In short: For small to medium cavities, composite is the sensible standard: one appointment, tooth-coloured, and it preserves substance. For large defects where a cusp is already lost, a laboratory-made ceramic inlay or partial crown lasts longer and protects the tooth better. Gold is the most durable of all and the least visually acceptable to most patients. Size of the defect decides more than material preference.
Patients usually ask which material is best. The more useful question is which material suits this defect, because the answer changes with the size of the hole.
The three materials
- Composite (tooth-coloured resin): placed and hardened in one appointment, bonded directly to the tooth, so very little healthy substance needs removing. Tooth-coloured. Best suited to small and medium cavities; on very large surfaces it wears and can discolour at the margins over years.
- Ceramic inlay or partial crown: made in a laboratory or milled in the practice, then bonded in. Highly durable, colour-stable, and it can rebuild a lost cusp and hold the tooth together. Higher cost, and more substance is prepared than for a composite.
- Gold: the most durable option, kind to the opposing teeth and extremely reliable at the margins. It is also unmistakably visible, which is why it is now mostly chosen for molars at the back.
What actually decides
The size of the defect and how much of the chewing surface remains. As long as the surrounding walls of the tooth are intact, a composite filling is a good and substance-sparing solution. Once a cusp has broken away or the walls are thin, a filling no longer stabilises the tooth — it just fills it. That is where a partial crown becomes the better mechanical answer, because it holds the remaining structure together rather than wedging it apart.
Two other factors matter: grinding, which shortens the life of any restoration and shifts the choice towards more robust materials with a night guard; and position, because a filling on a visible front tooth is an aesthetic decision while one on a back molar is a mechanical one.
On amalgam
Amalgam has become rare in Germany and its use is now heavily restricted. If you have existing amalgam fillings that are intact and symptom-free, there is no medical reason to replace them — removal costs healthy substance. If a filling needs replacing anyway, it is replaced with a modern material.
What we recommend and why
For a small cavity: composite, one appointment, done. For a large defect with a lost cusp: ceramic, because a large composite in that situation is likely to fail within a few years and the tooth pays for it. Where the extra outlay is genuinely worth it is precisely that case — not the small one, where a more expensive material buys nothing.
You receive a written cost plan showing the difference between the standard covered by statutory insurance and the option we recommend, with the reason stated. If the cheaper option is the right one for your defect, we say so.
Frequently asked questions
What does German statutory insurance cover?
For back teeth, insurance covers a durable filling as standard care; tooth-coloured composite in visible areas is generally covered too. Ceramic inlays and gold are private services, with the difference set out in your cost plan.
How long does a composite filling last?
For small to medium cavities, many years. Life is shortened mainly by size, grinding, and margins that are hard to keep clean — not by the material itself.
Should I have my amalgam fillings replaced?
Not if they are intact and symptom-free. Removing a sound filling costs healthy tooth substance for no medical gain. When one needs replacing anyway, a modern material is used.
Is ceramic worth the extra cost?
On large defects, yes — it lasts longer and stabilises the tooth. On a small cavity it buys very little over composite, and we will tell you that rather than sell it.
This article provides general information and does not replace a dental examination. Medically reviewed by Dr. F. J. Rodríguez Ruíz, MSc., dentist at A+ Dental, Düsseldorf-Oberkassel.