Amalgam vs Composite Fillings: Which are right for you?

So, you’re getting a dental filling

Getting a dental filling is never a fun task. Either you’ve been diagnosed with a cavity, or your tooth has cracked, chipped, or been discolored. Chances are, you have either a medical or aesthetic reason to seek out fillings. No one wants fillings, but they are extremely beneficial. If you need a filling, it’s best to get it as soon as possible—otherwise, you may put your teeth at risk.

One of the primary reasons people get fillings are because of cavities. These normally occur in children, teenagers, and seniors, although they can happen to anyone. Cavities are caused by a variety of factors, but many are due to lifestyle choices, such as poor oral hygiene, overloading on snacks, and having sugary beverages. As a result, cavities are largely avoidable. However, cavities also have other causes, such as certain bacteria, dry mouth, and eating disorders.

However, don’t be embarrassed if your dentist points out a cavity in your tooth!  Cavities can be annoying, as can other abnormalities of the tooth. Having obvious chipped or discolored teeth can be anxiety-inducing and demoralizing.

But having any of these conditions doesn’t mean you’re dirty, and forgetting to take care of your teeth is not a moral failing. Besides, coming across one of these minor dental issues is a good lesson. It can serve as a reminder that you have to brush and floss in order to maintain the health of your teeth—before your inaction can lead to any further damage.

It’s important to get fillings as quickly as possible. If you receive a cavity—which is a small hole of decay within the tooth—it’s imperative to fill it before it grows.

If it isn’t filled, bacteria can enter the cavity and decay it further. This can cause intense pain and may eventually lead to the tooth having to be removed.

Different types of fillings

Once you come to the decision to get a filling, you may be confronted with many options. There are about four or five main types of fillings available on the market, and this can be confusing. After all, what’s the difference? You just want your teeth to be filled.

But the fact is, the different types of fillings each carry with them pros and cons.

For example, you may come across descriptions of gold fillings. If you’re younger, this may seem archaic—like pirates, or old cowboys—, while, for other age groups, gold may be the first materials you associate with getting a cavity filled. For a long time, this was true: until the nineteenth century, the only way a dental filling was done was via the implementation of a gold alloy.

Gold fillings are still used today. They last the longest of any fillings—up to 20 years with proper care—but they’re expensive, and many people simply don’t like the appearance of a flashy gold smile. Luckily, if gold isn’t your thing, there are two more common types of fillings: amalgam fillings and composite fillings.

What are amalgam fillings?

Dental amalgam fillings are what some people might think of as silver fillings. They’re made of a silver alloy composed of many metals, such as copper, tin, zinc, and liquid mercury alongside the visible silver. However, it is inaccurate to refer to these as ‘silver fillings,’ as silver is only a small component of the structure of amalgam.

Referring to them as merely silver fillings can also potentially cause harm to patients with allergies. For example, patients who are allergic to zinc should be made aware that the alloy making up amalgam does include zinc—referring to amalgam as ‘silver’ in this scenario may give these patients a false sense of security.

Process of amalgam fillings

1. The dentist removes tooth decay via drilling the tooth.
2. The dentist may have to remove a very small amount of undamaged tooth tissue in order to accommodate the amalgam filling.
3. The dentist mixes the alloy products, which are in the form of powder, with liquid mercury. This forms a moldable substance.
4. This moldable amalgamation is placed in the drilled cavity, where it quickly solidifies.

What are composite fillings?

Composite fillings are made of a tooth-colored, subtle material called resin. Composite has become increasingly popular for people seeking discreet fillings, and has outpaced amalgam fillings in popularity in recent years.

Process of composite fillings

1. The dentist removes tooth decay via drilling the tooth.
2. Usually, the dentist does not have to remove healthy tissue in order to place composite fillings.
3. A sour-tasting acid conditioner is placed on the tooth briefly, creating an etched layer.
4. Liquid plastic is bonded on the etched area.
5. Layers of composite resin, colored and shaped like the tooth, are placed on the liquid plastic.
6. The dentist cures, shapes, and polishes the cured resin.

So, past the superficial differences between composite and amalgam fillings: what are the benefits and drawbacks of each option?

Amalgam vs. Composite Fillings: Cost

Amalgam fillings tend to be less expensive than composite fillings. This is partially because amalgam fillings take less time to place than composite fillings.

Average Prices without Insurance

Amalgam fillings: $150 (one surface)

Composite fillings: $200 (one surface)

Amalgam vs. Composite Fillings: Durability

Image: A young boy at the dentist’s office. Composite fillings last about half as long as amalgam fillings before they need to be replaced.

Amalgam fillings tend to be more durable than composite fillings. The plastic that makes up composite fillings is durable, but the silver alloy of amalgams allows amalgam fillings to last almost twice as long.

Average Lifespan of Fillings

Amalgam fillings: 15 years

Composite fillings: 7 years

However, with good oral hygiene, composite fillings can easily last a decade. Additional, poor oral hygiene could also cause amalgam fillings to have a shorter lifespan than composite fillings. So you can’t just rely on your material for durability.

Amalgam vs Composite Fillings: Appearance

Amalgam fillings are almost exclusively used for teeth towards the back of the mouth, as their shiny, silver coloring is unappealing to some patients. Composite fillings are used in both the front and back of the mouth.

Color

Amalgam fillings: silver, more likely to become discolored

Composite fillings: tooth-colored, less likely to experience discoloration

But which is better?

Ultimately, that’s a choice only you can make for your teeth. Are you willing to have visible silver on your teeth? Are you able to get composite fillings replaced every seven years? Where is your filling needed, and how big is the area?

If you’re in doubt about which type of filling is best for you, you can reach out to Dr. Elizabeth Wakim, who can guide you through a personalized dental plan.