Tooth-colored or Silver Fillings?

Dental Amalgam and Composite Resin are two of the most commonly used dental restoration materials.

Dental Amalgam or traditional silver fillings are strong, durable and economical. Dental Amalgam is a compound formed by combining silver and other metals with mercury. Mercury makes up approximately half of this compound. It binds the metals and holds them together forming a strong filling material. After many years of research, mercury continues to be irreplaceable in dental amalgam. While there is no conclusive proof that mercury as a constituent of amalgam is harmful, mercury by itself is very toxic.

Composite Resin or tooth-colored fillings are newer materials which can match different shades of teeth. The type most commonly used today is made of microscopic glass or porcelain particles embedded in an acrylic matrix. Composites are sometimes assumed to be weaker than amalgam and were initially used only to fill front teeth. In the last decade, newer composite resins have been introduced into the market, which are highly resistant to attrition and comparable to or even better than amalgam. In modern dentistry, composite resins are replacing amalgam as the material of choice for fillings.

Amalgam replaced by Composite

In India, traditional amalgam fillings are still very popular due to their longevity and low cost. These involve simpler dental techniques and less demanding skill levels. Many urban dental practices employ both amalgam and composite resin fillings.

My Choice:

I spent my years in dental school placing innumerable amalgam fillings, subsidized by the government for a community that is unable to afford composite fillings. The most obvious problem is they are…well, ugly :) I have seen no evidence of mercury leakage causing toxicity or that amalgam fillings have in any way been detrimental to health. I found that amalgam fillings have a remarkable clinical performance and am told their strength is unsurpassed.

That said, mercury is a known poison and is classified as a hazardous waste material. It is illegal to dispose of mercury or dental amalgam in the garbage. We are supposed to avoid skin contact with both amalgam and mercury. Yet, it can legally be placed in a patient’s mouth. I no longer feel it necessary to risk placing silver amalgam in my patients’ teeth, especially when I have access to the newly improved composites- which when properly placed look just like the natural tooth and also strengthen the tooth.

I prefer not to employ amalgam in my practice and have chosen to use only the best composites available.

Liquid Mercury

Amalgam replaced by Composite