Tooth Colored vs Silver Fillings

What are the different types of filling materials?

Well there are two major types of fillings that are typically done composite and amalgam. Composite fillings come in multiple different shades to best match the tooth or teeth they are being used on. Composite filling are often referred to as tooth colored fillings. Amalgam fillings have been used in dentistry for thousands of years first appearing in Germany in 1528 and then growing in popularity in the 1800s. Amalgam fillings are also called silver fillings.

What is the benefit of Silver (Amalgam) fillings?

Silver fillings have a long history of being used in dentistry because of their strength and durability. Silver fillings tend to last a long time and are a lower cost filling material.

What is the benefit of Tooth colored (Composite) fillings?

Composite fillings are a great shade and match the tooth so no one will know you have fillings except a dentist performing a routine exam. Aside from blending in very well composite fillings are chemically bonded to the tooth which means that less natural tooth structure needs to be removed to bond the filling to the tooth and they are less likely to fracture teeth.

What is the downside of Silver (Amalgam) fillings?

Silver color in the mouth is generally noticeable except on the farthest back upper teeth especially on someone with a large smile or bold laugh. Other downsides to amalgam is they stain the tooth and even after removal the tooth will tend to have a gray-blue tint to it. In my practice I have witnessed a lot more fractured teeth that had silver fillings resulting in the tooth needing a crown. The biggest controversy with amalgam fillings is the components used to mix the materials together. Amalgam fillings have silver, tin, copper, and mercury as components. The mercury is used to mix and combine the individual components.  The amount of mercury is very small and has not been shown to cause any health risks or harm according to ADA, FDA, American College of Medical Toxicology, and American Academy of Clinical Toxicology.

What is the downside of Tooth colored (Composite) fillings?

Historically tooth colored fillings did not hold up as long as silver fillings especially on back teeth. With improvement in technology and dental materials tooth colored fillings have much better wear characteristics and hold up to everyday chewing. Overtime tooth colored fillings can stain and change color but often the filling is still in good, serviceable shape. The biggest downside to tooth colored fillings is they cost more and insurance will pay the same amount whether it is amalgam or composite leaving the patient to pay the difference. On the flip side if the tooth is less likely to need a crown then the cost is usually worth it.

What type of filling material do you recommend?

In our office 99.9% of the time we perform composite, tooth colored, fillings. There are cases where amalgam can be a better choice but the benefits of a tooth colored filling such as cosmetics, more natural tooth, better bond, and less likely to fracture the tooth make it the go to choice.


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