Why did this new “white filling” break is a question I hear more and more in my practice. A new patient comes in for an exam and has a “new” filling that has been done within the last 2 years, sometimes within the last year, and it has already failed. Normally I tell the patient that it most likely was the filling material the dentist used or the bonding agent that was used. Both are critical in achieving a restoration that does not fail too early. Research is telling of controlled clinical studies that show the new “nano” fills are failing within the first 2 years at rates we have not seen since the late 1980’s. In my practice, based on my knowledge of materials, my research I have done and continue to do at the UTHSCSA Dental School, and the published research, we use a composite first manufactured in the mid 1990’s and a bonding agent first used in 1990. Why? Because they work, have long term clinical trials that say they work and in our practice normally last more than the American Dental Association’s average of 3-5 years. We want them to last more than 10 years and that’s the reason we are conservative in what we use to restore teeth to their vibrant form and function.