Silver vs. White Fillings

Two of the most common choices for filling materials are silver (called amalgams) and resin (called composite). There are several differences besides the obviously more esthetic results of composites over amalgams. A big difference, which insurance companies seem to consider the most important, is longevity. Amalgams last up to 20% longer than similar composite restorations, and they require less expensive materials. These two factors make silver fillings more economical than the more natural looking composites, so that together you can see why insurance companies rarely approve of a composite filling in the back teeth. Besides being virtually invisible, composites have a property of bonding to the tooth structure. This bonding protects and increases the overall strength of the tooth being restored, which a silver filling cannot do. The choice made depends on balancing appearances, longevity, strength of the tooth involved, and cost.

Which to Choose?

Silver:

Silver has been used as a filling for teeth for almost one hundred years. While there is mercury present in the silver filling material, called amalgam, in the past century there has been no evidence showing that silver fillings are harmful to patients. Just like the cyanide in crazy glue where the cyanide is compounded with other ingredients that make it harmless, the mercury in amalgam is compounded with silver, tin, and copper to make it just as harmless.

Silver is a strong filling agent lasting longer than comparable composite fillings. It also costs significantly less than composite fillings (up to 25% less in some cases). The main argument against the use of silver fillings is esthetic. Depending on where the tooth to be filled is located in the mouth, the appearance of a silver filling may be less attractive than a more natural-looking composite filling. Also, for some patients the feeling of metal in the mouth may be displeasing. Over time, like most metals, silver fillings will eventually corrode and even leak causing decay to reoccur underneath the fillings.

Composite Fillings:

Composite fillings are primarily a resin which has been "filled" with other inorganic materials. This compound makes a composite filling more resistant to wear, color adjustable, and easier to polish. The advantages of choosing a composite filling include a more natural appearance, frequently a strengthening of the filled tooth, and a bonding of the filling to the tooth creating a better seal. This bonding also means that the filling can often be made smaller than a comparable silver filling since silver requires certain size criteria be met to resist breaking or falling out. The disadvantages are that composite fillings themselves are weaker and may last a shorter period than a silver filling. In addition, a composite filling may cost about 25 % more than the same silver filling.

Composites suffer from what is called dissolution. They will actually dissolve slowly over time in your mouth regardless of whether you eat on them directly or not. In addition, they can discolor over time acquiring a yellowish tinge. Composite fillings also may get pitted leaving pinholes on the surface, which may pick up discoloring and stain permanently.

You might wish to see our related section Empress Crowns for more information on the types of crowns available.