Dr. Lawrence Wang runs Madison Square Dentistry in Manhattan, which specializes in cosmetic and restorative dentistry. Although some dentists advocate replacing silver fillings because of their mercury content, as part of his conservative dental philosophy, Dr. Wang holds that replacing your silver fillings is a matter of personal preference.
Silver (amalgam) has been something of the “gold standard” of dental fillings for years. But recently, composite fillings have become a popular method. I haven’t done a silver filling since dental school, and it is a practice that is being phased out in general — though it depends on which generation of dentist you go to. Dentists and patients have plenty of reasons to prefer composite fillings. But before you surrender your silver, consider some facts about fillings.
Silver fillings are durable, lasting on average 10 to 20 years, and they are strong, making them ideal for use in the large back molars. They also tend to be less expensive than composite fillings, but usually require more invasive preparations, such as removing part of your healthy tooth structure. The biggest drawback to silver fillings is aesthetic, as they can cast a gray hue over the surface of a tooth. Silver fillings have gotten a bad reputation because of their mercury content, but the FDA and ADA (American Dental Association) agree that there’s no proof that the compound has any adverse side effects. In fact, the mercury in amalgam fillings is only one, small component of a chemically stable alloy. Silver fillings have been used in dentistry for hundreds of years, and allergic reactions are rare.
Composite fillings, made of a mixture of glass and quartz materials, provide a tooth-colored restoration that looks more like your natural tooth. Composite materials are also versatile and can be bonded (held adhesively) to teeth, which calls for a less invasive procedure and leaves more healthy tooth structure beneath the filling. Compared to amalgam, composite fillings are slightly less durable and are better suited for teeth with light or moderate bite pressure. They can also take longer to place. Depending on your dentist and your insurance options, composite fillings can cost a bit more than amalgam. Finally, with silver fillings, the dentist usually has to use Novocaine, because they hurt more, while with white fillings you only need Novocaine about half the time.
Unless your dentist notices cracks or damages in your current fillings or expresses other concerns regarding your dental health, replacing silver fillings is a matter of personal preference.
The information in the article is not intended to substitute for the medical expertise and advice of your healthcare provider. We encourage you to discuss any decisions about treatment or care with an appropriate healthcare provider.
