WHITE COMPOSITE FILLINGS VERSUS
SILVER AMALGAM FILLINGS
Click here for page one: Basic information
about
white composite fillings
Questions and answers about amalgam
fillings:
 | Is the mercury in amalgam fillings toxic?
Answer: There is a controversy over the potential adverse health effects of
silver fillings, which are close to 50% mercury and generally have less than 40% silver in them. Although mercury is toxic, it has been thought
that it was not released to the body during use as a filling material. Recent research,
however, seems to show that these fillings release a very small amount of mercury vapor
during chewing. Whether or not this amount of mercury is harmful to the body is a subject
of controversy. Most people have some silver amalgam fillings in their teeth with no
apparent adverse effects. No harm from the mercury in amalgam fillings has ever been
absolutely proven. However, it has never been proved that it is not
harmful, either. Many people are preferring the mercury-free fillings because of this
health issue.
See our bookstore, where we
feature three books alleging that amalgam is toxic. We don't endorse the idea
that amalgam causes illnesses, but we don't call it safe, either. |
| Are composite fillings weaker than amalgams?
Answer: This is another question that is loaded and highly controversial in the
profession. The direct answer to this from me is yes, the mercury-free fillings or
composite fillings are weaker than amalgam. However, if you take the total result—the
filling plus the tooth—the composites are stronger because they bond to the tooth,
making the tooth more resistant to fracture. |
| Should I tell my dentist I want white fillings?
Answer: My personal advice is not to ever be assertive with your dentist in telling him or
her how you want your tooth restored. Listen to the options presented to you. Ask what
your choices are and what the dentist recommends. If your dentist is not offering the
white fillings to you as an option, there is probably a good reason. Many dentists do not
feel comfortable using these composites on back teeth—they require special training to
place. But if you press the dentist, he or she may say yes, they will place whatever
restoration you want, in order for you to be happy, even though he or she feels uncomfortable
with the procedure.
Here is an illustration of
why you need to be sure that your dentist is thoroughly familiar with
composite bonding technology before having white fillings done. The photograph
on the upper right shows a series of white composite fillings in teeth.
The dark spots around them are where they are leaking and
tooth decay is getting in around them. These fillings do not appear to have been
properly done, leaving them vulnerable to leakage and new decay. They also appear to be wearing away, meaning that they may not have been fully cured. On the lower right,
however, is the "after"
photograph, where the fillings have been replaced using proper techniques.
This beautiful work was done by Dr. Craig Carlson, a www.mynewsmile.com dentist in San Antonio, Texas. For contact
information, please see our Texas page. |
before |
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after |
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| How long have these white fillings on back teeth been around?
Answer: Their early history goes back to the 70s, well
before the technology was available to do them well. In the mid-80s, technology was
developed to bond to dentin and the materials were improved.
While I was practicing, we had been
placing these restorations since 1984. While it is true that in the 80's, these composite
restorations were functionally inferior to the old silver amalgam restorations, that is no
longer the case, provided that they are placed with proper technique by an experienced
practitioner. |
| Why do so few American dentists provide the composite fillings?
Answer: You can still graduate from most American dental schools without doing any white
composites on back teeth. The reason the dental schools give for not including
these techniques in their curriculum is that they are too busy preparing students for the
board examinations and have no space in their curriculum for topics that aren't required by
those board examinations. So, in short,
the answer is that the board exams don't require them, so dentists have to go out, often
after graduation, and learn these techniques from seminars, and dentists who are equipped
with only the essentials from dental school don't feel comfortable with the white
fillings.
For a listing of dentists trained in this new bonding
technology, please see our referral page. |
| I have had one of these white fillings and my tooth was really sensitive afterward. Why?
Answer: Normally, the mercury-free fillings should have practically no sensitivity
afterward - this is one of their chief advantages. There are several reasons they could be
sensitive. For the full answer to this, please see our page: My new
fillings hurt, on this web site. |
| Why does my
dental insurance company pay so little on these mercury-free fillings?
Answer: You need to understand that your insurance company is not a non-profit benevolent
society. They are in business to make money. Composite is more expensive to
place, and the policy of many insurance companies is to cover the cost of the least
expensive treatment, as long as that treatment is reasonably appropriate according to
their definition. I don't think they're being entirely
unreasonable in this. My experience has been that most patients who want the
nicer fillings are willing to pay the difference, and I think it's appropriate
that they do. See our page of explanation of the
costs of white fillings to learn
more. You can also visit our page on the
costs of cosmetic dentistry.Read about one
patient's experience with severe
pain in her teeth from the improper placement of white fillings.
Read about a dentist using
pins in a tooth to help
hold a filling in.
Visit America's Dental Bookstore to buy consumer books about the
mercury/amalgam issue.
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The listings below are paid advertisements and should not be confused with the recommended dentists we list in our "find a cosmetic dentist" section:
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