Should You Replace Your Old Silver (Amalgam) Fillings?

Before white, tooth colored, composite dental fillings became the standard for treating tooth decay, amalgam fillings were used. Amalgam fillings were made from a mixture of metals including silver, mercury, tin, and copper, have been used for decades due to their durability and affordability. Patients were concerned about the esthetics and safety of these fillings however, and started demanding an alternative solution. The mercury was also an issue for the environment, with the dental office needing to filter out the amalgam from the water used in treatment. This lead to amalgam filling getting more-or-less phased out from practice.

Why Patients Replace Amalgam Dental Fillings With Composite Ones?

The FDA insists that amalgam fillings are safe, but some people still choose to have these fillings replaced. Let’s explore why patients ask for the fillings to be replaced or why a dentist would recommend replacing amalgam dental fillings with composite one.

1. Mercury Concerns: One of the primary reasons patients opt to replace their amalgam fillings is due to concerns about the fillings’ mercury content. While the mercury in amalgam fillings is bound to other metals and the FDA says it’s not a cause for concern, some people worry about potential health risks associated with mercury exposure over time.
2. Aesthetic Reasons: Amalgam fillings are silver in color, which can be noticeable when smiling or speaking, especially in visible teeth. Additionally, these fillings can stain the teeth and gums over time as the metal leaches. Many patients prefer tooth-colored fillings for a more natural appearance.
3. Structural Integrity: Over time, amalgam fillings can wear down, crack, or form leaks around the edges, compromising the structural integrity of the tooth and increasing the risk of decay or fracture. Some patients or dentists would preemptively prompt the replacement of the dental fillings to make sure such issues don’t exists since these issues are not easy to spot when the filling is in place.
4. Allergic Reactions: Some individuals may experience allergic reactions to the metals used in amalgam fillings, leading to discomfort or other oral health issues. This leads to the need to replace the fillings with a material the patients is not allergic to.

The Dental Filling Replacement Process

The process for replacing dental fillings is similar to getting fillings in the first place:

1. Examination and Consultation: The first step in replacing old amalgam fillings is to schedule a consultation with a dentist. During this appointment, the dentist will assess the condition of the existing fillings, discuss your concerns and preferences, and recommend the most suitable replacement options. If the dentist is the one that is recommending the replacement, the consultation takes place during your regular dental visit.
2. Treatment Planning: Based on the findings from the consultation and examination, the dentist will develop a personalized treatment plan. This may involve replacing one or more amalgam fillings and selecting the appropriate alternative filling materials.
3. Removal of Old Fillings: The process of removing old amalgam fillings involves careful drilling and extraction to minimize the release of mercury vapor. Special precautions, such as the use of a rubber dam and high-volume suction, may be employed to protect the patient and dental staff from exposure to mercury particles. The water used in the treatment is passed through an amalgam separator to ensure it doesn’t contaminate the environment.
4. Filling Placement: Once the old fillings have been removed and the tooth is thoroughly cleaned and prepared, the chosen alternative filling material will be placed and shaped to restore the natural contours of the tooth.
5. Final Adjustments: The dentist will make any necessary adjustments to ensure proper fit and bite alignment. The filled tooth will then be polished to achieve a smooth finish and natural appearance.
6. Follow Up: If after a couple of days the filling doesn’t feel right in the mouth, the dentist will invite the patient in for further adjustment.

Alternative Filling Materials

Once the dentist removes the old fillings, here are a few dental materials they might use to replace it:

1. Composite Resin: Composite resin fillings are tooth-colored and can be matched to the shade of the surrounding teeth for a seamless blend. They bond directly to the tooth, providing excellent durability and aesthetics. This is the most commonly used alternative to amalgam fillings.
2. Porcelain Inlays and Onlays: Porcelain fillings, also known as inlays or onlays, are custom-made dental restorations that are fabricated in a dental laboratory and then bonded to the tooth. They offer superior strength, durability, and aesthetics, making them an ideal choice for visible teeth.
3. Glass Ionomer: Glass ionomer fillings are tooth-colored and release fluoride, which can help prevent further decay. While not as durable as composite resin or porcelain, they are often used in areas with less stress and can be a suitable option for children or individuals with low bite force.

If you are looking for a dentist near you in Olney to replace old amalgam fillings, our dentists would be glad to welcome you. You can book an appointment with them online or call 301.774.2000.