History of fillings

The History of Fillings

The first time a dental drill (or its Neolithic equivalent) was used to cut a cavity in a tooth appears to be in the mountain region of what is now called Pakistan. There, evidence has been found of teeth in skulls dating back to 7000 BC where small circular holes have been drilled on the back teeth.

Due to the location of the cavities, it is unlikely that these early dentists were attempting to remove decay. It has been speculated that the holes may have been drilled for religious reasons or to allow evil spirits to leave the body.

The first dental drill?

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Other early cultures, such as the Chinese, Egyptian and Greeks, also mention the practise of dentistry but it is the Etruscans / Romans (people living in central Italy) of 166-201 AD who were the most advanced dentists of the ancient world. Evidence has been found to indicate that gold was used to fill teeth and even make artificial crowns or caps!

There is reference in a Chinese test dating to 700AD which mentions the use of “silver paste”. However, after this nothing is recorded.

With the fall of the Roman Empire, Europe entered the so called dark ages in which the rate of learning slowed and a great deal of knowledge was lost.

People who were brave enough to allow cavities to be drilled in their teeth (with hand driven drills) had them filled with various materials such as stone chips, resin, cork , turpentine and gum. However, none of these were satisfactory. Either they were impossible to fit properly, or not strong enough.

The discovery that hot metallic leaves (such as gold, silver, tin and lead) could be slowly hammered into a cavity was the first significant advance. However, this process was slow and expensive.

By the early 1600s both German and French dentists began to dissolve metal in acid which they heated before pouring them into teeth.

This process was almost certainly as damaging as the decay in the tooth!

The early 1800s saw the advent and popularisation of the dental chair and dental drill. However, there was still no cheap long-term filling material, and as a result most teeth were extracted instead of being filled.

Louis Regnart is considered the father of dental amalgam, as he found that by adding mercury to base metals a substance could be made that did not need to be heated and could be placed while soft and then allowed to harden.

Despite the huge advantages of being cheap, easy to use and  less painful its introduction was met with huge resistance especially in the USA.

During the 1840s the American Society of Dental Surgeons effectively barred any dentist from using dental amalgam. They based their position on what they believed were the detrimental effects of mercury. However, there was also a component of not wanting a cheap alternative to their lucrative trade in making gold fillings.

Eventually amalgam fillings were accepted and in the 1870s the first white (silicate based) fillings were introduced which could be placed on front teeth.

Since this time there has been an exponential gain in knowledge in the field of dentistry, the materials used now are better, last longer and are stronger than ever before.

Things are still evolving. Dental amalgam still has its place in dentistry however it is likely that it will be superseded at some stage.

Our guidelines

When your teeth need fillings placed we have a couple of guidelines which we follow.

If you can see the filling when you smile then we will try to do it in white. If it is on a back tooth where no one will see then we will usually do it in silver amalgam.

We still believe that silver amalgam fillings have their place in dentistry.

Please refer to the NZDA statement on Dental Amalgam

http://www.healthysmiles.org.nz/assets/pdf/Amalgam_Statement_Final.pdf