The advantages and disadvantages of white and silver dental fillings. Plus: an expert discusses the supposed risks of silver fillings and reveals the pros and cons of replacing fillings for cosmetic reasons

When I was at school I remember that a return from a visit to the dentist would be greeted with the question “How many fillings have you had today?”

“I certainly don’t remember anyone asking whether the fillings I had were white fillings or silver fillings!”

As an adult, I’m more aware that the choice between silver (amalgam) fillings and white (composite) fillings can be an important one for a dental patient to make.

There are advantages and disadvantages to both types of filling.

Advantages of silver fillings

  • Cost – silver fillings are nearly always cheaper and price is an important consideration for those looking for good dental care. London dentist Ethicare’s price list shows that silver fillings cost between £50-£125; considerably cheaper than white fillings’ £60 to £200
  • They are harder, stronger and more durable

Disadvantages of silver fillings

  • Safety concerns about the safety of the mercury content in amalgam. (No scientific study has ever proved that silver fillings are harmful to health.)
  • Some people are allergic to the mercury in the fillings

Advantages of white fillings

  • Better for cosmetic purposes. The colour can blend in with your natural teeth
  • Health – the composite bonds with your teeth and less of the natural tooth structure is lost

I asked Dr Glafcos Tombolis, who runs London dental practice Ethicare some more questions about the relative merits of the two different types of filling.

Question: How long have composite (white) fillings been around for compared to silver fillings?

GT: White fillings have been around for 30-40 years, so they are relative newcomers compared to silver ones which have been around for much longer! Composite fillings have improved vastly over the years. Originally they were of relatively poor quality, with materials which made them vulnerable to shrinking and leaking. But this just isn’t the case any more

Q: How do you know if you’re allergic to the mercury in a silver filling?

GT: Allergies to mercury are rare but they do happen. You can always visit your GP to get a referral for an allergy test.

Q: Which filling is more likely to leak?

GT: A white filling.

Q: What are the lifespans of the two types of filling?

GT: A white filling has a lifespan of seven years plus, whereas an amalgam filling can last ten years plus.

Q: Where do you stand on the health risks of amalgam fillings?

GT: I tend to take my lead from the British Dental Association which is still happy to classify amalgam as a viable material. If it’s been the filling material of choice for the last 150 years then it’s good enough for me.

The most important thing is to consider which type of filling is the most appropriate for an individual patient.

We always strive to keep patients aware of the advantages of each type of feeling. For instance, in many cases silver fillings are better for deeper fillings while white fillings are often more appropriate for smaller fillings as they can be less destructive to the existing tooth structure.

Q: Should I replace my silver fillings with white fillings?

GT: Where there is a deep filling, it is possible that replacing the filling could aggrevate the nerve within the tooth. You should weigh up the risks – are you so intent on improving your cosmetic appearance that you want to jeopardise the health of your teeth? We are always happy to help patients make an informed decision about whether to ‘stick or replace’.

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