Dental materials are constantly evolving and improving. These days, almost all fillings are done with composite resin, a durable tooth-colored material. However, until recently amalgam, a silver metallic material, was by far the most common. These durable restorations were once the standard of care for treating cavities, and many people still have them today.
Unfortunately, nothing lasts forever and amalgam fillings can break down over time. Many people also worry about whether these fillings are safe, and may wonder if it’s better to get their silver fillings removed.
The short answer is: it depends. At Fort Washington Dental Associates, we don’t believe in performing unnecessary dental work, and we don’t recommend replacing silver fillings just because they’re old. But there are some good reasons why you might want or need to consider it!
What Is Dental Amalgam?
Dental amalgam is a combination of metals including silver, tin, copper, and a tiny amount of mercury. This last ingredient has led many people to worry that their silver fillings could harm their health, as too much mercury in the blood can be detrimental.
Is It Safe to Keep Silver Fillings?
Yes, as long as the filling is stable and healthy. The mercury is bound in a stable alloy and has been studied extensively for decades. Research consistently shows that the mercury in stable, healthy amalgam fillings poses no threat of toxicity. That’s why the FDA and American Dental Association have both stated that amalgam fillings are safe for most patients, and there’s no strong evidence that they pose a health risk when intact.
That said, removing amalgam fillings unnecessarily can sometimes increase your exposure to mercury vapor, which is why we don’t recommend removing them without a valid reason. If your silver fillings are healthy and functioning well, we usually suggest leaving them alone and continuing to monitor them during your regular dental checkups.
Of course, if you’re ever concerned about your existing dental work or any of the materials used, we are more than happy to answer any questions you may have.
When Should You Replace an Amalgam Filling?
While amalgam is long-lasting and strong, it’s not immune to the effects of time and wear. We typically recommend replacing a silver filling only if there’s a clinical reason to do so, such as:
- New decay under the filling
Decay can form beneath any type of filling. If bacteria sneak in around the edges, it can lead to cavities that compromise the tooth. - Cracked or weakened tooth
Over time, the metal in a silver filing can expand and contract with temperature changes, putting pressure on the tooth and increasing the risk of cracks. - Broken or loose filling
If the filling itself is chipped, cracked, or has separated from the tooth, it needs to be replaced to prevent further damage. - Aesthetic concerns
Let’s face it, silver fillings are noticeable. If you’re unhappy with how your fillings look when you smile or speak, replacing them with a more natural-looking option can give you a confidence boost.
At every routine visit, our dentists will evaluate your existing restorations and help you determine whether replacing them makes sense for your smile. We’re also happy to schedule a consultation if you have any doubts about your teeth or want to discuss having amalgam fillings replaced.
Why Not Just Use a Tooth-Colored Filling?
Composite (tooth-colored) fillings are a great option for new and small cavities, but they’re not always the best replacement for older silver fillings. That’s because:
- Many silver fillings are large and may leave too little healthy tooth structure to support a composite filling.
- A larger restoration needs to restore not just the surface but also the strength and integrity of the tooth.
- Composite fillings can shrink slightly when cured, which can lead to gaps or leaks in very large restorations.
- Amalgam can sometimes stain the enamel over time, so replacing them with porcelain frequently delivers better aesthetics than other options.
For these reasons, we often recommend a dental crown, inlay, or onlay for the best long-term result. These restorations are made from durable, tooth-colored materials and provide excellent protection, especially when a tooth has been weakened by decay, cracks, or older fillings.
Benefits of Replacing Failing Silver Fillings with a Crown or Onlay
- Improved durability: These restorations can withstand chewing forces and last for many years with proper care.
- Better fit and seal: Restorations like inlays, onlays, and dental crowns are custom designed to fit seamlessly and seal out bacteria and contaminants.
- Enhanced appearance: Porcelain or ceramic materials match your natural tooth color and completely cover any staining caused by the silver.
- Reinforcement: A crown or onlay surrounds and reinforces weakened teeth, helping to stabilize existing cracks and preventing future fractures or decay.
What to Expect if You Decide to Replace Your Silver Fillings
If it’s time to replace one or more of your silver fillings, we’ll walk you through your options. Here’s what typically happens:
- Evaluation and X-rays
We’ll examine the tooth to determine the condition of the filling and the surrounding structure. - Treatment Planning
Depending on the size of the filling and the condition of the tooth, we may recommend a crown, inlay, or onlay. - Comfortable Treatment
Your comfort is our top priority. We’ll use gentle numbing techniques and modern tools to make the experience as stress-free as possible. - Restoration
Your new restoration will be carefully crafted and placed to ensure a strong, natural-looking result.
Many of these restorations can be completed in just one or two visits, and you’ll leave with a tooth that looks and feels great.
Talk to Us About Getting Your Amalgam Fillings Replaced!
If you’re not sure whether your silver fillings should be replaced, the best thing you can do is schedule an exam. We’ll take a close look and help you understand:
- Whether the filling is still in good shape
- If there’s any damage, decay, or risk of future problems
- What type of restoration is best for your needs and goals
We’re not in the business of removing healthy fillings without reason. However, we’re here to support you if a replacement is needed or if you’d feel more confident with a more aesthetic solution. If you’re wondering about replacing silver fillings in the Washington Heights area, we’re here to help!
