Amalgam Fillings – Keep or Replace?

Updated: Dec 3, 2018

It seems the question for our era is how do you know what’s right for you?

To help you understand, we will briefly discuss the advantages and disadvantages of silver fillings. However, regardless of which materials are used, the process is nearly the same. The dentist “prepares” the tooth, removes decay, and places the filling directly into the tooth during one appointment.


Properties of materials chosen for dental restorations include:  performance under chewing or biting function, durability, longevity, cost and ease of placement.


The utmost considerations include safety and biological compatibility with very low incidence of allergic response.


But let’s get right to the point about silver fillings commonly known as dental amalgam.



But what is a dental amalgam?

Dental amalgam is a stable alloy made by combining mercury, silver, tin, and copper in carefully controlled proportions and mixed into a precise blend so there is no free or excess mercury. The mixture is plastic or mouldable initially, but “sets” hard. Mercury in amalgam combines with other metals to render it stable and safe. While there are very low levels of mercury vapour that may come off the amalgam during chewing that could be inhaled or ingested, these trace amounts are well below the amount that could cause harm.

In fact, scientific studies have found no ill effects in adults or children age six and older from using dental amalgam fillings.


Advantages of dental amalgam:

Those included are biocompatibility (not allergy producing or toxic), durability, ease of use, relative high resistance to wear and low expense.

It is a valuable option in the right circumstances because it can withstand very high chewing loads for molar teeth. It is also useful in areas where a cavity is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line.

Disadvantages:

Because of its silver appearance, it is unacceptable aesthetically for front teeth. Also, metal transmits temperature well, so there can sometimes be possible short-term sensitivity to hot or cold, especially with large fillings. Amalgam fillings may also require more tooth structure removal to keep them in place.



Alternatives To Amalgam Composite resin fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-coloured filling. Also referred to as composites or filled resins, they match teeth, transmit light well and can make imperceptible tooth restorations; however, they are subject to stain and discoloration over time. They provide good durability and resistance to fracture in small- to mid-size restorations that need to withstand moderate chewing pressure.


Composites can also be physically bonded to tooth structure, often allowing a more conservative repair. Their cost is moderate depending upon size.


Glass ionomers are translucent, tooth-coloured materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. When the dentist prepares the tooth for a glass ionomer, less tooth structure can be removed, often resulting in a smaller filling than that of an amalgam. They are primarily used in areas not subject to heavy chewing pressure. And because they have a low resistance to fracture, glass ionomers are mostly used in those fillings between teeth or on tooth roots. They also release a small amount of fluoride that may be beneficial for teeth with high risk for decay. Resin ionomers are also made from glass filler with acrylic acids, fine glass powders and acrylic resin. They are used for very small fillings between teeth and are only moderately resistant to fracture, making them useful in non-biting surface areas like tooth root surfaces. Both glass and resin ionomers mimic natural tooth colour but lack the natural translucency of enamel and experience high wear when placed on chewing surfaces. They are well tolerated by patients with only rare instances of allergic reaction.


The ultimate decision about what to use and when is best determined in a consultation with your dentist. You should discuss your concerns and the risks/benefits of all filling materials available,

including your susceptibility to tooth decay, so that you maintain optimal oral health.


If you are unsure about your fillings please speak with one of our dental team by calling 02866 329222, you can also find out more information for our website www.belmoredental.co.uk.

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ADDRESS: 16 Belmore Street, Enniskillen, Co Fermanagh, BT74 6AA

TEL: 02866 329222  |  ROI: 04866 329222

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