Is it Safe to Have Silver Fillings?

. . . or should I have them replaced with composite?

We hear this question from patients all the time.  There are several reasons to replace old silver (amalgam) fillings, but actually, safety isn’t one of them.  The short answer to the question in the title is: Yes, it is safe to have silver fillings.  We’ll elaborate a little more, so you can make the decision for yourself.

Why Are Some People Concerned about Silver Fillings?

For most of the twentieth century, dentist used a material called “amalgam” to replace tooth structure destroyed by cavities.  The word amalgam really just means a mixture.  The dental restorative amalgam includes silver, tin, copper, and mercury.  The mercury is the reason people have concerns over the presence of these amalgam fillings in the mouth.

• Yes, mercury is toxic at high levels.
• No, dental fillings do not contain toxic levels of mercury.

Is it Safe to Have Silver Fillings?

There are some rare people who have a true allergy to the mercury in dental amalgam.  For anyone else, silver fillings are safe.  Studies that they release only minuscule amounts of mercury over their lifetime, which is far less than someone receives from eating lots of seafood.

The American Dental Association states that most credible scientific evidence upholds the position that dental amalgam is a safe and durable option for restoring cavities.

Is it Safe to Remove Silver Fillings?

Yes.  One thing patients concerned about mercury exposure should understand, though, is that the exposure to mercury is higher during placement and removal of amalgam fillings than during normal function.   Even this higher exposure level is not unsafe.  No special instrumentation or ventilation is required for the removal of old silver fillings. Because the exposure to mercury occurs from inhaling the vapor, the dental assistant’s use of the high volume evacuation system (the really strong suction device) removes the vapor before it even exits the mouth.

If it is Safe, Why Do Most Dentists Use a Different Filling Material Now?

Amalgam is still in widespread use in dentistry.  Most private practices avoid it for the simple reason that patients want the most cosmetic restoration possible and will not approve of a dark, silver filling anymore.  Dental clinics in the military, teaching institutions and public health care settings all still use amalgam to restore cavities.

When Should I Have Fillings Replaced?

There are only two reasons you should replace silver fillings: 1) the filling shows significant breakdown and no longer does its job, or 2) you dislike the appearance of the old fillings and desire a more cosmetic option.

1. Breakdown of Existing Fillings

Silver fillings are durable and have remarkable longevity.  However, they can deteriorate over time due to normal wear and tear, new decay, or cracking and breaking.

If your filling shows signs of breakdown, we should be able to show it to you on an x-ray or a photo of the filling.  You may see gaps between the filling and the tooth, cracks within or around the filling, or a discoloration of the tooth around the filling.  All of these are signs that the filling is no longer performing its function to seal and restore the tooth to full function.

2. Desire Cosmetic Improvement

We have some patients who request the replacement of their old silver fillings with a matching tooth-colored material for cosmetic reasons alone.  Perhaps the dark color is visible when they open widely to laugh or speak.

This type of dental treatment would fall into the category of cosmetic dentistry because it uses a dental restoration to improve the appearance of the teeth.  Any choices in cosmetic dental options are at the discretion of the patient.

More Questions about Old Silver Fillings?

Call 940-382-1750 today to schedule a consultation with Dr. Chowning.  He can assess your current fillings and advise you as to the need for any replacements.