White Fillings

Many patients come to Dr. Motaref wanting to upgrade their silver fillings. They want their old metal fillings removed and substituted with tooth colored fillings. You can see side-by-side examples in the photo to the left of bonded white fillings vs. metal amalgam fillings. People often cite esthetic and health concerns about their metal fillings. It’s correct that the esthetics of a smile can be significantly improved with a far more natural, tooth-colored restoration. In addition to this, there are lots of reasons that explain why it’s smart to upgrade to a tooth colored porcelain restoration or a resin composite filling.

Everything wears away, and your silver fillings are no exception. They withstand stress-filled and heavy biting forces every day, and as they get older, they will split, leak and can also cause damaging fractures in the teeth. With time, metal amalgam fillings have the ability to absorb water, causing them to swell and even break free from the teeth. When this happens, your tooth is more at risk of decay and sensitivity.

Mercury/Silver fillings share some negatives worth listing that ought to be considered when it’s time to swap your restorations:

  • Silver fillings are much less appealing than tooth-colored fillings. Everyone agrees, they’re about as beautiful as large hunks of broccoli lodged in your smile.
  • Amalgam grows and contracts whenever exposed to hot and cold extremes in your mouth. The continuous expansion and shrinkage with temperature can easily set off cracks and fractures in your teeth. There may not be any sort of symptoms for a while, but these teeth could become very sensitive as the crack expands or opens when you bite down or chew food. It is not abnormal for patients to come in wondering how they broke their tooth while they had been eating something soft similar to bread or a banana. What they don’t realize is that the tooth almost certainly had a crack in it well before it finally came apart.
  • Silver fillings that are under constant chewing force are at risk of metal weakness or flexing and bending failure, a concept which may be fully understood and demonstrated by repeatedly bending a metal paperclip until it breaks.
  • Metal fillings are harder and far less flexible compared to the teeth they’re molded into. The more time they may be on the teeth, the more pressure they will place on the rest of the weakened surfaces of the tooth resulting in fractures and cracks.
  • Metal fillings are not cemented into the cavity. They just sit in the tooth and act under pressure to split the tooth apart, similar to how a metal wedge is utilized to split logs for firewood.
  • A minute gap around the filling edge exists as soon as the silver filling is plugged into the tooth; and in this space, normal corrosion and leakage occurs. This unnoticeable gap is large enough to allow for harmful bacteria and food particles to seep in over time and result in decay at the border between the tooth and the filling. Composite fillings, however, are actually glued to the tooth preparation area and seal the borders closed from invading bacteria.
  • To be able to prepare a tooth for a composite filling, the tooth can be treated a lot more gently and with less healthy tooth structure needing to be removed. And therefore, the dentist can maintain the highest possible amount of virgin tooth structure as is feasible.
  • Silver fillings require drilling undercuts (think carving out a pumpkin) along with removing larger good portions from the tooth so as to keep the mercury amalgam filling from falling out as it is not bonded right to the tooth. Those undercuts might also compromise the tooth as fillings get larger and relegate that tooth to subsequent cracking later on. These cracks could be significant leading to crowning the tooth to restore it or perhaps major cracks resulting in extraction of the tooth.
  • Composites, with their chance to be conservative and using their adhesive characteristics, may reinforce and guard against fracture. By simply intercepting the opportunity for fracture before going through the symptoms of hot/cold sensitivity and biting discomfort, new conservative treatment options such as tooth-colored restorations or porcelain-bonded restorations are reducing the negative effects of toothaches and broken teeth.
  • Finally, in many dentists’ opinions, bonded tooth-colored restoratives are probably safer compared to conventional fillings, given that they don’t have any mercury. While the American Dental Association (ADA) claims using mercury in metal fillings is harmless, there is an ongoing discussion in the dental field in regards to the side effects of those mercury amalgam fillings. In Europe, several countries have banned using mercury amalgam fillings to avoid any sort of hazards associated with mercury.

When reviewing the menu of negatives associated, and potentially associated, with silver/mercury amalgam fillings, it’s no wonder that patients are asking Dr. Motaref to be PROACTIVE about replacement of mercury fillings as opposed to being REACTIVE and waiting until something goes wrong with the tooth.