Should You Replace Your Old Silver Fillings?
Dental technology has changed dramatically over the last few decades and no doubt will continue to improve in the future. Many patients are concerned about the silver fillings that they or their children have had for years.
Dental amalgam is a mixture of mercury, silver, tin, and copper. Mercury makes up about 50 percent of the compound and is used to bind the metals together and to provide a durable filling.
The current position of the ADA and FDA is that amalgam is a safe, restorative material and should not be removed due to health concerns regarding mercury content. When mercury is combined with other materials in dental amalgam, its chemical nature changes, so it is essentially harmless.
The amount of mercury released in the mouth under the pressure of chewing and grinding is minuscule. It is less than what patients are exposed to in food, air and water.
In fact the highest exposure of mercury to patients is due to amalgam placement and removal. High-speed suction should be used when removing mercury-containing fillings to reduce excess mercury inhalation by the patient.
White (or composite) fillings are aesthetically appealing, but require a longer time to place the restoration and may come with an additional cost. Composites bond to the tooth to support the remaining tooth structure, which helps to prevent breakage and insulates the tooth from excessive temperature changes. Although not as strong as amalgam, the advances in composite resins make these restorations a durable option.
Composite fillings, which are more technique sensitive, require a saliva free environment. Your dentist may suggest amalgam in areas that are difficult to keep dry, such as molars (back teeth) or cavities below the gumline.
When To Consider Replacing a Silver Filling
Decay is present under filling If decay is left untreated long term it could lead to further complications, such as fracture or potentially infection.
Filling is fractured or leaking A chipped or fractured filling can lead to further breakage of the filling or of the surrounding natural tooth structure. Fillings that extend on multiple surfaces of a tooth may require a crown.
It was placed in a high cosmetic zone Let’s face it – in 2022, no one wants to see silver in his/her front teeth. If you have a silver filling that is visible in an anterior region, replacement may be an option.