Composite resins, or tooth-colored fillings, provide good durability and resistance to fracture in small- to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. They can be used on either front or back teeth. They are a good choice for people who prefer that their fillings look more natural.
Composites cost more than amalgam and occasionally are not covered by some insurance plans. Also, no dental filling lasts forever. Some studies show that composite fillings can be less durable and need to be replaced more often than amalgam fillings.
Dental amalgam is made from a combination of metals that include mercury, silver, tin, and copper. Sometimes described as “silver-colored” fillings, dental amalgam has been used by dentists for more than 100 years because it lasts a long time and is less expensive than other cavity-filling materials such as tooth-colored composites.
Because of their durability, these silver-colored fillings are often the best choice for large cavities or those that occur in the back teeth where a lot of force is needed to chew. Amalgam hardens quickly so it is useful in areas that are difficult to keep dry during placement, such as below the gum line. Because it takes less time to place than tooth-colored fillings, amalgam is also an effective material for children and special needs people who may have a difficult time staying still during treatment.
One disadvantage of amalgam is that these types of fillings are not natural looking, especially when the filling is near the front of the mouth, where it may show when you laugh or speak. Also, to prepare the tooth, the dentist may need to remove more tooth structure to place an amalgam filling than for other types of fillings.
Is Dental Amalgam Safe?
Although dental amalgam is a safe, commonly used dental material, you may wonder about its mercury content. It’s important to know that when combined with the other metals, it forms a safe, stable material. Be assured that credible scientific studies affirm the safety of dental amalgam. Study after study shows amalgam is safe and effective for filling cavities. The American Dental Association, U.S. Centers for Disease Control and Prevention, U. S. Food and Drug Administration and World Health Organization all agree that based on extensive scientific evidence, dental amalgam is a safe and effective cavity-filling material. The Alzheimer’s Association, American Academy of Pediatrics, Autism Society of America and National Multiple Sclerosis Society—all science-based organizations like the ADA—also say that amalgam poses no health risk.
The Mayo Clinic recently stated that dental amalgam is a safe and durable choice for dental fillings. They also note that “there are several kinds of mercury. The mercury [methylmercury] found in water that can build up in fish and lead to health problems if you ingest too much is not the same type of mercury used in amalgam.”
The ADA supports continued research on all dental filling materials and would promptly inform the public if the scientific community and government regulatory bodies determined that any cavity filling material was unsafe for patients. Your dentist’s foremost priority is your health and safety. That’s why the ADA encourages you to talk with your dentist about your cavity treatment options and what’s right for you. For more info, visit the FDA fact page.
It generally takes longer to place a composite filling than it does for a metal filling. That’s because composite fillings require the tooth be kept clean and dry while the cavity is being filled. Tooth-colored fillings are now used more often than amalgam, probably due to cosmetics. In a society focused on a white, bright smile, people tend to want fillings that blend with the natural color of their teeth.
Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by:
- brushing your teeth twice a day with fluoride toothpaste
- flossing daily
- eating a balanced diet
- visiting the dentist regularly.