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Wednesday, April 16, 2008

Fillings: Silver or Plastic – Black or White?

Most of us have had at least one filling in our life. The majority of readers probably have some silver fillings. Most of them are out of sight and out of mind. But, if we look carefully, we’ll notice that the term, “silver filling” is not descriptive of reality. Those fillings may have looked silver or gray the day they were placed, but they certainly aren’t silver any more. They are usually black!

Silver fillings, also known as “amalgam,” have been a staple of restorative dentistry for over 150 years and have served the public well. Certainly, many teeth would have been lost if we had not had an easy to place, long lasting restorative material like amalgam. But, times have changed and so has dentistry. While there are some groups that believe amalgam, which typically consists of 50% mercury, is a health hazard, there have been no scientific studies supporting those assertions.

Over the years, a number of alternative materials to restore teeth have been developed. Among them are: gold, porcelain, and composite (a high-tech plastic). The most modern material is composite, which is bonded to the tooth. Also known as “adhesive dentistry,” bonding has revolutionized dentistry. Materials like amalgam simply fill a hole in a tooth. After removing decay, dentists have to remove additional healthy tooth structure in order to create mechanical interlocks so the amalgam will stay in the tooth once it has hardened. White composite fillings have a big advantage over silver. It bonds, or sticks, to the tooth very firmly. Accordingly, dentists can be very conservative and limit the “drilling” to only the decay. No additional removal of tooth structure is needed to lock the filling in the cavity. The more of your own natural healthy tooth structure we preserve, the stronger and longer lasting your tooth will be.

Because amalgams are typically larger and don’t bond to the tooth, they can act as a wedge, possibly cracking teeth. Composite, being more conservative and bonded to the tooth, may be kinder, in the long run, to your teeth. A unique advantage of composite is that it seals the cavity better than amalgam. A good seal is important in preventing decay from reoccurring.

While amalgam is a simple material to place, composite requires meticulous attention to detail by the dentist. The technique is quite different. While an amalgam basically fills a hole, a properly done composite essentially rebuilds the damaged or missing tooth structure.

The advantage of composite over amalgam most apparent to patients is the color. Put simply, amalgam is black, and composite is white. Composite comes in a variety of shades that can be matched to the tooth being restored. Done well, a composite restoration disappears and is indistinguishable from natural teeth.

Which filling would you prefer to fix your cavities? Black or white? If you have old black fillings that show when you smile or talk, you may consider replacing them with newer more cosmetically pleasing composites.

As could be expected, composite is not the end-all in dentistry. There are times where the damage to a tooth requires more than a filling. Generally, if a cavity occupies than 1/3 the width of a tooth, a crown may be a better and longer lasting restoration. Your dentist can help you choose the best way to restore and keep your teeth healthy and attractive.

For more information and to see before and after photographs of actual cases, visit our website at:

Palm Beach Smiles, is located at Boynton Beach Blvd. and I-95. You can contact us at: 561-736-2377.

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