When it comes to dental restoration, gold fillings remain a popular and highly regarded choice due to their durability, strength, and long-lasting nature. For centuries, gold has been a go-to material in dentistry, revered for its ability to withstand the test of time. But in a world where aesthetic preferences often lean toward natural-looking alternatives, are gold fillings still a viable option, or are they an outdated choice? In this guide, we will explore the key factors that make gold fillings unique, discuss their advantages and disadvantages, and help you determine whether they are worth the investment for your dental needs.

What are Gold Fillings?

Gold fillings, also known as gold inlays or onlays, are a form of dental restoration that involves placing a custom-made piece of gold into a cavity. Unlike silver amalgam fillings, which are poured directly into a cavity and hardened, gold fillings are made from a mixture of gold, copper, and other metals, which are shaped and fabricated to fit precisely in the cavity. Once the gold filling is ready, it is cemented into place by the dentist.

Gold fillings are often used in the back teeth where chewing pressure is most significant, making them ideal for areas that experience high wear and tear. The material is biocompatible, meaning it’s well-tolerated by the body, and it bonds effectively with the tooth structure, ensuring a long-lasting and reliable restoration.

How Are Gold Fillings Made?

The process of placing a gold filling involves several steps. The first step is a thorough examination and cleaning of the tooth by the dentist. After the cavity is prepared, the dentist will take an impression of the tooth using dental putty or digital scans. This impression is then sent to a dental lab, where the gold filling is custom-made to fit the tooth perfectly. This step can take a few weeks, during which time a temporary filling is often placed. Once the gold filling is ready, the patient returns to the dentist’s office for placement.

Historical Significance of Gold in Dentistry

Gold has been used in dentistry for over 150 years, dating back to the mid-19th century when it was first employed for dental restorations. The material’s inherent properties—strength, malleability, and resistance to corrosion—made it an obvious choice for dental applications. Even today, many of the world’s best dentists still recommend gold fillings for patients who need durable, long-lasting restorations.

Durability: Why Are Gold Fillings Known for Longevity?

One of the most significant reasons why gold fillings have stood the test of time is their exceptional durability. Gold is a metal that resists corrosion, wear, and fracture, making it ideal for dental use. When you choose a gold filling, you’re opting for a material that can last decades, even a lifetime, with proper care.

Resistance to Wear and Tear

Gold fillings are known to be resistant to wear and tear, especially when compared to other materials like silver amalgam or composite resins. While composite fillings may chip or crack under pressure, gold fillings maintain their integrity much better.

Longevity

Gold fillings can last for 20 years or longer with proper maintenance. The material’s resilience makes it especially useful for people who have a history of clenching or grinding their teeth, as gold can withstand the additional forces without compromising the restoration.

Minimal Shrinkage or Expansion

Unlike other materials that may expand or contract over time (such as silver amalgam), gold remains stable. This characteristic means it is less likely to crack or break as a result of temperature fluctuations in the mouth from hot or cold foods and drinks.

Gold Fillings vs. Other Materials (Amalgam, Composite, Porcelain)

Gold fillings outperform silver amalgam and composite resins in many areas. While amalgam is a less expensive option, it tends to crack and deteriorate over time, especially under the strain of chewing. Composite resins, although more aesthetically pleasing, are not as durable and can stain or wear away more easily. Porcelain fillings are another popular alternative, but they are not as durable as gold and tend to be more prone to chipping and cracking.

Gold’s superior durability, however, comes with a tradeoff in aesthetics, which we will discuss later.

The Pros of Gold Fillings

Gold fillings provide several advantages that make them an attractive option for dental restoration. Let’s break down these benefits:

Durability and Strength

As mentioned, gold is one of the strongest materials available for dental restoration. It can withstand the intense pressures from chewing, which is crucial in areas like the back teeth where forces are highest. The filling will not crack, chip, or wear down easily, which significantly reduces the likelihood of needing a replacement filling in the future.

Biocompatibility

Gold is biocompatible, meaning it won’t cause an allergic reaction or irritation in the mouth. For patients who have sensitivities or allergies to other metals, gold is an excellent choice.

Aesthetic Considerations

While gold fillings are not as discreet as tooth-colored options like composite resin, they do blend in well with the natural contours of the tooth. In some cases, the golden color can complement the natural hue of the teeth, especially if they’re located toward the back of the mouth where they won’t be as visible.

Little to No Sensitivity

Gold fillings can provide relief from tooth sensitivity, especially compared to amalgam fillings that may expand or contract with temperature changes. Since gold doesn’t react to temperature in the same way, patients often experience less sensitivity to hot or cold foods and drinks.

Minimal Need for Tooth Reduction

Gold fillings are custom-made to fit the cavity precisely, meaning that your dentist can remove less healthy tooth structure than with other types of fillings. This results in less impact on the natural tooth and a better long-term prognosis for the tooth.

The Cons of Gold Fillings

While gold fillings have numerous benefits, they are not without their drawbacks. Here are the key disadvantages to consider:

Aesthetic Drawbacks

The most significant downside to gold fillings is their appearance. While some patients may appreciate the durability and strength, others may prefer a more discreet, natural-looking solution. Gold fillings are highly visible, and in some social or professional settings, this could be a concern. This is especially true for fillings in visible areas like the front teeth.

High Cost

Gold fillings are significantly more expensive than other types of fillings, such as silver amalgam or composite resins. The cost of a gold filling can be three to four times higher than that of an amalgam filling due to the price of the materials and the labor-intensive process involved in crafting the custom filling. The exact cost will depend on the size and location of the filling, as well as your dentist’s pricing.

Long Procedure Time

Gold fillings require multiple dental appointments. The first appointment involves cleaning out the cavity and taking impressions of the tooth, which will be sent to a dental lab. After that, a second appointment is needed to fit the gold filling into place. This process takes longer compared to other types of fillings, which may be placed in a single appointment.

Potential for a Heavy Feeling in the Mouth

Some patients report that gold fillings can feel slightly bulky or heavy in the mouth, especially after they are first placed. This is due to the thickness of the gold material, which may take some time to get used to.

Requires Skilled Labor

Because gold fillings are custom-made to fit your cavity, it’s essential to find a highly skilled dentist who is proficient in working with gold restorations. If your dentist doesn’t have experience in placing gold fillings, the process may take longer, or the result may not be as precise as you would like.

Cost Considerations: Are Gold Fillings Worth the Investment?

As mentioned, gold fillings are more expensive than other filling options, and this price difference can be significant. The cost varies depending on factors such as:

Factors Affecting the Price of Gold Fillings

The cost of a gold filling varies depending on several factors:

• Size and Location of the Cavity: Larger cavities or those in difficult-to-reach areas may require more material and more time to prepare, which increases the cost.
• Dental Laboratory Fees: The quality of the laboratory and the craftsmanship involved in creating the filling also contributes to the overall cost.
• Geographic Location: Dental fees can vary significantly depending on where you live. Urban areas may have higher costs due to increased overhead, while rural areas may be more affordable.
• Dentist’s Expertise: Dentists who specialize in cosmetic or restorative dentistry may charge more for their expertise.

Gold fillings are priced based on the materials used, the labor involved in creating the custom filling, and the number of appointments required. You may find that dental insurance only partially covers gold fillings or may not cover them at all, given their high cost compared to alternative materials.

However, when you factor in their durability and longevity, gold fillings may be worth the investment in the long term. With proper care, gold fillings can last 20 years or more, which means you may not need to replace them as often as you would with other types of fillings. This longevity could save you money over time, as you won’t need frequent touch-ups or replacements.

Situations Where Gold Fillings are the Best Option

While gold fillings are an excellent choice for many patients, they’re not the best option for every situation. Here are some cases where gold fillings might be the ideal solution:

Large Fillings and Back Teeth

Gold fillings are an excellent option for large cavities in back teeth (molars and premolars), which experience significant chewing forces. The material’s strength allows it to withstand these forces without cracking or wearing down, ensuring a long-lasting solution.

Patients with Bruxism (Teeth Grinding)

Patients who grind their teeth at night (bruxism) put considerable pressure on their teeth. Gold fillings are particularly effective in these cases because they are resistant to the grinding forces that can break down other types of fillings, such as composites or porcelain.

People with Metal Sensitivities or Allergies

If you have a known sensitivity to other dental materials, such as mercury or certain metals used in amalgam, gold fillings provide a safe alternative. Gold is non-reactive and hypoallergenic, making it an excellent choice for individuals who may experience allergic reactions to other fillings.

Patients Seeking Long-Term Solutions

For those who want a filling that will last for decades, gold is the top choice. While other fillings may need to be replaced or repaired within a few years, gold fillings remain intact for decades, offering excellent long-term value.

When Other Fillings Fail

If other fillings, such as amalgam or composite resins, fail due to cracking, decay, or wear, gold fillings are often a great choice to restore the tooth. Gold fillings can be placed in teeth that have already undergone other treatments and can offer greater durability than alternative materials.

Conclusion

Gold fillings are considered a premium option in restorative dentistry due to their remarkable durability, biocompatibility, and long-lasting effectiveness. These fillings can withstand significant pressure from chewing and resist wear over time, making them ideal for back teeth or molars that endure the most stress. However, gold fillings may not be the best aesthetic choice for everyone, particularly for those who are concerned with the visible appearance of dental work. They are more noticeable than tooth-colored alternatives like porcelain or composite fillings, which can blend seamlessly with natural teeth.

The decision to choose gold fillings depends on several factors, including the size and location of the cavity. Larger cavities, especially in the back of the mouth, are often better suited for gold due to the material’s exceptional strength. Personal preferences also play a role—if you prioritize durability over appearance and are comfortable with a visible restoration, gold fillings may be a great choice. Additionally, gold fillings come with a higher upfront cost, which can be a consideration for some patients. However, their long lifespan can make them a smart long-term investment.

It’s essential to consult with your dentist before making a final decision. A professional can assess your specific dental needs, offer personalized recommendations, and help you weigh the pros and cons based on your oral health, lifestyle, and budget.