Which would you choose, the first restoration or the second?
In this case, pictures speak a thousand words. If given the choice, the overwhelming majority of people will chose white fillings over amalgams every time, purely for aesthetic reasons.
Amalgam fillings have also been the center of an ongoing controversy in the dentistry world. The material in amalgam fillings is nearly 50% mercury, a known neuro-toxin. Most general dentists refer to amalgam fillings as “silver fillings”, even though they have more mercury than silver in them, because people know mercury is toxic. Current research regarding the safety of mercury fillings remains inconclusive—a small amount of mercury vapor does appear to be released during chewing, but it has not yet been determined whether that small amount of vapor is harmful to the body.
Click here to read more about Dr. Hadgis’ stance as a mercury-free dentist.
Why Choosing the Right Dentist is So Important
So, why wouldn’t you always choose white fillings over amalgams? Because your dentist may not offer them as an option. General dentists are not required to learn how to place white composite fillings as part of their general dentistry training, and most dentists are not comfortable performing a procedure they have not been trained to do.
If you ask for white fillings, and your dentist seems uncomfortable or uncertain, do not press the issue. Seek the services of a dentist who has been trained in the placement of white composite fillings. If you push your dentist into doing something he/she is not comfortable doing, the results may very well be substandard.
Advantages of White Fillings
- White fillings look like part of your natural tooth.
- White fillings bond to your tooth, unlike amalgam fillings, and actually restore more of the strength of your natural tooth. The silver in amalgam fillings actually weakens your tooth, making it more vulnerable to cracking or breaking.
- The composite material in white fillings does not conduct heat or cold like the amalgam material does, making teeth restored with white fillings less sensitive.
- The composite material in white fillings does not contain mercury, a known toxin.
- Proper application of an amalgam filling requires that a greater part of the tooth is drilled away (see picture on left below). A white filling requires removal of only the decay, yielding a much smaller change to the natural tooth (see picture on right).
Advantages of Amalgam Fillings
- They are generally less expensive, and take less time to place than white fillings.
- General dentists can place them without any extra training.
- The filling material itself is stronger than composite material, though it weakens the entire tooth structure.
White Fillings and Alcohol Consumption
A word of caution—if you consume beverages with a high alcohol content on a daily basis, you may want to go with amalgam fillings. Beverages that have a high alcohol content (i.e. hard liquors) make the composite material used in white fillings deteriorate.