Dear Dr. Hall,
I have two amalgam fillings I would like removed completely and replaced with composite for two back teeth. However, my dentist mentioned to me these fillings may have stained the teeth and they may not be as aesthetic after the work is done.
Is it true that amalgam fillings can stain teeth, and if so what does create the stain? And what option can exist to remove such stain? In addition, these two teeth have around 70% filling: Is white composite a good option for strength and durability vs amalgam?
– Stephan in Seattle
I have taken out a lot of old amalgam fillings and replaced them with composite and they always looked better. Yes, amalgam can discolor your tooth a little bit, but I never found that to be an issue that significantly detracted from the appearance of a back tooth.
It sounds to me like your dentist simply isn’t very comfortable with the composite fillings on back teeth. I would absolutely warn you about trying to press this matter. Placing composite fillings in back teeth is very different from placing amalgam fillings, and I have received e-mails of some horror stories of patients ending up needing root canal treatments because of the damage to their teeth from improper technique. If your dentist is indeed trying to tell you that he or she doesn’t want to do this, just drop the matter. If this is important to you, I would advise finding a different dentist who is trained to provide the kinds of services you want and whose values are more in line with yours.
And I have two additional points about these fillings, which you say cover about 70% of the teeth. If that’s true, the teeth really should have crowns, if the fillings are that large. So you’ve given me another reason to question your dentist. But if they do have fillings, the white composite fillings bond to the tooth and strengthen it where the amalgam fillings just sit in the tooth and make it easier for the tooth to fracture. The amalgam material itself is stronger than the composite, but the combination of the filling plus the tooth is much stronger if the filling is composite.
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About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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