Gold Inlays and Onlays in Missoula MT
One of the oldest restoration materials for repairing teeth is gold. An "oldie, but a goodie" and "the gold standard" are both apt descriptions for this material. The track record shows that a high noble gold alloy (that describes the elemental makeup of all the different types of metals used where 90% of the metals are precious metals) simply lasts. While we can get good longevity from porcelain, composite, and amalgam restorations, gold is rarely beat. The secret lies in its ability to be strong, yet flexible. So you can burnish (move on a microscopic level) the margins (that's the transition point from tooth to restoration) to an extremely close fit, but it won't break. It's the only material that is capable of this. Also, since it's so strong, you can use relatively thin amounts allowing you to be more conservative in how much of your tooth needs to be removed. I like it when I can save tooth structure because nothing has been invented that's as good as natural tooth!
Benefits of Gold Onlays
But there are more great benefits to gold. It's a naturally occurring noble element. That doesn't mean it's royal, but it does mean it is inert and will not react with other elements. And that means it will never change color or change the color of the surrounding tooth. Since gold can be polished incredibly smooth, plaque and bacteria have a hard time sticking to it--it's cleaner! My favorite part about gold is that it will wear the opposing teeth just about the exact same as natural teeth would. That's one of the big drawbacks of porcelain -- it will abrade other teeth much more quickly.
Why Don't Dentists Always Use Gold?
So why aren't all dentists using gold to fix everything all the time? The first reason is cost. Often you get what you pay for, and this is no exception. These restorations are like jewelry for your teeth, and good jewelry is never cheap. The next reason is time. To prepare the tooth often takes extra skill and patience, then the gold needs to be finished to the tooth and polished with a specific and special technique that not every dentist has the resources or skill to do. And some patients are... well... not patient enough to wait for the work to be done. How long is the extra time? Well, every tooth is a little different, but on average it might take 3 hours total split into two different appointments (whereas a full crown might take 2 hours total over two different appointments).
Why did I reference the time to do a full crown? Well, there are two different types of restorations gold is typically used for: inlays and onlays. You can think of inlays as gold fillings and onlays as conservative crowns. I'll include some pictures of my very own cases on this page.
Frequently Asked Questions
Amalgam, or silver colored fillings, contain mercury; which has been a point of contention and lead to many controversial debates. While large quantities of elemental mercury are certainly bad for you, the amount in fillings is not. As with many things in life, we must weight the "pros" vs. the "cons." Amalgam has been one of the longest used filling materials of all time with great clinical success. And for all those decades there has been no solid evidence of mercury poisoning from amalgam fillings.
Mercury in Fillings
This is largely due to the fact that the mercury is amalgamated (mixed) with the other components to form a solid and stable chemical bond that renders the mercury inert. At this point, no traceable amount of mercury is able to chemically interact with your body. So not only has amalgam proven to be safe over the years, but I (Dr. Nelson) also have amalgam fillings in my own teeth! Not only that, but the American Dental Association supports it's use (click here for information for dentists and here for information for patients).
That being said there are two times where there is a minor risk for mercury exposure: as the filling is being placed and hardening (finishing the reaction that sets the filling up) and when these fillings need to be removed (small amounts of vapor). Fortunately, these are easily avoided by the use of a rubber dam. A rubber dam allows for isolation of the teeth from the rest of the mouth and makes it easy to clear away any excess amalgam during placement or removal.
Dental Cleanings in Missoula
But that still doesn't answer the question! The answer is yes, we offer composite (tooth colored) and gold (also called "inlays" instead of "fillings") fillings that have no mercury in them. I believe that amalgam and composite both have their indications in different situations, and I love having these different "tools" in my metaphorical toolbox to help me provide the best treatment for my patients. So don't hesitate to ask me about which option is best for you.
Meet Our Doctor:
Dr. Jonathan Nelson
Dentist
I am no stranger to Montana. From about preschool to 3rd grade I lived in Missoula near Chief Charlo Elementary. In fact, I was part of the inaugural 3rd grade class at Chief Charlo when it first opened. Before that, I attended C.M. Russell Elementary just down the road from our current dental office! Then, due to my parent’s job relocation, we moved to Helena, MT.
I graduated from Capital High School and then went on to graduate at Montana State with the degree of Cell Biology and Neuroscience. Similarly to ...
Featured Blog Posts - Gold Inlays and Onlays
The Surprising Benefit of Gold Onlays
You’ve found out that your tooth has a cavity, and your dentist is recommending a gold onlay. You are not sure what that is, or why it needs to be made out of gold? Aren’t tooth-colored fillings a more desirable choice? Here’s what you should know about onlays in Missoula, MT.
Why Is My Dentist Recommending an Onlay?
If your dentist is suggesting a gold onlay for your tooth, it is likely that it is a molar in the back of your mouth. Molars take the brunt of your biting force ...