ADVANTAGES AND DISADVANTAGES IN THE USE OF GOLD
Clinical Observations
by Richard V. Tucker, D.D.S.

There are many advantages of the use of cast gold rather than other types of filling materials for the restoration of posterior teeth. Some are listed as follows:
1. Gold will not oxidize and discolor the teeth.
2. Fragile areas of tooth structure remaining can be protected by covering them with a thin onlay of gold. Gold will not fracture even when it is thin.
3. The cast gold restoration will not fracture in the isthmus or other areas.
4. The margins at the junction of the tooth and gold are nearly imperceptible if handled properly, and will not be so likely to harbor plaque, and consequently should contribute to better tissue health.
5. Contact areas can be placed and polished for ease in the use of dental floss, thus promoting better tissue health.
6. Gold can be polished and finished to a higher degree than other materials. This polished surface will last longer with gold than with other materials. This highly long lasting polished surface will retain less plaque and thus promote better tissue health.
7. Gold castings such as 7/8 modified full crowns or conventional full crowns can be used to 'bind the tooth together' and prevent tooth fracture, or relieve sensitivity from incipient tooth fractures.
8. The normal tooth anatomy can be more nearly reproduced with a casting.
9. Cast gold wears more nearly the same as tooth structure and does not produce submarginal surface. Precise fitting castings will support the marginal enamel rods which prevents chipping and fracturing at the cavo-surface margins and minimizes the possibility of marginal leakage and bacterial invasion.
10. Gold castings have a favorable coefficient of expansion with tooth structure.
11. Well placed gold casting will last much longer than other filling materials used today.
12. The sensory acceptance of gold by the tongue and the feel during mastication is enhanced by the smoothness and anatomical replication of the missing tooth structure. Since there is no perfect or ideal filling material in our dental armentarium, some of the disadvantages will be listed.

1. The procedures for making castings are more time consuming than for other materials.
2. The cast gold restoration is necessarily more expensive for the patient.
3. The gold casting is quite Technique sensitive. If it is not done with a real concern for excellence, it probably is not as satisfactory as other types of restorations.
4. Gold, especially if not handled properly, can be esthetically unacceptable.