illustration image of teeth with gold fillingsFor many years, gold fillings were considered literally the gold standard in dentistry. There were good reasons why they were a better choice than metal amalgam, the main alternative for more than a century. Now, it’s important to have a beautiful smile, with a tooth-colored filling or crown. 

Compared to metal amalgam, gold is more durable and less likely to damage teeth. Plus, it’s unlikely to corrode and rarely causes galvanic currents in the mouth. So it’s no wonder that for more than a century, people who could afford it would choose gold over silver fillings

But the advent of advanced ceramic fillings changed everything. These fillings promise similar benefits over metal amalgam as gold, but they have an additional benefit: they look like natural teeth. 

So why is it that some dentists are now claiming that we should move back to gold fillings? They claim benefits for gold that are either uncertain or extremely dubious. Here’s what to keep in mind when considering gold fillings. 

Claims in Favor of Gold

Dentists who advocate for gold fillings now generally make two claims about them: they last longer and they have better marginal fit. 

Advocates of gold fillings claim these are essentially permanent. They say that most gold fillings last more than 15 years, and regularly up to 30 years. Gold advocates also claim that gold fillings have the best marginal fit of any restorations. 

But do these claims hold up?

Do Gold Fillings Last Longer?

While it is true that gold fillings can last a long time, it’s unclear that this is longer than the lifetime for advanced ceramic fillings. In part, we have been doing gold fillings long enough to do longer studies on them. Many advanced dental ceramics haven’t been in use for even 30 years, so we don’t know for sure how they will fare. 

However, some studies have shown that even in the early days, ceramic fillings are not that far off gold in terms of durability. One long study showed that up to 95% of gold fillings were still in place after 25 years. How did ceramic fillings fare? One study showed that they had an 88% survival rate after 27 years. That’s less than gold, but not by much, especially given that the gold survival rates in the study varied widely, dropping as low as 90% at 20 years. It’s likely that similar studies conducted on fillings placed today would probably show that the survival rates for the two restorations were even closer. 

Do Gold Fillings Have Better Marginal Fit?

Having good marginal fit matters for fillings. The narrower the gap between the filling and the tooth, the less bacteria and food will slip between the two, leading to secondary decay. 

Gold advocates claim that the margin between gold fillings and the tooth are about 1/100th the size of that between ceramic fillings and teeth. But here’s the trick: they rely on unpublished data for this. Unpublished data is little better than saying “trust me.” 

Their claims seem unlikely given the published data on the marginal fit of these fillings. Studies show the marginal gap for ceramic fillings is around 35 microns, compared to a marginal gap of 5364 microns for gold fillings. (For comparison, human hair ranges in width from 17 microns to 181 microns.)

In other words, published data shows that ceramic fillings give a better fit than gold. 

Ceramic Fillings in Savannah

If you are looking for fillings that look and feel natural, then ceramic fillings are your best choice. And the data shows that these fillings are almost as durable as gold, while having an even better marginal fit. In other words, you don’t have to sacrifice durability to get the beautiful smile you desire. 

If you want to learn more about the benefits of ceramic fillings in Savannah, please call (912) 234-8282 today for an appointment with a cosmetic dentist at Beyond Exceptional Dentistry.