The answer is - it depends! We will assess your case and give you our recommendation. Sometimes less treatment is better - we do not recommend a blanket rule of replacing all amalgams like some dentists.
Mercury Content
Most people are concerned about the mercury content. However, during the setting, the mercury actually gets attached to the other metals and thus becomes inert. There have been many studies done which show the exposure is extremely minimal and even with every tooth filled with amalgam, the mercury released is well below toxic.The times when mercury exposure is highest is actually during placement of the filling, and during removal (due to the heat generated by the drill). Thus, we don't generally recommend filling removal simply because it is a silver filling. If you are concerned, please mention this and we will explain what measures we can take to reduce this, such as using a rubber dam, maximising water to cool the drill, and using the high speed evacuator.
Silver Fillings and Cracked Teeth
We may recommend replacement if we see cracks around it.
Why does amalgam stress your tooth? A few reasons. Firstly, amalgam doesn't bond to the tooth. Therefore, to make it stay in we actually have to cut mechanical retention into your tooth which is more destructive to your tooth structure. The tooth preparation has angles which puts stress at certain points of the tooth rather than distributing the force. Lastly, amalgam expands and shrinks in heat and cold differently to your tooth, which over time, can create cracks in the tooth.
Appearance
Silver fillings can make the tooth look very grey and dark, and from afar can look like a hole. Many of our patients elect to replace the visible ones to improve the brightness of their smile - this is a perfectly valid reason!
Are there any advantages of silver fillings?
Yes, they tend to be more resistant to bacteria than white fillings so get decay under them less. They are also very strong. I have seen some very, very big fillings stay stable for a long time.
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