Your dentist told you that you have a cavity. Now you need to decide what kind of filling you want to restore it with. You have a choice. The choice is between a composite (white) filling or an amalgam (silver) filling. Each of these materials have their place and it is ultimately up to you to decide what material is used. But wait! What is an amalgam? What is a composite? I will explain…
This article will discuss everything you need to know about your choice of filling materials. I will discuss what each type of filling is composed of and best case scenarios for each of their uses. Read on so you can make an informed decision about what goes into your mouth. I will also discuss the controversy over whether amalgams are safe to use in the mouth.
The History of Fillings…
For over 150 years, dentists have been using amalgam (which is another name for silver) fillings. This has been the material of choice and most common material used for several reasons. Amalgams are less expensive, stronger and easier to work with. They are a mixture of mercury with other metals. Because of this, they have a metal color and they are a less appealing option due to their silver color.
With controversy over mercury and possible negative health concerns, more and more people have opted for composite fillings. I will discuss this controversy later on. Composites have become more popular lately due to aesthetics. Patients want to have tooth-colored restorations placed that match the color of the rest of their teeth. This makes it difficult to tell where a composite filling has been placed.
Since the beginning of the 1990s, composites have been gaining popularity with dentists as well. When a composite filling is used, less tooth structure needs to be removed from the tooth when removing the cavity. This leaves more of the tooth structure intact causing less weakening of the tooth.
What’s In An Amalgam?
A traditional amalgam is formed from a process called amalgamation. Merriam-Webster’s dictionary defines amalgamation as: “the action or process of uniting or merging two or more things : the action or process of amalgamating“. This process forms an amalgam with a composition of the metal portion being approximately 65% silver, 25% tin, 6% copper and 1% zinc. Zinc prevents corrosion of the amalgam and it helps keep the other metals from oxidizing.
The powdered alloy made from different percentages of silver, tin and copper is mixed with elemental (liquid) mercury. By weight, a typical amalgam will contain approximately 50% of elemental mercury.
Originally, amalgam was thought to be stronger than composites. However, modern composite materials are more durable than they were in the past. They are strong enough to be used on molars which are subject to extraordinary chewing forces.
When considering which material to use when restoring your teeth, it is important to keep in mind that dental amalgam has a long history of longevity. On average, tooth-colored composites last 5-7 years whereas, dental amalgams last 12-13 years.
What Is a Composite?
According to Wikipedia, composites are made when two separate materials are combined to make one. The new mixture has properties that are different than either one of the seperate components on their own. A composite is made from a mixture of powdered glass and acrylic resin. When a composite is used for a dental restoration, it starts off with a silica-glass material and is blended with a plastic type resin. Once the composite mixture is prepared, it is applied directly to the tooth needing restoration.
The composite filling is bonded directly to the tooth so less tooth structure needs to be removed. After the material is placed on the tooth, it is cured in layers using a special type of blue light called a curing light. It will immediately be hardened and ready for use.
Differences You Need To Know…
- The procedure is easy and fast
- Material can be used for large cavities
- Least expensive tooth restoration option
- Durable (can withstand chewing forces)
- Long lasting (up to 15 years)
- More of the actual tooth structure needs to be removed in order to place the filling
- Can cause tooth and nearby teeth to appear “dark” as material shines through enamel
- As amalgam expands and contracts, it can weaken the tooth causing fractures in enamel
- Possible allergy to mercury (1% of the population has this allergy)
- Noticeable because they do not match the normal tooth color
- The material is bonded to tooth structure for more support
- Less tooth structure needs to be removed
- No expansion or contraction of material with exposure to hot and cold
- Can be used on front teeth as well as back teeth
- Matches the color of your teeth
- They do not hold up as well to chewing forces and can chip or crack
- More expensive than amalgams
- Insurance does not always cover the cost of composites and can be more expensive
- They do not last as long as amalgams (on average 5 years)
- The placement procedure takes longer
- Should not be used for large cavities
Your choice of fillings may depend largely on where in your mouth your cavity is. Most dentists will want to preserve the look of your smile by placing a tooth-colored filling in an area that shows when smiling. This would mean composites would be recommended for all of your front teeth. They also would be suggested for your premolars (the two teeth directly behind your canines) since these teeth also show when you smile.
If a filling is needed in a back tooth, your dentist may feel an amalgam would be the best option. You do have a choice though if you would prefer that no amalgams be placed in your mouth.
Controversy Over Amalgams
There are concerns about whether amalgams are safe to use in the mouth. Recent controversy has raised questions about the safety of mercury in amalgams. The main concern is whether the mercury in silver fillings can contribute to adverse health conditions such as Alzheimer’s, MS or Parkinson’s Disease.
Ultimately, the decision to have amalgams used is up to you. However, I would like to refer to a couple of significant sources that may help you decide which dental restoration material is right for you. The International Journal of Dentistry reassures the use of amalgams. The Food and Drug Administration (FDA) goes into further detail on the pros and cons of using dental amalgams.
Prevent Decay Before It Starts
Knowing how to care for your children’s teeth will set them up for a lifelong positive experience regarding their dental health. As an adult, you can learn how to best take care of your own teeth with the best dietary habits including avoiding soda.
By using the right tools, you can more effectively reduce the bacterial plaque in your mouth. Bacterial plaque, when mixed with the sugars in your diet will create acid. This acid is what eats away at enamel creating cavities. Brush twice a day using an electric toothbrush for the adequate plaque removal. An electric toothbrush has been proven in a Cochrane study to reduce plaque by 21% more over a three-month period compared to a manual toothbrush. This article will discuss the best electric toothbrushes for optimal plaque removal.
Flossing is recommended once a day but if you are not a good flosser, using an oral irrigator will remove twice as much bacterial plaque than flossing can. Learn more about the best oral irrigators available today. By maintaining good home care habits, you will be reducing your chances of decay along with keeping your gums healthy. Preventing gum disease is just as important as preventing cavities.
Talk To Your Dentist!
You now know what is in an amalgam. You also know what is in a composite. I have outlined the important pros and cons of each dental restoration material. It is best to have a discussion with your dentist as to what may be the best option for your particular situation. Please leave your questions and comments below and I would be happy to help.
The information that I provide on my website is not intended to take the place of medical advice, diagnosis or treatment. Care and investigation should always be sought from an appropriate health care provider. I am not a doctor and do not claim to be one. I have created this site as a way to share information and experiences.
I think I prefer the amalgam better than anything else. In all honesty, this is really good to see that there is a choice. Having teeth alternatives in case a person runs into a dentition problem is a big issue. Seeing this here is a much more affordable and simpler offer- I like it a lot. Thanks so much for sharing this information. Thumbs up!
Michelle Mussehl, RDH
Many people do still choose amalgams over composites even though they are an older option. Some people like the durability and longevity aspect of silver amalgams. For these people, the positive aspects of an amalgam may outweigh the negative aspect of the filling not being the same color as your existing teeth. Thanks for your comments.
This is clearly amazing and I have not had the knowledge of white filing before now. There is indeed a consideration going by cost, time and durability- I will give it it’s due credits. However, the cons can’t be overlooked because they are quite serious. First, the allergy is one thing I wouldn’t want to risk and the problem of having to remove extra from the tooth for it to fill doesn’t sit well with me. Thanks for sharing .
Michelle Mussehl, RDH
Thanks for your comments. Weighing the pros and cons is very important when deciding between an amalgam or a composite. Your dental provider can help you to make the best decision for your mouth.
Md. Asraful Islam
Thank you so much for sharing such an informative article. This article allows anyone to easily understand the advantages of amalgams and composites. Amalgam is currently the most popular of these two methods. The amalgam method is safe for the mouth. Amalgam is originally made of a mixture of these three metals: silver, zinc and copper.
My grandfather followed the amalgam process for dental treatment that I shared from my experience.
Michelle Mussehl, RDH
Your Grandfather likely used amalgams in most situations. It was not until the 1990s that composite fillings really gained popularity. There are some dentists who prefer placing amalgams over composites simply because they are faster and less technique sensitive. Thanks for sharing your experience.
Dental amalgam is an old technique in the medical field used in filling teeth. This is of medical significance to everybody. You did a great job by putting all this together. Nice job.
I do have a question. Is dental amalgam also suitable for children or is there an age limit where this procedure can be carried out?
Michelle Mussehl, RDH
The U.S. Food and Drug Administration (FDA) states that they consider dental amalgam fillings safe for adults and children ages 6 and above. Pregnant women and children under 6 are advised to talk to their dentist when considering silver fillings versus composites.
Thanks for your question,
After reading this article I now understand what an amalgam is and also the difference between having a filling made of composite material and one made from a silver amalgam.
I get the fact that a silver amalgam will last much longer than a composite filling, but I am wondering if there are amalgams made for dental fillings that are made from other materials other than silver?
For example gold. Is gold a good material for use in fillings, and if so how long would a gold amalgam last?
Michelle Mussehl, RDH
Thank you for your comments and questions. Silver amalgams will all contain silver but may be in different percentages of silver and the the other metals included. Gold is a seperate filling material all together. Gold is often used for people who grind their teeth or have issues with worn or cracked fillings. Due to its durability, it is a desirable material. The only problem is the cost. Gold is not used as much because of how expensive it is.