Metal Free Fillings
What is a Composite Filling? A One-Appointment Solution
If an old filling is small, it can easily be replaced with a white, tooth-colored filling. We complete tooth-colored, or composite, fillings in one appointment. The process includes thoroughly numbing your tooth, removing the old filling while cleaning out any decay, and then placing a new composite filling. A composite filling will be tooth-colored and shaped to look like your original tooth.
A big difference between amalgam fillings and the current composite fillings we use is the bond to the tooth. Amalgam does not bond to the tooth which means it does not add strength to a tooth that has been weakened by decay.
Once a cavity has been removed, for a silver filling to fit properly, extra healthy tooth structure must be removed. Because of the way the amalgam has to be placed in the tooth along with its tendency to expand and contract with temperature changes in the mouth, cracks and fractures are very common in teeth with silver fillings.
Composite fillings are the restorative option we have chosen in our office. We use composite (white) fillings as opposed to silver because we believe it is the best option for our patients. Along with it being cosmetically pleasing, composite fillings bond directly to the tooth.
This bond means added strength, better margins, the removal of less tooth structure, and a seamless appearance. The direct bond to the tooth means only decay has to be removed before the filling can be placed so the most amount of healthy tooth structure stays intact.
Composite also does not react to temperature changes in the mouth like amalgam does, meaning it will not expand and contract causing cracks or fractures. When done right, composite fillings can outlast amalgam fillings.
This Large Amalgam Filling resulted in cracks beneath the filling:
The blue arrows point to cracks that are visible once the silver filling was removed.
The red circle indicates cracking in the adjacent filling.
Before Composite Restoration (center tooth)
Composite Restoration (center tooth)
done by Dr.Brad Alderman
The composite restoration in the first molar (middle tooth) shows the superiority of this material versus amalgam. It is difficult to even see the restoration meaning it has almost undetectable margins making it difficult for bacteria and decay to infiltrate the tooth. The composite has bonded to the tooth giving it strength.
Faulty Silver Restorations
As with any dental restoration, when the integrity has been compromised it is important to have it replaced. Bacteria can seep into a silver filling through poor margins (edges of the filling pulling away from the tooth), chips, cracks, and fractures. This can cause the tooth to rapidly decay. When a filling shows any of the above defects, it should be replaced.
If, however, the amalgam filling is still intact without cracks and is pain-free, we recommend leaving it alone. A silver filling consuming a majority of the tooth may require a crown to help prevent the tooth from cracking, but the filling may stay in place as removing it would compromise the tooth structure.
If you would like to remove your silver fillings for cosmetic reasons, we are happy to do so, but will never push silver filling replacement on you without cause.