Amalgam and Composite fillings

What are amalgam fillings?

Amalgam fillings are also known as “silver fillings.”  Dental amalgam is a combination of mercury, silver, tin, copper and small amounts of zinc, indium or palladium.  Mercury makes up 50% of the filling material and it binds all the other metals together to provide a strong, safe and durable filling.

What are composite filling?

Composite fillings are also known as “tooth-colored fillings” or “white fillings.”  Composite is a blend of plastics and small glass particles that are used to do small and large fillings for front and back teeth.

Pros and Cons of amalgam and composite fillings

Pros: Amalgam fillings

·       Proven-most popular and effective filling material used in dentistry for the last 150 years

·       Economical-cost less than composite fillings

·       Durable

Cons: Amalgam fillings

·       Unesthetic & Noticeable-black/grey teeth

·       Allergies-some people are sensitive to the metals in amalgam

Pros: Composite fillings

·       Esthetic-natural looking, match the color of natural teeth

·       Easy adhesion-bond directly to the tooth surface

·       Preserves maximum amount of tooth structure, less drilling, and less tooth structure reduction

Cons:  Composite fillings

·       More frequent replacement, they don’t last as long as amalgam fillings

·       Placing a composite filling is more involved and it is a longer appointment

Why is mercury used in amalgam and is it safe?

·       Mercury is used in amalgam because it binds all the other metals together to provide a strong, safe and durable filling. Mercury also helps making the filling material pliable. When mercury is mixed with alloy powder it becomes soft enough to mix and press into the tooth.  Amalgam filling hardens quickly and can withstand the forces of biting and chewing.

·       In 2009, Food and Drug Administration (FDA) evaluation and research concluded that amalgam fillings are safe for adults and children ages 6 and above.

Are amalgam fillings a problem?

·       In 1998, the American Dental Association’s (ADA) Council on Scientific Affairs published the scientific literature on dental amalgam and concluded that amalgam continues to be a safe and effective restorative material.  

·       In recent years, tests show very small amount of mercury (vapor) can be released as the amalgam filling wears in the mouth over time.

·       Several reviews of the research concluded that any amount released from amalgam in the mouth is very low.

·       Other studies showed that the amount of mercury people are exposed to from the fillings is less than the amount that people are exposed to in their environment and their foods.

When should amalgam fillings be replaced with another type of dental material?  What material? 

·       Patients should remove their amalgam fillings if tooth is breaking, chipping, decaying or when the filling is worn.  There is no need to replace the amalgam if amalgam is intact with no tooth problems.

·       Removing good amalgam fillings can cause unnecessary loss of healthy tooth structures and can release more mercury (vapor).

·       Depending on the size and locations of fillings; your options are composite fillings, porcelain fillings (inlays/onlays) and others

Dr. Anna Lee is a general & cosmetic dentist in Glendora, CA.  She is knowledgeable about different types of dental material for fillings. If you have any questions about amalgam and composite fillings, please visit us at www.annaleedds.com or call for a dental checkup at 626-335-5114.