You will be hard pressed to find someone that has never fallen victim to a cavity in their lifetime. Yet as universal as cavities are, there is not just ONE universal type of filling material. For decades the standard of dentistry fillings was amalgam, in fact many of you reading this may have an amalgam (silver filling) currently in your mouth. As the new millennium has progressed and the search for a more biocompatible and esthetic filling material has evolved, white fillings have become more and more mainstream. While exceedingly common, we get asked often by patients what the difference between silver and white fillings actually is (other than the color), and ultimately – which one is better (and safer). So today we tackle the modern dentistry debate: White or Silver?
As mentioned before, silver fillings have been around for decades and have been a reliable way to fill a tooth after removing decay. As reliable as this material has been through the years, there are many reasons why this is likely not the best filling material of choice- and thus why many new filling material products have come about. For starters, let’s not beat around the bush, there are people that are downright sensitive to metals. These types of people can not metabolize and eliminate metallic components and byproducts from their bodies, and this can lead to several conditions and symptoms throughout the body. Even more worrisome is the fact that many are not even aware that their body is sensitive to metal and thus they go years living with issues and symptoms. At this point, let me clarify that this effects only a small percentage of patients, however if you feel that you suffer from many of the symptoms listed here please talk with both your dentist and your primary care doctor so that you can be tested for mercury sensitivity.
Moving on, there is another concerning issue with silver fillings and that is the fact that over time, they can expand. Being a metal, they expand at a different rate than the tooth structure does. This leads to cracking of the filling, especially in large silver fillings. Cracks an expansion can then lead towards fracture of tooth structure as well as pain and sensitivity. Many teeth (although not all) with large silver fillings eventually end up requiring a dental crown because of this expansion. Due to these reasons, dental product manufactures and researchers set out to create dental filling materials that were more biocompatible, that is having similar qualities to the natural tooth and more friendly to the body.
These new type of filling materials can be generically grouped into the category “white fillings”, although not all white fillings are made of the same components. The most obvious advantage to white fillings is the fact that they are more esthetic, mimicking the natural tooth color. Another advantage of white fillings is that they are more durable and much less prone to expansion and cracking. Those that have a body sensitivity to metals will also likely tolerate the chemical makeup of the white fillings as well. As mentioned above, there are several types of white filling materials and patients should discuss with their doctors the type that is best for them and their specific dental situation.
One important thing that should be made clear with white filings is that fact that isolation of the tooth is critical for filling success. What does this mean? Saliva and water can greatly weaken the bond strength between the tooth and the filling material. This is why dentists use techniques such as cotton, rubber dam and plastic isolation barriers to keep your tooth dry when placing a filing. Liquid contamination of the tooth can lead to early loss of a filling and sensitivity, among other things. If for some reason you feel that keeping your tooth dry, or tolerating such isolation techniques, will be difficult for you discuss your concerns with your dentist!
Dentistry has evolved tremendously in the last several decades and filling material options are just one of the ways that dentistry keeps up with the modern times. While white fillings are certainly not for everyone, they are what our practice feels is best, and what majority of dentists are switching to. Do you have questions about white vs. silver fillings? Be sure to discuss the pros, cons, and concerns with your dentist!
Dr. Arshia Kalantari has been a practicing general dentist for over 8 years and grows to love his profession more and more every single day. Since finishing dental school, Dr. Kalantari continually chooses to advance his education and takes specialty seminars and courses to become well practiced and knowledgeable in the fields of Sleep Apnea, Invisalign, Root Canal Treatment, and Cosmetics. Dr. Kalantari views his patients as an extension of his family and appreciates the bond he is able to form, always up for a chit chat or to lend a listening ear.