I have been with the same dentist since I was ten years old. I do love him to pieces, but sometimes I feel he is stuck in a different era of dentistry. I have about six silver fillings on back teeth. I want to replace all of them with the white composite fillings, which I feel are more attractive and natural looking. My dentist insists this is a bad idea because the silver fillings will have stained my teeth and I will not have the aesthetic result I am hoping for. Is this true? If so, can anything help it? One other question. One of these fillings is about 65% of the tooth. Will composite be able to hold these together the way amalgam can?
Tara
Dear Tara,
I am going to be honest that I don’t have a lot of confidence in your dentist here. First, I want to start with the most concerning issue. You mentioned one of your teeth is 65% filling. This is bad for your tooth. Once a tooth is around 30% decayed, you need a dental crown in order to protect the tooth over a long period of time. I don’t understand why he just used filling for decay that extensive.
While he is correct that the amalgam mixture in silver fillings can discolor teeth, the teeth still always look better with the composite fillings. This is aside from the fact that the mercury that makes up the majority of the ingredients of the amalgam filling is a toxic metal.
All of that being said, I do not recommend you press your dentist on this for two reasons. First, he is obviously uncomfortable with the idea of placing composite bondings. The procedure for bonding composites is different than what he is used to doing with amalgam fillings. If he doesn’t do it right it can cause problems for you.
Second, I mentioned earlier that the main ingredient of amalgam fillings is mercury. Mercury has a low melting point and you do not want to swallow or inhale any of the mercury or the mercury vapors. These have very toxic properties. Because of that, you need a dentist who knows how to do it safely. There is something known as a sanitary amalgam removal. It requires specific techniques and tools. I doubt your dentist has them. You need to go to a dentist who does. My suggestion would be to look for a mercury-free dentist. He or she should be used to doing this safely.
As to whether a composite filling can support a tooth as well as an amalgam filling, it actually supports it more. Amalgam requires the dentist to dig out more tooth structure than is decayed in order to keep it in. Composite, on the other hand, is bonded directly to your tooth.
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