When discussing treatment options with patient a question that often comes up is “How long will my filling last?”
While I have seen some fillings in service for 40 years I have seen others which have lasted less than a year; the answer does depend on a number of factors. Factors which can contribute the longevity of a restoration include:
- the type of restorative material used (composite vs amalgam vs gold vs porcelain)
- diet and oral hygiene
- the size of the filling
- the condition of your oral environment
- your bite and how your teeth come together
- other habits including grinding and clenching
- the technique used in placing the restoration
What do the studies and statistic say?
Listed below are the average lifespans of the major classes of filling materials according to various studies. Please be aware these are averages and that the longevity of a filling will vary for the reasons above; sometimes longer and sometimes shorter. Just because a filling falls short of these averages does not mean it is due to “poor dentistry” or “my previous dentist did a bad job”.
On average white fillings last for 5-7 years
On average silver amalgam fillings last 10-12 years
On average porcelain fillings last 10-15 years
On average gold fillings last 15-30 years
What can we take away from these numbers?
- Nothing lasts forever! While a filling may be serviceable for a number of years, like many things in life, fillings are not a permanent fix and have to be replaced when they fail or breakdown from wear and tear. That is why prevention is better than the cure. Once a filling is placed it will generally have to be replaced somewhere along the line.
- Gold and porcelain indirect restorations on average last longer than direct amalgam and composite resin fillings. These types of restorations typically require more time to place, require more steps and often involve the skills of a dental technician to complete the laboratory work. While these addition steps mean there is a higher initial cost, the benefit is that their initial cost is outweighed by a longer service life and lower rate of replacement.
- Amalgam fillings tend to last longer than composite for back teeth. This is certainly the case for back teeth, but once again, there are many factors at play. Amalgam has been around for a long time in dentistry and has been shown to be a cost effect and long lasting material. Composites typically have be replaced at more regular intervals but a major benefit is that they are a more conservative material that results in smaller fillings being placed.
Larger long lasting fillings vs smaller more frequently replaced fillings…. Nothing is perfect and everything is a compromise.
- Longevity is not everything. Other factors which may influence the decision for a particular material: ability to keep the area dry which is important for composite fillings, the size of the cavity, aesthetics and will the filling be visible, cost?
So, what do I tell my patients?
One of the best ways I explain the longevity of fillings to my patients is using the analogy of a car:
“You have a choice of cars; some cheaper, some more expensive; some of a higher quality and some more basic; some more reliable and some more likely to breakdown. Nothing lasts forever, your tooth is like a car, will serve you a number of years if you look after it. If you service it regularly and look after it well it will last you a longer time than if you neglect it or abuse it. For this reason, your mileage will vary from the average……..
Sometimes accidents or crashes happen and, similar for your tooth, breakages and chips can happen at any time. We can’t predict when this happens as we don’t have a crystal ball but we will always ensure that we place the best restoration possible; the rest of the driving, servicing and care is up to you.”