Want to feel like a million bucks? Why not get a gold filling? Dental records taken from the US Civil War-era in the 1800s show that gold was the most popular and most preferred filling material owing to its strength and durability.
Although other filling materials like tin and amalgam were present and less expensive, gold remained the "gold standard" in those days and other materials were held in low regard.
However, getting a gold filling in the early days was a nightmare, especially since it was difficult to place. As Dr. Martin S. Spiller revealed in Dr.Spiller.Com:
"The cohesive gold foil technique consisted of removing decay, laboriously refining (preparing) the shape of the cavity and then hammering tiny pieces of cohesive gold foil into it until the cavity preparation was filled - a tedious and painful procedure. It required the removal of all decay and the minute refinement of the cavity preparation in order to create a retentive and stable space for the gold."
Thankfully, advances in modern dentistry have changed all that. Gold is still used today since it can withstand chewing forces and last as long as 15 - 30 years. Gold is also pleasing to the eye and some people find it more acceptable than other fillings.
On the downside, gold is quite expensive - up to ten times higher than the cost of the more common amalgam fillings. It requires at least two dental visits to place and can be irritating for some people since it conducts heat and cold.
"A gold filling placed immediately next to a silver amalgam filling can cause a sharp pain (galvanic shock) to occur. The interaction between the metals and saliva causes an electric current to occur - it's a rare occurrence, however," explained the editors of WebMD.Com and the Cleveland Clinic Department of Dentistry.
Amalgam or silver fillings remain the most commonly used material to fix decayed teeth. They are a mixture of mercury (from 43 - 54 percent) and powdered alloy made mostly of silver, tin, zinc and copper. Amalgam was supposedly used by the Chinese to fill teeth in the 7th century but the French dentist Auguste Taveau is credited as the inventor of this material.
In 1816, Taveau developed his own amalgam filling from silver coins and mercury which he first used in 1826. His material was cheaper than gold but had to be heated for the silver to dissolve and set in place. It also had a tendency to expand after it was placed. Because of this, its use was abandoned.
"Amalgam in those early days had serious drawbacks since its physical characteristics depended on the exact proportions of silver and mercury, and the mixture often expanded on setting causing the tooth to crack," Spiller said. Taveau's formula was later brought to the United States by two French quacks. The Crawcour brothers saw its potential and packaged it under the name of "Royal Mineral Succedaneum." Many dentists denounced this since the brothers had no dental training whatsoever and they warned that mercury was poisonous. But this didn't affect the brothers' business.
"When the Crawcour brothers opened for business in New York in 1833, they didn't have to wait long for their first clients. To anyone with tooth troubles, the brothers' advertisements were irresistible. Why pay a fortune to have your cavities plugged with gold when two brilliant dentists from Europe could fix them with a miraculous new sort of filling. With their amazing Royal Mineral Succedaneum, they could make a tooth as good as new - cheaply, painlessly and in just two minutes," according to Stephanie Pain in The New Scientist.
In spite of the criticisms that later formed the basis of the anti-amalgam movement, the Crawcour brothers treated large numbers of patients successfully - none of whom developed the symptoms of mercury poisoning. How this did happen? This clearly illustrates the safety, relative ease in placing amalgam fillings, and their durability that can extend up to 15 years.