In your dental practice, is dental amalgam still the restorative material of choice?
Anationwide survey by the ADA Health Policy Resources Center showed that in 1999, almost 86 million resin-based composite restorations were placed in the United States, compared with 71 million dental amalgam restorations that same year. In contrast, amalgam restorations numbered 99 million in 1990, compared with only 48 million resin-based composite restorations that year.
Published data from Strategic Dental Marketing in New City, New York, a dental industry marketing consultant, show that sales of resin-based composites outpaced those of dental amalgam in 2001 by a three-to-one ratio. In the United States, the market for resin-based composite accounted for almost $119 million in sales, up 13 percent from the previous year. Amalgam sales totaled $39 million in 2001, an increase of less than 1 percent.
When May JADA readers were asked if dental amalgam still is the restorative material of choice in their practices, 54 percent said it is. Several said they prefer dental amalgam because "it still is the most practical, long-lasting, inexpensive restorative material available."
Some respondents said they prefer to use amalgam for posterior and subgingival restorations, but they give their patients options. "I place amalgam in more teeth than any other restorative material," said one. "However, I do try to provide the best recommendation in addition to listing and discussing alternatives."
"I do about half amalgam and half composite based on patients’ preference," said another. "Amalgam is my material of choice."
Forty-two percent of the respondents to the May Question of the Month said dental amalgam is not the restorative material of choice in their practices.
Some said that is because their patients find resin-based composites more esthetically pleasing. "I feel amalgam is very safe for my patients and the environment," said one reader. "But the overwhelming choice by my patients is to have the ‘tooth-colored’ fillings when given the choice."
"I offer each patient the choice between amalgam and resin, and easily 95 percent choose resin even with its greater cost and potentially shorter life span," said another.
Four percent of respondents answered yes and no, or neither. Some indicated that they choose restorative materials based on the situation or patient preference. "I provide information as to the costs, risk benefits, longevity and esthetics," said one. "The patients choose, although I sometimes make recommendations."
"Every material has optimum uses, and I try to utilize those properties and not be trendy," said another. "It is exciting to see new developments and make choices based on materials science."
"We will continue to monitor the trends as they evolve in coming years," says Dr. Daniel M. Meyer, director of the ADA Division of Science. "Current indications are that restorative materials such as resins, gold, glass ionomers and other porcelain compounds are increasingly popular with dentists and their patients, with a focus on esthetics."
