If you’ve ever been told you have a cavity, you know what comes next: getting a filling. There are four main types of filling materials, and every type has their own specific advantages and disadvantages. Ahead, we'll break down the differences between the filling materials, as well as the pros and cons of each!

Amalgam Fillings

Amalgam fillings have been used for nearly 150 years, and have been the tried and true dental filling material for nearly as long. Amalgam fillings are made of a mixture of metals including liquid (elemental) mercury and a powdered alloy of silver, tin and copper. Though the popularity of amalgam fillings have waned in favor of natural-looking composite fillings, amalgams are still widely used due to their reliability, affordability, and durability.

Pros and Cons of Amalgam Fillings

Pros

• The most affordable and inexpensive tooth filling option
• Applied quickly in a single dentist visit
• Durable and long-lasting – with proper care, can last 10-15 years.

Cons

• Very visible, most patients find the color unsightly
• Not suitable for front teeth
• Expand and shrink in extreme temperatures, which may cause damage to teeth over time
• Corrode and darken over time
• Although the amount of mercury in amalgam fillings is regulated and deemed safe by the ADA and FDA, some still find the use of mercury concerning.

Composite Fillings

Composite fillings are the most popular type of filling material used today, due to their natural appearance combined with fair durability and cost. They are made of a “composite” of silica, powdered glass, or other ceramic particles in an acrylic resin base, and custom-matched to your natural tooth color. After your dentist thoroughly removes and cleans away the decay from your tooth, they will apply the composite resin in layers directly to the tooth. A special blue light is also applied to cure the resin, which helps it bond with the tooth and makes the material harder and more durable. The result is very natural looking, and the entire procedure is easily completed in one visit.

Applying a composite filling takes longer than an amalgam filling, but is still completed in a single, simple office visit. The procedure is virtually painless, does not require excess removal of tooth enamel, and most patients don’t require any anesthesia.

Pros and Cons of Composites

Pros

• Affordable
• Applied in a single, simple office visit (about 30 minutes or less per tooth)
• Does not expand or shrink in extreme temperatures (unlike amalgam)
• Great aesthetics, custom-matched to your natural tooth color

Cons

• Composites will eventually stain over time
• Not as durable as amalgam - more prone to breaking and wearing down from biting/chewing forces
• Not as long-lasting – though with proper care, can still last 5-10 years.

Gold Fillings

Gold fillings adhere strongly to tooth structure and are highly biocompatible with gum tissue. They are usually composed of about 75% gold combined with about 25% other metals (like silver or palladium) to increase durability. They are extremely resistant to wear and fracture, and do not wear away opposing teeth.

Gold fillings require more than one office visit to place because they need to be crafted by a dental lab from an exact mold of your teeth. Prized since ancient times as a symbol of wealth, gold fillings have also waned in popularity in recent decades in favor of more natural looking, tooth-colored composite fillings.

Pros and Cons of Gold Fillings

Pros

• Highly biocompatible
• Will not wear down opposite teeth
• Will not corrode or change color
• The most durable and longest lasting option – with proper care, can last 15-30 years.

Cons

• Not as many dentists offer gold fillings (compared with composite and amalgam)
• More expensive than amalgam or composite
• Typically requires two dentist visits to complete
• Quite visible (though this may be a “pro” for some who like the appearance of gold!)

Porcelain Fillings

Porcelain fillings belong in a specific category of dental restoration called “indirect fillings,” and are called “inlays” and “onlays.” They are typically only used for molars and premolars which have sustained too much damage to support a filling, but not so much damage that a crown is necessary.

The procedure for getting an inlay or onlay is similar to that of getting a gold filling, and typically takes two dentist visits. During the first, the dentist will remove the decay, make an impression of your mouth, send the mold to a dental lab to craft your custom porcelain inlay or onlay, and fit you with a temporary filling to protect the area. During the second visit, your dentist will remove the temporary filling, fit and cement the porcelain inlay or onlay into place, and make any necessary adjustments.

Porcelain inlays and onlays are shade-matched exactly to the shade of your natural teeth, and are quite strong and highly resistant to staining.

Pros and Cons of Porcelain (Indirect) Fillings

Pros

• Very natural appearance
• Very resistant to staining
• A good intermediary option between a filling and a crown.
• Quite durable and long lasting – up to 15-20 years or longer with proper care.

Cons

• Only used for molars and premolars with a specific amount of damage
• More costly (about the same as gold fillings)
• Must be completed in two separate dentist visits
• Natural teeth may stain and change color over time, appearing mismatched with the porcelain.