Tooth Fillings

Dental Amalgam

Dental amalgam is a filling material that has been used by dentists for over 150 years. A mixture of metals that typically includes silver, copper and tin, dental amalgam fillings (commonly referred to as “silver fillings”) also contain mercury, which has raised safety concerns among patients from time to time. In response to those concerns, the U.S. Food and Drug Administration (FDA), American Dental Association (ADA) and other organizations have conducted numerous studies over several decades and have repeatedly found that the small amount of mercury released during placement and removal of amalgam fillings does not cause adverse health effects.

Amalgam fillings remain a safe, cost-effective and durable choice when it comes to the restoration of decayed teeth.

Frequently Asked Questions about Amalgam Fillings

Why is amalgam still used to fill teeth when composite materials are available?

While composite (or “tooth colored”) fillings are more durable than ever thanks to advancements in technology, there are still many cases where amalgam fillings perform better (and longer). This is often the case with teeth that are naturally subjected to extensive chewing force, such as molars. Mercury is an important part of the amalgam mixture as it contains unique elements that allow it to be manipulated with ease during placement and then harden quickly after. In addition to the benefits of longevity, amalgam fillings are also more affordable than composites.

A hand holding a model of a dental amalgam fillingWhat concerns are there with mercury and its effects on the body?

Mercury is a naturally occurring metal and one that we are exposed to in small amounts through water, air and food throughout our lives. Excessive exposure to mercury can negatively affect the brain and kidneys – however, it is important to understand that amalgam fillings do not cause dangerous levels of mercury exposure. Numerous scientific studies and thoughtful research have led the FDA to stand behind its position: amalgam fillings are a safe and effective restoration method for patients over 6 years of age.

What is the ADA’s position regarding the use of silver amalgam fillings?

A thorough summary of evidence ranging from 2004-2010 led the ADA to reaffirm its position that amalgam is a valuable and safe choice for patients.

When is it appropriate to use composite fillings?

Composite fillings are typically made of a resin and glass mixture, tinted to the color of your tooth, and commonly referred to as “white” or “tooth-colored” fillings. They serve an important purpose for teeth that are visible when smiling, providing an aesthetic benefit not afforded by silver fillings. While resin composite fillings undoubtedly look better than amalgam ones, they are generally considered to be less durable, and therefore may not be ideal for teeth that are subject to extreme chewing and biting forces. It is worth noting, however, that composite materials continue to benefit from technological advancements, contributing to enhanced durability. The ADA supports composite materials in small or mid-size fillings on teeth that are exposed to moderate pressure from chewing, and acknowledges that they are a good choice for a more natural-looking filling.

The bottom line? 

The ADA Council on Scientific Affairs has concluded that both amalgam and composite materials are considered safe and effective for tooth restoration.

Advantages of Tooth-Colored Restorations

There are many advantages to tooth-colored restorations. Resin onlays are bonded to the teeth creating a tight, superior fit to the natural tooth. Such restorations can be used in instances where much of the tooth structure has been lost. The tooth remains intact and stronger.

Since the resin used in tooth-colored restorations contain fluoride this can help prevent decay. The resin wears like natural teeth and does not require placement at the gum line, which is healthier for your gums!

The result is a beautiful smile!

Replacing Silver Fillings with a Tooth Colored Restoration

You can have your silver fillings replaced with tooth-colored restorations (onlays). This process requires two appointments.

Your First Appointment:

  1. The old filling is removed along with any additional decay.
  2. An impression is made of your teeth. A model of your teeth is made and sent to the lab.
  3. A temporary onlay is placed on the tooth.

At the Lab: A resin is carefully placed into the model of your teeth. It is then designed to look natural.

Your Second Appointment:

  1. The temporary onlay is removed.
  2. A conditioning gel is placed on your tooth to prepare it for the new onlay.
  3. Bonding cement is placed on the tooth and a high intensity light bonds the resin to the tooth.
  4. The tooth is then polished.

Your teeth are restored to a natural look and feel, they are stronger and the tooth is protected!

The Advantages of Composite Resin Fillings

Some benefits of tooth-colored resin fillings are:

  • They look more aesthetically pleasing since they match your natural tooth color and appearance.
  • They require less drilling, so not as much tooth structure needs to be removed.
  • They harden in seconds instead of days like other materials.
  • They bond to the tooth giving it greater strength, which helps prevent breaks.
  • They can be repaired if damaged.

The Disadvantages of Composite Resin Fillings

Some drawbacks of these types of fillings are:

  • They’re more labor intensive for your dentist to place on your tooth.
  • You may experience some brief tooth sensitivity following the procedure.
  • They tend to wear out sooner than metal fillings, especially if you have heavy wear from grinding and chewing.
  • They may stain from frequent and/or prolonged exposure to coffee, tea, red wine and other foods with staining properties.
  • They can degrade from recurrent and/or extended exposure to high alcohol content drinks.
  • They’re more expensive than silver fillings.
  • Your dental plan may only cover resin fillings in your visible teeth (the incisors, cuspids and bicuspids). Plus, your dental insurance company may require higher co-payments and/or additional costs for resin fillings.