Tooth-Colored vs. Silver Fillings: What's the Difference?

If you need a filling, you'll probably be offered a tooth-colored one. If you're older, you may also have silver fillings from years past. Both have been used successfully for decades. Here's how they compare, and what to do about the silver fillings you already have.

What composite (tooth-colored) fillings are

Composite fillings are made from a tooth-colored resin reinforced with fine glass or ceramic particles. The dentist places the material in layers and hardens each layer with a special light, then shapes and polishes it to match your tooth. A typical filling takes a single visit with local anesthetic.

Advantages

• Blend in with your natural teeth
• Bond directly to the tooth, which can help support what's left of it
• Usually need less removal of healthy tooth structure
• Can also repair small chips and worn edges
• Contain no metal

Considerations

• Can be more sensitive to how the area is kept dry during placement, so technique matters
• May wear somewhat faster than amalgam in very large fillings under heavy chewing forces
• Can stain slightly over many years

What amalgam (silver) fillings are

Amalgam is a mix of metals, including silver, tin, copper and mercury, that hardens into a strong, durable filling. It has been used for more than a century.

Advantages

• Very durable, especially for large fillings on back teeth
• Less sensitive to moisture during placement
• Often lower in cost

Considerations

• Silver-gray color shows when you laugh or talk
• Requires removing more healthy tooth structure to hold it in place
• Doesn't bond to the tooth
• Over decades, it can expand and contract with temperature changes, which can contribute to cracks in the tooth

Is amalgam safe?

Amalgam contains mercury bound with other metals, which understandably concerns some patients. Major health organizations consider amalgam fillings safe for most people. The FDA has recommended that certain higher-risk groups, including pregnant women, nursing mothers, young children and people with certain health conditions or mercury sensitivity, consider alternatives when appropriate. Zen Family Dental places tooth-colored fillings, and we're happy to talk through any concerns you have about the materials in your mouth.

Should old silver fillings be replaced?

Not automatically. Removing a healthy, intact amalgam filling means removing more tooth structure and briefly releasing more mercury vapor than leaving it in place. We generally recommend replacing an old filling when:

• It's cracked, broken or worn down
• There's new decay underneath or around it
• The tooth itself is cracked or painful
• You'd like to change its appearance and understand the trade-offs

At each checkup we look at your existing fillings and take X-rays as needed to check for decay underneath. If a filling needs attention, we'll explain why and show you on an intraoral camera image.

When a filling isn't enough

If a cavity is very large or a tooth is cracked, a filling may not be strong enough to hold it together. In that case, a crown may protect the tooth better. Our post on whether you need a crown explains how we decide.

Fix small problems while they're small

The best filling is a small one, placed before a cavity grows. Regular checkups make that possible. Learn more about our restorative dentistry, then request an appointment online or call Zen Family Dental at (703) 385-2772.