For Our Patients
Why Gold Fillings are Excellent Restorations
1. Gold castings will not break or fracture
The gold casting will never break or fracture when properly prepared. Silver amalgam, due to its brittle nature, has a greater tendency to fail under load. This is not to infer that dental amalgam is not a 'permanent' filling, but points out a greater propensity for fracture in the mouth. Fracture does not seem to be a significant problem with resin composites (white fillings).
2. Gold Will Not Exhibit Marginal Wear of the Material Itself
The gold casting maintains marginal integrity even after many years of function. The composite filling, though tooth-coloured, gradually erodes away, which may leave the enamel margins unsupported and prone to chipping and wear.
3. Gold Has a Coefficient of Expansion Similar to Tooth Structure
The favorable coefficient of expansion of the gold alloy, as compared to that of the tooth, is important. The tooth and restorative material shrink when exposed to cold and expand with exposure to heat. Since the temperature in the mouth varies from cold ice cream to hot coffee, it is important that the filling material expands and contracts to a similar extent as the tooth structure.
4. Gold Supports and Protects Enamel Margins of the Tooth
The gold casting can be placed so accurately in the tooth that the enamel at the margin of the cavity is supported, so that, as the patient functions, the enamel is protected from breakage. It is as if the gold braces the enamel rods to prevent them from breaking down.
5. Gold Can Provide Precise, Stable Anatomical Form
Returning a tooth to its normal, healthy form is elementary for any restoration. This produces a restoration that allows proper function with opposing teeth and allows food to pass over the dentition in a normal chewing and grinding motion. The gold casting is made in the laboratory from an accurate replica of the preparation and adjacent and opposing teeth. Since is it fabricated outside the mouth in a far more open environment, it is possible to create a final restoration that is as close as possible to ideal.
6. Gold Restorations Can be Finished to a Very Smooth Surface
There are obviously advantages to having a highly polished restoration. It is much easier to accomplish this in the laboratory, where we have much better access and visibility and are not dealing with oral tissues and fluids. The polish surface is less likely to accumulate plaque and presents a more pleasing feel to the tongue.
7. Gold Does Not Flow or Change Shape
While it is true that gold is not likely to flow or change shape in the mouth, the improvements in high copper amalgams tend to make it less of a comparative factor than it was 30 years ago.
8. Gold Does Not Absorb Oral Fluids
Saliva and other oral fluids will not penetrate the surface of a gold casting. On the other hand, resin composites are penetrated by oral fluids and occasionally absorb enough so that there is a putrid smell when they are removed.
9. Gold Does Not Oxidize in the Mouth
Gold fillings are of such a noble metal that they do not oxidize or corrode as can amalgam fillings over time, although they would still be considered more esthetic for anterior restorations.
10. Gold Does Not Produce Discoloration of the Tooth
Gold castings do not produce discolouration of the tooth, which may occur from ion penetration with silver amalagams. Occasionally, if the tooth is very thin, the gold may reflect through the enamel, but it does not usually create any esthetic liability.
11. Gold Allows for Easier Formation of Proximal Contacts
Since the anatomy of the tooth is carved as a wax pattern in the dental laboratory, it is relatively easy to simulate the broad contact are of a natural tooth. It is also simpler to produce a well-rounded marginal ridge that produces the appropriate occlusal spillways for food movement during mastication.
12. Gold is Esthetic
Before tooth-coloured materials were available, gold was often placed for esthetic reasons, particularly because it does not discolour a tooth and has a 'clean' look. Today, dentists are careful to display as little gold as possible by creating a cavity preparation that does not extend out to visible areas of the tooth.
13. Gold Castings Can Be Cemented Successfully Without Adhesive Bonding
It is the opinion of some that time
14. Cast Gold Restorations Allow Good Tissue Health
15. Gold Restorations Do Not Abrade the Opposing Dentition
16. There is No Mercury in Gold Casting Alloys
17. Wear of the Gold Restoration is Similar to Normal Wear of Tooth Structure
18. Gold Does Not Liberate Toxins
19. The Physical Properties of Gold Support Long-term Occlusal Function with Minimal Thickness
20. Gold Restorations Have Excellent Longevity
1. Gold is Not Tooth-coloured
2. Gold Restorations are More Expensive Than Some Other Types of Fillings
3. Gold Castings Require Considerable Care, Skill and Technique From the Operator
This summary was copied from an article written by Dr. R.V Tucker
Understanding your gum disease
What is Gum Disease?
Gum disease, also known as periodontal disease, is a bacterial infection of the gums and bone holding the teeth into place. This infection is caused by plaque build-up. When bacteria also known as plaque, accumulates below the gum line it can become organized like a 'community'.
This makes the plaque harder to remove and can cause damage to the surrounding gums and bone.
This infection starts as gingivitis. When plaque is below the gum line it irritates the gums causing them to swell up. This happens when the body's defense system is trying to fight the harmful plaque. If bacteria is not removed properly further damage can occur. Removing this bacteria can reverse gingivitis.
If plaque remains, the infection can progress from gingivitis to periodontitis. In periodontitis, the space between gums and bone has deepened where bacteria travel and release toxins that cause damage to the tooth's supporting bone and gums. This is the body's way of trying to fight off the harmful bacteria. It is important to have low levels of bacteria as periodontitis is irreversible.
Do not bleed and are not puffy. The space between the gum and the tooth, otherwise known as a “pocket” has a shallow reading when measured by the dental hygienist. Healthy bone levels anchor teeth into place.
Gums are puffy, red, tender and/or can bleed easily. No damage has occurred to the bone anchoring the teeth in place.
Gums are puffy and can bleed easily. Plaque bacteria travel further below the gum line and release toxins that damage the supporting bone. The “pocket” between the gum and the tooth are deeper
Gums continue to be puffy and can bleed easily. The pocket reading has deepened even more. Plaque bacteria have traveled further below the gum line and gums are receding. More damage has occurred to the bone levels. This damage to the bone that anchors the tooth into place can become so advanced that the tooth is mobile.
Signs of Periodontal Disease
- Bleeding gums during or after brushing
- Red, puffy and/or tender gums
- Teeth that are mobile/loose
- Deep spaces between teeth and gums
- Bad breath and/or bad taste in the mouth
Some Factors to Consider
Other factors can play a role in increasing the risk of getting periodontitis:
- smoking/tobacco use
How to Prevent Periodontal Disease
- Brush teeth twice a day
- Clean between teeth daily
- Eat a good balanced diet
- Visit your dentist and dental hygienist regularly
Created by M.J. Kennah & Kelly Nguyen (October 2007)
- http://health.rutgers.edu/factsheets/gumdisease.htm (October 13, 2007)
- www.fda.gov/fdac/features/2002/302_gums.html (October 13, 2007)
- www.apfelbaum-perio.com/periodon.htm (October 19, 2007)
- www.pediatricdentistsf.com (October 30, 2007)