ENOUGH lecturing, you say – I floss properly, and I will eat a balanced diet. I will even give up my nightly chocolate bar while I watch TV. But what about the five cavities I now have? You say – I know that you as a dentist are only trying to help, but when it comes down to the nitty-gritty, I am the one who has to get into that dental chair, and it is my mouth you will be shooting up with local anaesthetic and how I hate that needle! Well, patients, you do have a choice.

If the dentist asks the patient to choose between, say two types of filling materials, should the final decision rest solely with the dentist? Patients should make some practical choices when it comes to restorative dentistry.
Start thinking in at least semi-professional terms. Your dentist does not call the work he does on your cavities “fillings,” he calls it “restoring.” His job is to restore form and function. Anybody can be taught in a relatively short period to fill a hole, even in a tooth, after the dentist drills it out, cleans it up and dresses it ready to build. But only a dentist is taught how to restore form and function properly.
Ask your dentist about “comfort linings.” These are linings or bases, usually medicated, placed under restorations to keep teeth from being sensitive to cold or heat, especially cold. If the restoration is made out of silver amalgam, it will certainly conduct temperature changes in the tooth. If the restoration is quartz composite, the chemicals can irritate the pulp or nerve, as you call it. The comfort liner acts as an insulator cushion and medicated layer, protecting against pressure, chemical irritation, or temperature changes – all of which add up to comfort.
In a nice manner, at your introductory interview, your dentist knows that you know what to expect and that you do expect it and that you will not settle for less. If the outcome is not right, you can be sure that he knows it. If both of you know better, surely you can take the opportunity to have the situation corrected.
I truly believe in that old wonder, the silver amalgam restoration. If that restoration area is not too extensive, and if the proper technique is employed, the old “silver filling” is a real marvel. I have seen some of them going fine even after 45 yrs! But over the years, there has been a tremendous improvement to the extent that amalgam fillings now have no place in my clinic. The tooth-coloured composite resin is among the best for front teeth. Unfortunately, it may get discoloured after a few years and may require changing. Chemically, it may be irritating to the tooth issue, so like all restorations, it should be placed over a cover (tooth protective) liner.

Important points to remember are the following: –
* Never think your dentist lectures extensively; if and when that happens, rest assured they don’t do it for fun.
* Learn about the procedures you anticipate the dentists would execute, so you can understand and “level” with them.
* Composite resins and silver amalgams continue to be the most common restoration materials around because they have stood the test of time and are relatively cheap.