The post-amalgam era: a selection of materials and their longevity in the primary and young permanent dentitions

During the last decade there has been a rapid change in the selection of dental restorative materials as the use of amalgam has decreased. The aim of this study was to obtain information on children's restorative dental care in Finland and to analyse the longevity of failed restorations.

A random sample of public dental health care centres was drawn from the registers and the dentists working there were asked to record information for each restoration they placed during a three-day period. The survey data comprised a total of 2186 restorations in patients younger than 17 years.

Of the children in need of restorative treatment, only a few had previous amalgam restorations. Primary caries was the main reason for restorative treatment in both primary and permanent dentitions (80% and 83%, respectively). In primary teeth, the most common restorative material was resin-modified glass ionomer cement (57.4%), whereas in permanent teeth, composite resin dominated (58.7%). Amalgam was not used at all in the primary dentition and in only 0.6% of permanent teeth. Eighteen per cent of treatments in primary and 12% in permanent teeth were replacements of previous fillings. The mean age of failed glass ionomer restorations was 2.8 years (n = 101) in the primary dentition, and 3.5 years (n = 54) in the permanent dentition.

Until better restorative materials are developed, more attention should be paid to the prevention of dental caries as well as to the proper handling of alternative materials.