creighton Institute in downtown Omaha. The Institute was funded by a $140,000 gift from Creighton benefactor John A. Creighton.

Mark Latta, D.M.D., M.S., associate dean for dental research and professor of general dentistry at Creighton University School of Dentistry wrote this article. His personal research interests include prosthetic dental restorative materials, adhesives and bonding and dental material clinical trials.

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