Composite Dental Filling Warnings
Q: I am in my fifties and my dentist wants to fill some cavities with some white material that he calls bondo or rosins. I had these years ago, I think, and all of them had to be replaced. Is this still the way to go?
Allow me to correct the nomenclature: Bondo and rosins are for fixing the front spoiler on your 72 ‘Vette after you dropped your Neil Diamond 8-track on the floor and hit the lime green AMC Gremlin in front of you. You probably mean “bonding” and “resins” or “composite resin” fillings.
Back in the eighties, a dental professor at S.U.N.Y. Stoney Brook came up with the concept of bonding white colored filling materials to tooth enamel and dentin using special lights to cure the material to its final hardness. This was to replace gold and amalgam (silver) fillings. The dental profession went a little nutty and started “bonding” everything. Huge fillings the size of walnuts and slapping it onto the front of teeth for esthetic purposes. (‘til this day, we joke and call some dentists: “bondo-dontists.”)
This material has its limitations. I recommend composite dental fillings only to restore small cavities on the sides of front teeth. When used on the posterior molars, in deep situations, many patients have terrible sensitivity; some requiring root canals to stop the pain. A better choice are porcelain inlays which are robotically milled from a digital “no-goop” impression taken in the office. In thirty years, I have not had one patient complain of post op sensitivity after porcelain inlays.
As far as cosmetic use; composite resin dental fillings can be used to paint the whole front side of a tooth, but if you are doing a full smile, use porcelain veneers, made in a similar fashion as the inlays.
And, most importantly, current dental school professors are still teaching that composite resin (tooth bonding) restorations only last five to seven years. (My offspring at Tufts told me this.) Porcelain veneers and inlays on my patients have been making it past fifteen and twenty years with proper oral home care and professional cleanings four times per year.
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.