When Should You Replace Metal Fillings with Composite Ones?

By Dr. Damon on March 26, 2014

Fort Worth Tooth-Colored FillingsIn the past if you had a cavity, your only option was a metal filling. But patients today have a more attractive option: Tooth-colored composite fillings. And the results are so remarkable that many patients wonder if they should proactively replace all their metal fillings with composites.

It’s a choice that patients should make in consultation with their dentist. Cosmetic dentist Clark Damon, who offers a full range of cosmetic and restorative dentistry treatments in Fort Worth, can explain the ins and outs of tooth-colored fillings as well as discuss when replacing metal fillings is appropriate.

In short, the simple answer is replacement is a good option for certain patients. We do not recommend removal unless patients want the sliver out, want it removed for esthetic purposes, if a fracture is present, or if it becomes decayed. However I do not place silver fillings.

Benefits of Composite Fillings

Dental Composite restorations have become mainstream since about 1995. Composites are a relatively new choice, but one that has quickly climbed in popularity for a number of reasons. A prime consideration for many patients is appearance. Restorations with composites create a tooth-colored repair that blends in with other teeth, avoiding the harsh and unattractive appearance of metal.

But composites have other advantages as well. In addition to looking natural and visually blending in with other teeth, composites:

  • Do not contain mercury.
  • Bond to the tooth and strengthen it.
  • Require less of the tooth to be removed to place the filling.

With so many advantages, you may be weighing the benefits of swapping out your metal fillings for this more attractive option.  

Reasons to Replace Amalgam Fillings

If you are thinking about replacing metal fillings, here are typical reasons to update them:     

  • Fracture Teeth. I see so many teeth that have amalgam fillings, with cracks all around their teeth. Even small conservative amalgam fillings done on pre-molar teeth can lead to their fracture. Why? when dentist remove the cavity and prepare the tooth for an amalgam filling, a predetermined amount of tooth structure must be "sacrificed" - removed - so there is adequate bulk of amalgam to resist breakage. The net result is more tooth structure is lost and the tooth becomes weaker. With composite fillings, we dentists can be conservative and we are "bonding" to the tooth - so it becomes stronger.
  • Age.  All fillings get old and at some point need to be replaced. Loose fillings allow bacteria to invade a tooth and introduce new decay. If your metal fillings are old, now may be the perfect time to swap them for tooth-colored composite ones.
  • Leakage. Amalgam fillings are not bonded to tooth structure, so overtime saliva, food, bacteria can creep down the margin of the filing into the tooth and set up tooth decay.
  • Cosmetic Reasons. Metal fillings were designed for function, not beauty. But in our telegenic world, many people believe an attractive smile is an important benefit that tooth-colored fillings provide.

A Major Consideration

There’s one more consideration before you remove your fillings. The Food and Drug Administration (FDA) does not support removing metal fillings until they become old and start to fail because the extra dental work to remove them prematurely can cause more harm than good.

Also, be prepared for sensitivity for 2 weeks if you have them replaced. I think for esthetically driven patients removal is a good option, but any time a tooth is drilled on it may be sensitive, and unfortunately it is normal.

Limitations of Composites

Another reason to think twice: Though composite fillings are more durable than ever before, they are not appropriate in all situations, such as when fixing a large cavity. Limitations of composites include:

  • May need to be replaced every seven to ten years.
  • May not be suitable for a large filling.
  • Cost more than amalgam fillings. Typically around 15-30 dollars.

As noted above, if you are considering having metal fillings replaced, you should request a personal consultation with a dentist to discuss the pros and cons. Dr. Damon can assess your tooth, explain when it would be appropriate to remove the old filling, and discuss what type of filling would be suitable.  

Please call for an appointment.

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