As the name suggests it is an amalgam of metals, namely tin, silver, mercury and copper. It has been used as a filling material in dentistry for over 100 years. It is inexpensive and durable. The main issues with amalgam are its poor appearance and mercury content. Mercury is a heavy metal and is toxic. There are widely varied views as to whether it is a health concern as it is used in restoration of teeth.
Composite has been around for about 50 years and is now commonly used. Its advantages are its appearance, and its ability to bond to tooth. This allows minimal tooth removal. Small to medium sized composites last extremely well. With large restorations in back teeth it is best to use porcelain or gold for longevity.
Crowns are an excellent way of improving the long term prognosis of structurally weakened teeth. This will usually involve heavily filled and root canal treated teeth.
All ceramic crowns tend to be used in front teeth as they look great and strength is not so important.
Porcelain fused to metal crowns are used in places where strength and aesthetics are important, generally in the premolar region.
All gold crowns are used in posterior molars where strength is paramount.
These are generally more conservative on tooth structure than conventional crowns. Usually the filling and any decay and possibly a little weakened tooth are removed. The void is replaced by usually either porcelain or gold. It is an excellent and conservative way of restoring a broken down tooth improving its long term prognosis.
Root Canal Treatment
If a tooth becomes painful to touch or aches for long periods of time it is likely the nerve (pulp) inside the tooth is inflamed. This is often caused by deep decay, cracks or a previous deep filling. At this stage the options are to either extract the tooth or undergo root canal treatment. Root canal treatment involves filing and disinfecting the canals inside the tooth. Different teeth have a different number of canals so the length of time and cost needed for root canal treatment depends on which tooth is affected. Once the canals have been prepared, a medication is placed inside the canals (usually antibiotic/anti inflammatory paste called ledermix or calcium hydroxide). It is the left for 10-14 days and you return to have the second stage of root canal treatment where the canals are cleaned out and sealed. It is advisable to crown a root treated tooth as it has generally lost a lot of tooth structure and it is more brittle due to losing its mositure (blood) supply. Most root canal treatments are successful (85-95%) if done correctly. Biological factors such as degree of infection and cracks can also affect the outcome.