Replacing Dark Fillings

Our patients often ask us if they should replace their old dark fillings with a more up to date white material. Common concerns are tooth sensitivity, discolored teeth, and the mercury that is imbedded in silver fillings.

There is no definitive yes or no answer. Research has shown no conclusive evidence that silver mercury fillings are harmful to your health (regarding mercury leeching), but in our experience we have seen many other problems as a result of not replacing silver fillings early. The problems include infection, pain, tooth decay, and cracked or broken teeth.

These problems cannot be assessed by looking in your mouth or with x-rays.  Silver fillings are opaque to radiographs. It is difficult to see a cavity under the filling until they are quite large or present symptoms.  Preventing the growth of these cavities can mean the difference between getting another filling, needing a crown, or even a root canal.

Do white fillings prevent teeth cracks and decay?

We know that silver fillings do not strengthen teeth.  On the contrary, silver filling acts like a wedge.  When you bite down on a silver filling, the forces are transmitted to the remaining tooth structure causing stress on the tooth.  Silver filling material provides no adhesion to tooth structure.  With tooth colored fillings, we utilize bonding agents that create a seal and strengthen the tooth.

Cavities can develop under an old filling over time.  This occurs through the expansion and contraction of the material.  Bacteria can get under the silver filling and causes both the filling and the tooth to rot.

Ultimately, whether you replace all your fillings depends on how proactive you want to be.  Some patients come to the dentist when they are in pain or want to wait on treatment until the problem is obvious. It can be fear, finances, or just the philosophy of the patient.

Other patients have the preventative viewpoint: “My teeth are important to me and I would rather act now and avoid an unpleasant problem later.”  These patients also understand that doing 10 fillings is less expensive than a crown and root canal.

I discuss these options with my patients to give them the information they need to make an informed decision.