Gold
Gold has been used in dentistry longer than amalgam. It is extremely durable and has been shown to be relatively biocompatible. Since it is a metal alloy, the gold used in dentistry is still capable of creating galvanic currents. It is also relatively expensive and often not used because of more esthetic tooth-colored alternatives.
Porcelain
Porcelain restorations are the best dentistry has to offer. Not only are they highly esthetic, but they are extremely durable. Porcelain offers properties similar to enamel, and it is biocompatible. They are made outside of your mouth in a dental laboratory so the shape of the restoration has a precise fit against the adjacent teeth. Porcelain restorations are more costly than white fillings; however, porcelain needs to be replaced less frequently than white fillings.
White Fillings
White fillings (also known as composite fillings) are an excellent esthetic and biocompatible alternative to porcelain. Composite fillings are shaped directly in the mouth and cost less than porcelain because there are no laboratory costs. Although they are less durable than porcelain, the newer composites are showing wear characteristics that are as good if not better than amalgam. The bonding characteristics of composites can increase tooth strength up to 98% of its original pre-decayed state. The one problem with composite fillings is the likelihood of post operative sensitivity to cold and moderate pressure. Although everyone responds differently, this sensitivity usually dissipates after a couple of weeks.
It is important to remember that no single material is “safe” (non-reactive) for everyone. The potential for reaction exists for any foreign material placed in the body. Biocompatibility testing provides information on any material sensitivities a patient may have. This simple test allows the dentist to select a dental material that is most compatible for each individual.