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Should I replace my old metal amalgam fillings with tooth-colored composite fillings?

If you are over the age of 30 or 40 and had a cavity when you were younger, it's likely that you may have one or more metal amalgam fillings, as these were the only option for many years. Metal amalgam is no longer a preferred material for dental restorations due to its many drawbacks, and at TopDental we use only high-quality materials for oral rehabilitation including tooth-colored composite; composite or e.max (lithium disilicate) onlays or inlays; and e.max or zirconia crowns.

One of the more common questions that patients ask me when they come in for their routine dental cleaning and examination is whether and when they should remove their old amalgam fillings and replace them with newer technology, tooth-colored restorations. In fact, while we don't always recommend doing so for patients whose metal amalgam fillings are still in good shape, there are also many reasons that patients choose to replace their amalgam fillings.

Some People have no idea they have decay under old fillings

Silver amalgam fillings are packed into teeth rather than bonded like composite fillings. Since there is no bond between the filling and tooth, as the amalgam wears away over time, areas of the walls inside your teeth become exposed and bacteria can seep in, causing decay. And you won't even be able to see it! Many people have no idea that they have decay under old fillings until it is so advanced that they need a crown to preserve the tooth instead of just a new composite filling. So make sure to have your dentist check your old fillings for leakage and ask if they are due for replacement.

Amalgam fillings react to temperature changes and cause microfractures in your teeth

Amalgam fillings are made of about 50% mercury, a metal that expands and contracts with temperature changes. Think about mercury in thermometers, which adjusts to the temperature. When you drink something hot, the amalgam expands and places extra force and strain on your tooth, which over time can cause cracks and microfractures in the tooth. Similarly, when you eat something cold, the filling contracts. Over time, these expansions and contractions weaken your tooth and can lead to a major fracture of your tooth in the future.

On the other hand, composite fillings can strengthen your tooth, because they are designed to bond directly to your tooth, so that the filling and tooth work together, not against each other, as can happen with amalgam fillings. A tooth with a composite filling gives under force, while a metal filling is solid and immovable, creating an uneven distribution of force that can damage the non-filling areas of your tooth and cause cracks and fractures.

Amalgam fillings contain mercury

Mercury can potentially cause a health risk for certain patients. Research in this area is ongoing. A 2011 study (Sjursen et al.) published in the Journal of Oral Rehabilitation found that patients who had amalgam fillings removed reported a significant decrease in oral and general health complaints. Peace of mind in having a "mercury-free" mouth is important for many patients.

Laugh and smile without showing any silver!

When you smile or laugh, silver amalgam fillings are noticeable and show how many fillings you've had. Meanwhile, composite fillings match the color and morphology of your teeth and are virtually invisible.

Still have questions about removing and replacing amalgam fillings? Contact us today at 0959146867 or!

Dr. Victor Carreño has trained in the United States, United Kingdom and Ecuador. His dental practice in Manta, Ecuador is committed to excellence and offers high-quality, patient-centered comprehensive dental care to a diverse patient population at competitive local prices.

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