Better Alternatives to Silver Fillings
Dr. Lorin Berland
Traditional silver fillings were first used in France in 1826. That was a long time ago, and silver fillings are not really even silver: They are actually mostly made of mercury, mixed with some silver, tin and copper too. This high mercury content has created concern for the health safety of silver fillings, and several countries have even banned their use.
Fortunately, the alternatives to these old-fashioned amalgams contain no toxic metals -- and they look better too. They also help preserve and conserve your teeth, and as a result, strengthen them. Here, we compare the top two alternatives so you know what to go for:
Composite is a tooth-colored, plastic-like material made to withstand the force put on teeth. Composite fillings look a lot like teeth.
Because they bond to teeth, they’re durable. And even though they’re more expensive than silver fillings, insurance usually covers most of the cost.
Composites are more difficult to place than silver fillings and usually take longer to put in. Also, if you’re looking to replace your silver fillings with them, it may be difficult and may not last: Because silver fillings use bulk for strength, big holes will be left in your teeth after taking them out, which will make it hard for composites to bond on them.
The Bottom Line:
Composites are an affordable, sturdy choice for first-time fillings.
Inlays and Onlays
An inlay is shaped to fit the cavity and cemented into place. First, an impression of your tooth is taken, and the inlay -- or onlay, which covers the cusp of your tooth -- is created in gold or tooth-colored polymer ceramic. Then, it fits like a puzzle piece over your tooth, putting it back together in its original shape again.
The tooth-colored inlays or onlays are hardened with light, pressure and heat -- a triple advantage that tends to make them more durable than composites, which are hardened only with light. Bonding seals them in to better protect the tooth from future decay.
They are much more expensive than composite or amalgam fillings, and insurance usually covers part of the expense. In addition, they often require two office visits about two weeks apart. (In the interim, you’ll be fitted with a temporary.) Some dentists, however, have their own laboratory and can do it all in one visit.
The Bottom Line:
They work very well in cases where the tooth fracture is substantial, or if you are replacing large amalgam fillings (that includes your old silver fillings). If you don’t have great dental hygiene habits and can afford it, an inlay might even be a good choice for large first-time fillings.
Dr. Lorin Berland is a Fellow of the American Academy of Cosmetic Dentistry and the founder of Berland Dental Arts in Dallas. In 2008, he was honored by the American Academy of Cosmetic Dentistry for outstanding contributions to the art and science of cosmetic dentistry.
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