IF the dentist asks the patient to choose between 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. So, you may 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?” People say that dentists are only trying to help, but when it comes down to the nitty-gritty, I have to get into that dental chair, and it is my mouth they will be shooting up with local anaesthetic and how I hate that needle! Well, patients, you do have a choice.

Start thinking in at least semiprofessional terms. Your dentist does not call the work he does on your cavity “fillings”. He calls it “restoring”. His job is to restore form and function. Anybody can be taught relatively quickly to fill a hole, even in a tooth, after the dentist drills it out, cleans it up and dresses it ready to build. However, only a dentist is taught how to properly restore form and function.

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 hot, especially cold. If the restoration is made from 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.

At your introductory interview, your dentist knows that you know what to expect and that you do expect it and 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 area to be restored 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 years! But over the years, there has been 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 irritate 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 about your dentist lectures extensively. 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 are the most common restoration materials because they have stood the test of time and are relatively cheap.