Silver (amalgam) fillings: still a good choice in 2008
For many years, the dental profession has been moving away from gold and silver restorations to composite (plastic) and porcelain/ceramic restorations. However, they are not always the smartest options for certain circumstances. While there is a lot of misinformation out there about the alleged dangers of (mercury) silver fillings, here’s the simple truth: Silver fillings are perfectly safe, and there is not ANY reputable research by any reputable organization that has shown that the mercury from the fillings causes ANY harm. PERIOD. All that misinformation is simply that – misinformation. ‘Nuff said.
When do I recommend silver fillings? There are just a couple circumstances in which I actually recommend silver fillings instead of a tooth-colored restoration (composite or porcelain):
1) Patients who have high rates of decay; IOW – anyone who seems to get cavities frequently no matter how hard they try to care for their teeth. These include patients with acid reflux, who drink a lot of sodas, who are on medications that dry up their saliva, who have recently been through radiation treatment of the head/neck, or similar conditions. In my experience, while there are steps that can be taken to reduce that risk, silver fillings last longer with fewer problems.
2) Patients who grind their teeth and who do not wear a nightguard. Again, in my experience and in a fair amount of current research, composite fillings do not last as long. While the ability of composite fillings to withstand significant wearing forces is definitely improving, in the teeth of patients who really grind, they’re just not there yet.
3) Patients who need a lot of work and need to stage it over time: in our practice, silver fillings are still less expensive because the material is less expensive. We still take just as much time as necessary to restore the tooth as with a composite filling, but we believe it is fair to pass on the savings in cost to our patients, because that helps make dentistry more affordable.
And the thing is, while old silver fillings can look pretty ugly and flat, properly-placed new silver fillings can look extremely natural, just not tooth-colored.
Here’s an example of a silver filling that’s probably been in place 20+ years:
Here’s what 2 shiny new amalgams can look like:
So while most patients still prefer tooth-colored restorations, there really isn’t anything wrong with silver fillings, and under some circumstances, they can be a better solution for some patients.