Advantages, disadvantages and costs of dental fillings

Basically, it is up to the patient which tooth filling material he chooses. However, some crucial factors play a role here, which should be discussed with the dentist in charge. Costs are of course an important issue.

If caries eats a hole in the tooth, the defective tooth substance must be removed with the drill and the cleaned cavity (hole in the tooth) must be filled in to prevent tooth decay and thus tooth loss. There are various materials for this. Everyone has their advantages and disadvantages. In addition to durability, resilience and aesthetics, the cost factor also often plays an important role when it comes to choosing the right tooth filling. The health insurance companies do not cover the bill for everyone. Here is a brief overview:

amalgams

Amalgam has been used in dentistry for more than 100 years and is a mixture of copper, silver, tin and possibly also zinc, mixed with different amounts of mercury.

The main advantages of amalgam fillings are their long durability and perfect fit, as they can be inserted and adjusted directly by the dentist into the tooth defect. In addition, allergies to the metal mixture occur less frequently than with plastics. Not to be scoffed at either: the mercury alloy is quite chew-resistant and usually lasts for at least ten years.

One obvious disadvantage of amalgam is its (silver) gray color, which makes it undesirable for aesthetic reasons in the area of ​​the front teeth. Therefore, its use is mostly limited to the molar region – where there is high pressure due to chewing.

Another possible flaw: Since amalgam contains the toxic metal mercury, discussions about its potential harm to health flare up again and again. Therefore, some of the patients reject such fillings. They fear that the mercury will come out of the seals in the organism – e.g. in the kidneys – accumulates and makes you sick (e.g. headache, depression, visual disturbances). However, there is no clear scientific evidence for this.

The costs for the inexpensive amalgam fillings are borne entirely by the Austrian health insurers.

Plastic fillings

Plastic fillings (composites) consist of a mixture of substances – e.g. made of glass particles and methacrylates (plastics). They are in a soft (kneading-rubber-like) and thus processable state. After they have been inserted into the tooth defect, they harden using UV radiation.

Since plastic fillings are made in shades similar to natural teeth, they can be adapted to the existing tooth substance and are hardly distinguishable in terms of color. Therefore, from an aesthetic point of view, they are the ideal filling material for the front and side area of ​​the bit.

It is not so good for their durability. Their "life expectancy" is only about four to eight years. Then they have to be renewed. In addition, when they harden, they are subject to a shrinking process, which creates gaps between the filling and the tooth structure, which can encourage caries to form again.

Another danger: plastic mixtures call – more often than other filling materials – allergic reactions such as Pinchy skin, nodules in the oral cavity or respiratory tract infections. This applies to both patients and dentists. The potential allergens such as e.g. Formaldehyde when the dentist places the plastic mix in the drill holes of the teeth. Hardened plastic fillings – like amalgam – should also constantly release small amounts of their ingredients. An allergy test before using it therefore seems advisable.

The costs for the inexpensive, aesthetically pleasing, but rather short-lived fillings are only taken over by the health insurers if they are placed in the front or side tooth area or if there is a proven allergy to other fillers (e.g. amalgam). Plastic fillings in Austria cost between 60 and 200 euros.

Gold or ceramic inlays

Inlays (filling inlays) are used for larger holes in the teeth. They mostly consist of gold in various alloys or ceramics, but porcelain and glass inlays are also used. Unlike amalgam or composite fillings, inlays (filling inserts) are not simply placed in the tooth defect. They must first be made by the dental technician in the dental laboratory using a dentist-approved impression before the dentist fits the molded block with special adhesive or dental cement in a second session. Inlays serve to “repair” holes in the posterior region. Especially when a defect is too extensive for a composite filling. Prerequisite: The tooth walls must still have a certain minimum thickness after the hole has been drilled out, so that the forces generated during chewing movements do not cause the tooth to break.

The advantage of inlays is above all in their longevity, and in the materials that match the tooth shade (e.g. porcelain) also in aesthetics. For example, gold inlays – well-maintained, of course – can last a lifetime, since their filling edges can be adjusted to a wafer-thin size, which enables optimum marginal sealing. In addition, insoles are generally very well tolerated by the body, i.e. hardly any allergen.

However, the use of inlays is relatively expensive. Depending on the material and the cost of the treatment, up to 3,000 euros can be incurred per tooth. The health insurance companies do not assume any costs for this.

The expenditure for the respective dental treatment is generally based on the fee guidelines published by the Dental Association and updated annually. However, one thing applies to all tooth fillings: Regardless of the material and price, fillings must be replaced if they have become brittle or unsightly or if caries has formed between them and the tooth.

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